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Work Capability Assessment Under Attack in Emotional House of Commons: ME Comments

Messages
646
What happens next is that that information is flatly contradicted by DWP with no reason or evidence given for that flat contradiction and I have to appeal their decisions. They often flat-out lie as the appeal goes up the chain. In their submission to my ESA appeal tribunal, DWP said that the health professional (a nurse) who assessed my claim said that I'd be fit for work within two years. The health professional actually said I wouldn't be fit for work for at least two years.

This sort of thing has happened to me over and over and over again over the decades, not just since Atos. I could give more examples but it would involve too much typing! But some of the things they've tried to pull have been breathtakingly wicked.
Yes, it's tempting to place all the problem with ESA - and accept the explantion that is convenient for the Government - that is that all the faults lie with the under contract ATOS, when actually the fundamental problems are with the DWP over which the Government has direct control (though no doubt additional outsourcing there is under active consideration).

However we shouldn't be seduced by ideas of 'the past was better'. Under the pre 1980s system, the intimidatory role was primarily applied within the harsh medical examinations carried out in Government run facilities - some of the abuses from back then make ATOS seem positively customer friendly. Change to this 'trial by medical examination' was gradual and happened in response to a number of conflicting influences. A growing independent advice sector began to provide a voice for people who were being appalling treated*, the increased level of community care, the success of which depended upon disabled people having adequate personal finance, plus the the cynical use of Invalidity Benfit by the successive Governments led by Margerate Thatcher as a means of massaging high unemployment caused by Government policy, all contributed to change in the Medical Assessment process.

Through the 1980s the harshness and unfairness of the system was shifted from Medical Assessment to the adjudication process, which was deliberately altered to reflect commercial insurance practice - that is the presumption of the administrators shifted from acceptance to refusal of any claim. The result was that the adjudication process became ever more litigious and welfare rights advice became an essential element of maintaining a modicum of fairness. Being informed, assertive, educated and articulate (being well ?) or having acces to someone who had those qialities, remained a key qualification in getting a just award under Invalidity Benefit, and subsequently awards of DLA and Incapacity Benefit. There seems little change under ESA and the forthcoming PIP, except that access to advice has been drastically cut due to reduction of the funding Goverment provides for independant agencies or (heaven help us), lawyers.

*(examinations in unheated rooms in winter, people with obvious mobility impairments forced to walk in public corridors in their underclothes to demonstrate levels of disability etc were just some of the lesser degradations)

IVI
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
I think, further, that one issue has become the 'indefinite' awards for incapacity benefit (as was) and Disability Benefit for that matter: and the need (now) for all sickness/disabled benefits to be regularly reviewed. This might seem to us as an unnecessary additional cost but it does at face value seem reasonable...

Ha! Got you going!

My point would be that 'indefinite' awards should be made but under specific circumstances (circumstances that previous changes to the system - and non-uniform application of the rules have been seen to render arbitrary perhaps). So, I would venture that an 'indefinite' award was made for terminal, progressive (where the claimant was assessed initially as warranted the benefit and could subsequently apply for increases as and when necessary; and for those disabilities whereby the claimant's functional state is unlikely to change and/or will decrease.

What to do with 'fluctuating' or conditions whose aetiology and nature is not understood? Well here's where any system is likely to fall down because you can't base a system on any single (or mulitple) actual diagnoses. It has to be on the individual's functional capacity and their need for help/care. And that need will be assessed based on some set of measures, and on various opinions - a la what we have now.

Of course all of these reforms (little 'r') are ideologically motivated with a further view towards the [warped sounding trumpet blast] Universal Credit :) Another 'great' idea but hells bells if they pull it off I will eat my shorts!

I can only shudder at the thought of what bureaucratic nightmare this will be. The 'good news' is that this will potentially screw up so many (working) and able people's benefits (and tax returns possibly) - that the country might be energised enough to demand it's withdrawal. But I won't be holding my breath.

We are an apathetic nation at the best of times.
 
Messages
646
I think, further, that one issue has become the 'indefinite' awards for incapacity benefit (as was) and Disability Benefit for that matter: and the need (now) for all sickness/disabled benefits to be regularly reviewed. This might seem to us as an unnecessary additional cost but it does at face value seem reasonable...
DLA was actually designed to be an annually awarded benfit, so that each 12 month award was treated as a seperate claim from what went before. This actually led to some 'interesting' interpretations of what 'consistency' meant in terms of administration, with utterly perverse reversals of award from one year to the next. I rather lost track of what the circumstances of the slippage of annual awards of DLA actually were but I'm fairly certain there were no provisions for 'indefinite' awards in the initial legislation. Invalidity Benefit and its successor Incapacity Benefit were one off awards that could be withdrawn on the basis of new information - i.e someone got better - but of course these were both recognised as long term benefits because an award of the short term Sickness Benefit would have to have run out before IB and ICB could be claimed. I can't recall what the review period for IB or ICB was, although my impression is that there was no standard period and that it was very much a function of Regional Departmental workload and particular condition, with Doctor's letters, particularly Consultant opinion, playing a large role in the judgement made about whether to bring someone in for a medical review.
My point would be that 'indefinite' awards should be made but under specific circumstances (circumstances that previous changes to the system - and non-uniform application of the rules have been seen to render arbitrary perhaps). So, I would venture that an 'indefinite' award was made for terminal, progressive (where the claimant was assessed initially as warranted the benefit and could subsequently apply for increases as and when necessary; and for those disabilities whereby the claimant's functional state is unlikely to change and/or will decrease.
Terminal illnesses are of course dealt with separately under ESA, although the DWP doesn't always seem able to recognise what constitutes - 'likely to be dead in six months'. But you are quite right - there are other circumstances where an annual cycle of reapplying and ATOS testing makes no sense for either the claimant or tax payer. Even with M.E/CFS perpetual annual reviews may make little sense, given that where disability is significant and has been present for a number of years, substantial and sustained improvement is rare, and the age profile of the patient population (lots of 45 plus) militates against re-achievement of employability.

The irony with ESA, is that by setting the bar for qualification very high, benefit award in the case of chronic illness is strongly aligned with the likelihood of permanent unemployability. ESA Work Group transfer to employment is less than 0.5% in any one year, about a fifth of what even the long term unemployed are achieving. There aren't seperate figures for chronic illnesses but the rate for movement from ESA to employment is likely vanishingly small. Even with some magic economic revival, unemployment rates in the UK are going to remain high for at least another decade, to spend £00 millions perpetually chasing seriously ill people in case they show improved capacity is beyond absurd, except perhaps in some conservative functionalist fantasy of 'instilling a work ethic back in to the country'. The 0.5% rate doesn't even exceed the incidence rate of disabling conditions, so the Government would be reliant on a high death rate amongst disabled and chronically ill people to show improvement in the figures, if ATOS and the DWP don't keep up their wrongful denial of benefit work. Oh dear, am I demon eyesing the system ?

IVI
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Have often pondered what the number of people found 'fit to work' actually found sufficient work to enable them to achieve and maintain a basic standard of living. You are right. This hasn't made it's way into the figures. Once out of ESA you are 'lost' to the system. And what do they care? You go from what, £90 a week on ESA to £70 on Job Seekers Allowance. As far as they are concerned the economy (and you) are 'better off'. You because 'it's better for you to be working' ;)

And what about the number of reapplications? And how long do people struggle on JSA before reapplying? And what about the Support Group element of ESA. Are they 'safe'? What are the entry requirements - I never did discover? And if in the Work Related Activity Group - where are the figures showing what/how much job retraining is taking place?

You are meant to receive help accessing/returning to the workplace taking into account your disability - where are the data for that little ideology? I've been here for nearly 4 years and haven't heard from the Jobby Centre once!! Couldn't face another appeal and I don't benefit in terms of cash - only NI contributions - as I have a private disability pension from my previous employer.

Hurrah! Up zee revolution amigo's :)
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Couldn't face another appeal and I don't benefit in terms of cash - only NI contributions - as I have a private disability pension from my previous employer.

I expect to have to go to appeal as standard these days - I have become so practised at putting applications in over the years that I no longer find them very distressing (they used to really upset me in the early years). I'm pleasantly surprised if I get a benefit without a fight.

Watch out for those NI contributions, Firestormm - did you hear the news about the new flat-rate State Pension of £144 a week for people getting it from 2017 if you've got 35 years' worth of NI contributions (or credited contributions)?
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
From 20 January 2013 Vox Political a blog written about this OP debate in Parliament:

“We are, in effect, trying to put a sticking plaster on a gaping wound,” said Labour MP Ian Lavery (Wansbeck). “Atos and the WCA are not fit for purpose. Does the hon. Gentleman agree that we should bin them both, and start again with the idea of looking after disabled people, rather than the opposite?”

Mr Hoban did not. “Much has been said about employment and support allowance not working—that is untrue,” he said. “What we are seeing is people coming off ESA and getting into work. The number of working-age people on ESA and incapacity benefit in February 2012 was 2.56 million—the lowest level since the introduction of IB in 1995. Early estimates to September 2012 suggest that overall numbers for this benefit are falling and will for the first time be below 2.5 million.”

So his yardstick for success was the number of people who have been cut off from benefit. That’s very revealing.

Not endorsing the blog - I ain't red it all yet ;)
 
Messages
646
And what about the number of reapplications? And how long do people struggle on JSA before reapplying? And what about the Support Group element of ESA. Are they 'safe'? What are the entry requirements - I never did discover? And if in the Work Related Activity Group - where are the figures showing what/how much job retraining is taking place?
There are some statistics, but I can't find the data online now - the Guardian has a load of figures but they are almost as mangled as the Government's own. Private Eye drilled down on disability issue revealling that less than 0.5% of ESA claimants go work in a 14 month period. This statement from the PAC gives a flavour of what is going on: http://www.parliament.uk/business/c...c-chair-on-work-programme-outcome-statistics/

13 December 2012
Statement from The Rt Hon Margaret Hodge MP, Chair of the Committee of Public Accounts


This first analysis of the Work Programme performance figures shows the extent to which the scheme is failing participants, and particularly the young and the harder-to-help. Against a contractual target of 5.5 per cent, the lowest performing provider did not manage to place a single person in the under 25 category into a job lasting six months. The Work Programme was specifically designed to incentivise providers to assist those furthest from the work place, but the appalling performance for ESA ex-incapacity claimants demonstrates how this experiment simply is not working. Between June 2011 and July 2012, of the some 9,500 ex-incapacity claimants referred to providers, I am astonished that only 20 people have been placed in a job that has lasted three months.
My committee will be taking evidence from the department next week when we shall expect a clear explanation for what action is underway to turn performance around and get the Work Programme working for participants and the taxpayer.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Thanks IVI. Methinks the minister (who the heck had ever heard of him and why wasn't a more senior bod in that debate?), was full of excuses and bereft of detail. Hoban. What a sad excuse. Farcical performance. I am quite saddened (though not surprised given the focus elsewhere) that this debate did not raise even the eyebrows of the BBC let alone other news agencies. Missed the radar completely. The focus turned - conveniently and understandably to the Algerian fundamentalists it would seem.
 
Messages
15,786
Between June 2011 and July 2012, of the some 9,500 ex-incapacity claimants referred to providers, I am astonished that only 20 people have been placed in a job that has lasted three months.

British benefits systems make my head spin ... am I correct in thinking that ESA is only for ill and disabled people who are unable to work, either due to disability alone (support group) or due to needing retraining resulting from disability (work related activity group)? And if in the work related activity group, benefits can be reduced if not "cooperating", whereas in the support group, you're not expected to be able to work and don't have to go to interviews, etc.

And it's ATOS employees that are deciding which group applicants go into, if any? The assessment guide seems to suggest that getting more than 15 points (guide page 17) on the questionnaire means the applicant gets on ESA. Based on careful (re)reading of the guide, the applicant has to show "limited capability for work-related activity" to be in the support group, which requires them to be is the most severe categories (guide page 24) - cannot repeatedly move 50 or more meters, can't move to another seat, can't raise arms, can't pick up half a liter, and/or can't press a button or turn a page are the physical requirements. The only activity that has "repeatedly" as a qualifier (and only in the guide, not the questionnaire) is moving 50, 100, or 200 meters.

So a few things seem weird. The only points awarded seem to be 6, 9, or 15 per disability. It seems a rather arbitrary amount. Why not 2, 3, and 5 points per disability? Or even 1, 1.5, and 3? Or something else entirely? Why is being unable to sit up for half an hour less disabling than being unable to walk 50 meters repeatedly - are there jobs available where we can lie down most of the day? And why bother adding points up at all - why does being unable to reach above your head + being unable to move a liter of liquid around make you disabled enough for ESA when either disability on its own is insuffucient?

The amount of disability required to qualify for the support group versus the work related activity group seems ridiculously high. I can see why people at death's door are told to go to job interviews, based on those criteria. Aside from having literal paralysis, I'm not sure what other physiological disease or illness would generally be sufficient, even in severe cases.

What is the rationale behind having a group that is disabled enough to get assistance, but healthy and capable enough to go to training and go to work? It almost seems like they are combining two very different concepts, disability and job training, into one, and suggesting that job training can usually overcome disability. It gets even more bizarre when you factor in ongoing illness (which it explicitly covers in addition to disability), and seems to suggest that job training can overcome illness-induced limitations.

The lack of a "repeatable" qualification for all activities except for moving however many meters, means that the only physical limitation they're really respecting (but not enough to put it on the actual questionnaire) is mobility. They'd might as well get rid of most of the questions and replace it with "Can you eventually get to work without much assistance if work is located on the same block that you live on? If so, get to work you lazy git!"

The whole thing is insane. It might be amusing to see how the points would add up for variously absurd groups - for example, a toddler, a trained monkey, someone with a bad case of pneumonia, and someone severely injured in a recent car accident.
 
Messages
646
British benefits systems make my head spin ... am I correct in thinking that ESA is only for ill and disabled people who are unable to work, either due to disability alone (support group) or due to needing retraining resulting from disability (work related activity group)? And if in the work related activity group, benefits can be reduced if not "cooperating", whereas in the support group, you're not expected to be able to work and don't have to go to interviews, etc.
That's more or less correct - however the issue of 'retraining' overstates what is on offer. The UK used to have a rather good, if some what limited range of retraining following injury or acute health impact, this has been gradually diminished over the years and now barely exists. All that is really on offer to those put in the 'work group' are insultingly banal 'skills help' suchas 'how o write a cv', plus unpaid placements in the private sector so that people can 'get used to working again'. Punitive measures for non compliance can be applied although compliance may mean no more than attending a monthly meeting with an advisor. A much more serious problem exists for people who have a level of disability which doesn't qualify them for ESA - their disablement is treated as non existent by the benefits systm and withdrawl of benefit fr sustained periods can be imposed for no compliance.

The work group has lower rates of benefit than the support group, and crucially is only payable for one year before it becomes means tested - in effect it means that if you are ill/disabled and not in the support group, then if you have a partner who is working then they are expected to support you.
And it's ATOS employees that are deciding which group applicants go into, if any? The assessment guide seems to suggest that getting more than 15 points (guide page 17) on the questionnaire means the applicant gets on ESA. Based on careful (re)reading of the guide, the applicant has to show "limited capability for work-related activity" to be in the support group, which requires them to be is the most severe categories (guide page 24) - cannot repeatedly move 50 or more meters, can't move to another seat, can't raise arms, can't pick up half a liter, and/or can't press a button or turn a page are the physical requirements. The only activity that has "repeatedly" as a qualifier (and only in the guide, not the questionnaire) is moving 50, 100, or 200 meters.
ATOS is only responsible for operating the capacity tests. All decisions on actual award of benefit lies with Civil Servants in the Department of Work and Pensions - they use the reports they get from ATOS too come to thir decisions.
So a few things seem weird. The only points awarded seem to be 6, 9, or 15 per disability. It seems a rather arbitrary amount. Why not 2, 3, and 5 points per disability? Or even 1, 1.5, and 3? Or something else entirely? Why is being unable to sit up for half an hour less disabling than being unable to walk 50 meters repeatedly - are there jobs available where we can lie down most of the day? And why bother adding points up at all - why does being unable to reach above your head + being unable to move a liter of liquid around make you disabled enough for ESA when either disability on its own is insuffucient?
There is some logic within the system though I doubt any of it is realy defencible. In the case of sitting versus lying - this would differentiate between someone whose only disability was in mobility, and someone whose disablement is more complex. For example not being able to walk may not amount to qualifying for the support group if the claimant could use a wheel chair.[/quote]

The amount of disability required to qualify for the support group versus the work related activity group seems ridiculously high. I can see why people at death's door are told to go to job interviews, based on those criteria. Aside from having literal paralysis, I'm not sure what other physiological disease or illness would generally be sufficient, even in severe cases.

What is the rationale behind having a group that is disabled enough to get assistance, but healthy and capable enough to go to training and go to work? It almost seems like they are combining two very different concepts, disability and job training, into one, and suggesting that job training can usually overcome disability. It gets even more bizarre when you factor in ongoing illness (which it explicitly covers in addition to disability), and seems to suggest that job training can overcome illness-induced limitations.

The lack of a "repeatable" qualification for all activities except for moving however many meters, means that the only physical limitation they're really respecting (but not enough to put it on the actual questionnaire) is mobility. They'd might as well get rid of most of the questions and replace it with "Can you eventually get to work without much assistance if work is located on the same block that you live on? If so, get to work you lazy git!"

The whole thing is insane. It might be amusing to see how the points would add up for variously absurd groups - for example, a toddler, a trained monkey, someone with a bad case of pneumonia, and someone severely injured in a recent car accident.
Yes, those are all fair observations. ESA was sold (under the previous Government and pre economic crash) as an empowering move - "no one to be excluded from society/work" and the theory could have worked to a degree if the training, inwork support and jobs were there. What we have now is just another 'cut Government spending' process and to hell with the social costs.

IVI
 
Messages
15,786
That's more or less correct - however the issue of 'retraining' overstates what is on offer. The UK used to have a rather good, if some what limited range of retraining following injury or acute health impact, this has been gradually diminished over the years and now barely exists. All that is really on offer to those put in the 'work group' are insultingly banal 'skills help' suchas 'how o write a cv', plus unpaid placements in the private sector so that people can 'get used to working again'.

It still seems very weird to act as though almost all people with disabilities should be able to get a job if they learn how to write a CV, etc. In the US I think you're either too disabled to work or you aren't, and job retraining and job finding skills are something you'd only find potentially required in other sorts of non-disability assistance programs, such as if getting welfare payments due to being unemployed.

There's no logical connection in the ESA system. Job finding skills (and most retraining) do not overcome disability. Especially when there's no shortage of able-bodied workers for the few jobs that the moderately or severely disabled could perform. Why does the government offer the benefits at all if most of the people supposedly intended to benefit from them can't really access them?

The entire system seems like an excuse to reduce benefits without cause. You mentioned that work group becomes means tested after a year... would this mean that a single disabled person in the work group would stay in the work group indefinitely and receive the regular rate? Could/Do some disabled people with partners making money move onto Jobseekers Allowance instead to receive that benefit?

Did ESA always work this way, or did the punitive Work Group aspects get added later? And why are benefits so much lower for the first 13 weeks of ESA?

I suppose it just all seems perverse. "Look at all these amazing benefits we offer everyone that needs them. Oh, no, you can't actually have them after all. But don't they look so wonderful?" At least in the US everyone knows they'll get the "bugger off" as soon as they walk in the door, instead of being led on and messed around with for a while first :p
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
The entire system seems like an excuse to reduce benefits without cause.

Hi Valentijn - unfortunately that is exactly what it is and it's very widely recognised to be so in the UK. You're trying to make sense of a system that doesn't make sense and we all know it doesn't.

We're in a recession and the government is pushing a rhetoric of 'benefit cheats and scroungers' to try to justify benefit cuts not just for the disabled but for everyone. Recently a backlash has been growing but there is no sign of it affecting the government's actions.
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Next Monday Panorama at 20.30:

The great disability scam?

Only half of all people with a disability are in work. Panorama investigates if one of the government's most ambitious welfare reforms, costing billions of pounds, can solve the problem of disability unemployment. Reporter Sam Poling reveals the private companies who are getting rich from the new reforms despite only being able to get a small fraction of disabled people back to work, and speaks to the charities who feel the most vulnerable in our society are being failed.

http://www.bbc.co.uk/programmes/b01qgk9h
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Next Monday Panorama at 20.30:

Thanks, Firestormm, I'll watch this.

There are two failures going on - the failure to support those disable people who could work, and the failure to accurately identify those who can't. I think the second failure more often has been overlooked lately.
 

barbc56

Senior Member
Messages
3,657
I did go through the Department of Disability for a job at home. All they had were jobs cold calling people to sell something. Just the thought of doing that could put someone in a flare.
Barb

ETA I am in the states as well as being in a state of illness.:rolleyes:
 

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Am just getting around to looking at what my Cornish MPs who took part in the debate had to say about things. The first comment is from my own (Liberal) MP Dan Rogerson and comes not from the debate but from his regular article in the local Cornish Guardian:

Friday January 18 2013 Cornish Guardian: Dan Rogerson:

"On Thursday, I called a debate on work capability assessments carried out by the company ATOS. The system was introduced under the previous Government in order to assess whether someone is fit to work, or whether they are entitled to receive Employment Support Allowance if they cannot work due to medical conditions.

It is right that, if people with disabilities or serious health conditions are able to, then they are supported back to work. But I still have some concerns that people aren't being assessed properly and are being recommended for work when they shouldn't be, so I was urging the Government to try to improve the system."

Ok. So pretty mild really - although interesting that he refers to 'the Government' when he's a part of it. I've been in touch with Dan on several occasions drawing his attention to my own 'journey' through the system and the appeals and the delays and the 'wins' etc.

I find it 'odd' that he considers people with "serious health conditions" to be fine if found fit for work. And this this notion of support back to work has become something of a meme. If I didn't think it would cause me hassle I'd go back to him and alert him to the fact that in 4 years of WRAG I have had no contact from the Job Centre - so no support.

This situation even with support is starkly underlined by the link that IVI provided above. I think it is about time - beyond time - that the WRAG was exposed. Let's see what actually happens in WRAG and what support is afforded. Let's see them blow the belief I have that WRAG is merely an excuse to pay claimants less money, out of the water.

I also - while on the subject - find it 'odd' that WRAG gets support (allegedly) and yet the 'Support Group' doesn't. Presumably that 'support' is financial i.e. £20 extra a week and 'only' an annual review to look forward to.

Back to the Cornish-contribution to last Thursday's debate. Just for my benefit and purposes (hope y'all don't mind):

Stephen Gilbert (St Austell and Newquay) (LD): I join hon. Members in congratulating the right hon. Member for Oldham West and Royton (Mr Meacher), the Backbench Business Committee and my hon. Friend the Member for North Cornwall (Dan Rogerson) on securing this timely debate.

As the hon. Member for North East Derbyshire (Natascha Engel) said, we need to separate two things. The first is the principle of assessing those on out-of-work benefits to establish whether they can rejoin the workplace. As everyone in the House accepts, that must happen if we are to be responsible guardians of the public purse and if we are to help people who can work to get back into work. The second is the need to look in detail at the practice of how the assessments are being conducted.

Mr John Leech (Manchester, Withington) (LD): I am grateful to my hon. Friend for giving way so quickly. A number of people who have been assessed reasonably recently had their incapacity benefits stopped but then reintroduced on appeal are now being reassessed and found fit for work once again. Surely people who have recently been assessed and won on appeal should not be being recalled by Atos.

Stephen Gilbert: I absolutely agree with my hon. Friend and what he says goes to the nub of the points I wish to make. This debate should focus on the practice of how these assessments are being conducted. He, like me and probably every Member, will have had scores, if not hundreds, of constituents experience a similar problem as they go through the system.

There is a consensus in the House on the principle of making assessments. The last Administration set up the WCA and the Atos contract in 2008, and it was right that in 2007 Liberal Democrat Members pressed for and secured the annual review of how the WCA was being implemented.

Over the last few years, as every hon. Member will know, these reviews have revealed a catalogue of errors, and, to their credit, the coalition Government have taken action: there has been increased flexibility for assessors to take additional evidence, not least from consultants; there has been better communication with people undergoing assessment; and new standards have been implemented for descriptors.

All that is having results. The numbers going into the ESA support group have risen to 26%—from 11% under the last Administration —so fewer people are now being found fit for work.

None of us can underestimate or undervalue the human effect that some of these assessments are having. I would like to read into the record an e-mail I received from a constituent. It is probably similar to e-mails that all hon. Members have received. It reads:

“They never asked about the amount of pain I have to contend with or how tired I get from coping with it. After the interview I was told I was to be disallowed ESA benefit. I could probably go down the route of appeal but I really don’t feel like fighting for a benefit that I have already been made to feel that I do not deserve, neither do I have the energy to appeal.

If we in this House cannot give voice to these people, who are some of the most vulnerable in our society, I really do not know what we are for.

Steve Rotheram (Liverpool, Walton) (Lab): To illustrate one of those cases, I shall cite a letter I received from a constituent, Janine, in Liverpool. Her dad was thrown off sickness benefit in November after an Atos work capability assessment and was declared fit for work despite suffering from chronic obstructive pulmonary disease. Six weeks later, on Christmas day, Janine’s father died. Does the hon. Gentleman agree that this example clearly highlights the fact that the work capability assessment, run by the DWP, is fundamental flawed?

Stephen Gilbert: As I have said, and as I am sure the hon. Gentleman would acknowledge, the point is not the principle of conducting assessments but the practice—how they are rolled out and how millions of our constituents experience them.

Constituents have told me that they find the process dehumanising and degrading and that they are often seen by people who are unqualified to make an assessment of their condition. We have to get the assessment process right. That is right for the individuals concerned, but it is also the decent, moral and humane thing to do.

I am particularly concerned about those with fluctuating conditions such as ME—myalgic encephalomyelitis, or chronic fatigue syndrome—and those with lifelong degenerative conditions, who will never recover from the illness from which they are suffering but who continue to be called in for repeated assessments.

The principle is the right one; the practice, however, is failing many millions of the most vulnerable people across the country. Although the coalition has made welcome efforts to get right a system that it inherited from the last Government, much more still needs to be done to ensure that we are doing things in a humane way.

Annette Brooke (Mid Dorset and North Poole) (LD): Does my hon. Friend agree that most people were extremely pleased that Professor Harrington convened his working group to look at the descriptors for fluctuating conditions? However, whatever has happened has not solved the problem for people with ME, multiple sclerosis or mental health conditions. It is therefore imperative that the DWP get on with this and make the system work for those people.

Stephen Gilbert: I could not have put it better. This is not about the principle of assessments; it is about how they are conducted in practice. We owe it to some of the most vulnerable people across our country to ensure that we get this right.
1.1 pm

Dan Rogerson (North Cornwall) (LD): I pay tribute to the right hon. Member for Oldham West and Royton (Mr Meacher) for leading the effort to secure this debate. I was happy to accompany him and the hon. Member for Harlow (Robert Halfon) when they appeared before the Backbench Business Committee, and I am grateful to the Committee for having found time, in what is a busy schedule, for a debate on this issue.

It is of great concern to many Members and, more importantly, to those who have been assessed under the WCA system and those who work to support them and are inundating us with case studies.

We have heard a lot about the history of this issue, so I will not rehearse what has been said on that. I am pleased that an annual review of the system is in place and that it is highlighting the concerns, which we are then able to address in this House. The coalition Government have moved to tackle some of the concerns, but they need to do more, such as by addressing the issues raised by Professor Harrington.

I remember a case that arose during the last Parliament—when this system was introduced—involving a constituent of mine from one of the north-coast villages. He was told he had to attend an assessment, and printed information on how to travel to the assessment venue by public transport was sent to him. The suggested journey involved an overnight stay on a railway platform. It was hardly helpful to send such a suggestion to someone who was travelling to attend a WCA.

We have moved on a little since then. As we have heard, however, people attending WCAs are often nervous and fail to get across all the points they want to make, and they frequently feel that, as a result of the process, they are railroaded into responding in a certain way. As we heard from the hon. Member for Bridgend (Mrs Moon), the people who accompany them are sometimes shut out of the process, too, even though they can perform the valuable role of giving their companion the confidence to represent themselves thoroughly.

The hon. Member for Airdrie and Shotts (Pamela Nash) raised the important point that the process is recorded. As we all know, telephone calls to many organisations are routinely recorded and people, including those undergoing WCAs, should realise that the recording of proceedings is for their benefit as well as that of the organisation concerned. Those undergoing WCAs can get a copy of that recording, too. That point was raised with me by a woman whose son had to wait for seven months to get his assessment, which serves to highlight that we must also speed up the process. Work needs to be done to help Atos understand the problems that might be leading to those delays.

Sarah Newton (Truro and Falmouth) (Con): Does my hon. Friend agree that we must make Atos understand that in remote rural constituencies such as those we both represent some people have to travel long distances? That problem is leading to a lot of no-shows at the Truro Atos centre, which in turn is leading to lots of delays in assessments, thereby causing a great deal of anxiety.

Dan Rogerson: That is also a common problem in respect of visiting district general hospitals. I have repeatedly asked hospitals to make sure that people travelling long distances are seen in the middle of the day, rather than early in the morning. Sensible decisions like that would help.

A constituent who would rather I did not reveal her name also raised the issues of delays and recordings, and others have mentioned the lack of expertise. If Atos has practitioners with different areas of expertise—some in physical disability, others in mental health issues, for instance—it should arrange assessments in such a way as to utilise that.

The language that is used and how people are treated are also important issues—some Members of this House could probably moderate the language they use in discussing this subject.

Ian Lavery (Wansbeck) (Lab): We are, in effect, trying to put a sticking plaster on a gaping wound. Atos and the WCA are not fit for purpose. Does the hon. Gentleman agree that we should bin them both, and start again with the idea of looking after disabled people, rather than the opposite?

Dan Rogerson: The problem with that suggestion is that all the people who have been through the process and have won appeals will have to go back to square one. I am therefore in favour of improving the current system. Every time we renew a system, we go back to square one. Those who have been through an assessment and an appeal and have finally got the right result should not be sent back to square one. The hon. Gentleman articulates the anger that is felt, and there are clearly problems with the process, but I do not think scrapping it and going back to square one is the best way to proceed. Professor Harrington has not suggested that course of action, either. What he has said is that there are problems that need to be resolved.

Guto Bebb (Aberconwy) (Con): Will the hon. Gentleman give way?

Dan Rogerson: No, I want to conclude so that others can have a chance to speak.

There are certainly questions to be asked about the company operating this process. The hon. Member for Stafford (Jeremy Lefroy) said it was drinking in the last-chance saloon. We have heard in other contexts that people can remain in that saloon for a long time, however, and this debate serves to show the Government that we are taking this issue very seriously.

There is another issue, too. Those who are found capable of work even after an appeal should be supported into work. We must do that properly. I hope we will address that issue on another day, as it is the second part of this process and there are problems to be solved.

I thought this comment was especially pertinent to what we were talking about previously (not from one of my lot unfortunately):

1.33 pm

Dr Eilidh Whiteford (Banff and Buchan) (SNP):

...

Finally, I want to say a quick word about the situation facing people with serious mental health problems and long-term fluctuating conditions. There is a world of difference between being potentially fit for work, given the right support, and being an attractive prospect to a potential employer.

The elephant in the Chamber today is the fact that many employers will think very long and hard before taking on a member of staff with a serious long-term or fluctuating health condition. Anyone with a chequered work history knows that they are perceived as a risk to prospective employers.

Many employers will admit this in private but will not come out and say it publicly. I do not think the Government are being realistic enough about the stigma attached, for example, to degenerative conditions or mental illness. These hurdles are not insurmountable, but we must admit that they exist if we are to challenge them.

I hope that today’s debate will inject a dose of realism into the Government and that they will stop hounding and persecuting disabled and sick people for their disabilities.

This strikes me as 'odd':

The Minister of State, Department for Work and Pensions (Mr Mark Hoban): We do ask GPs and consultants to provide medical evidence; we send a form to them. Only 37% of those are returned in time.

Now I know they did/do this in respect of the Disability Living Allowance; but I didn't think they did for ESA. I can't remember but I'm fairly sure that my doctors were not asked by the DWP to provide evidence - I had to ask them myself and was initially going to be charged by my GP for the privilege at one point. Maybe they are/were asked and simply hadn't returned the forms? I wish this was certain - it would save patients one hell of a job. But then how would we know if they'd asked all the medical professionals we see? I suppose the medical professionals would tell us but as they never have I have to conclude that the Minister is out of touch and indeed, incorrect. I don't believe the DWP asks for evidence directly from medical professionals. I certainly couldn't afford to rely on his assumption.
 
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I find it 'odd' that he considers people with "serious health conditions" to be fine if found fit for work. And this this notion of support back to work has become something of a meme. If I didn't think it would cause me hassle I'd go back to him and alert him to the fact that in 4 years of WRAG I have had no contact from the Job Centre - so no support.

Lumping in the physically ill (serious health conditions?) with the physically disabled seems like a huge mistake. If you've got the flu, you're ill and you should stay home until you recover. Why is it different with longer term illness? You're still in a fluctuating state where you're mostly non-functional and activities, especially employment, are a constant exhausting struggle. It's generally acknowledged that you should rest and not push yourself when ill - why does that advice change when the illness is incurable and not going away after a respectable amount of time?

I think you could have two people with a similar level of physical disability, one ill and one not. And sending the ill one off to work on the basis that he's just as able-bodied as the non-ill disabled person seems ludicrous and cruel. Physically ill people are in a relatively vulnerable and fragile state, and putting that sort of demand on them is not going to benefit them - to the contrary, it is very likely to make them even more ill.

This situation even with support is starkly underlined by the link that IVI provided above. I think it is about time - beyond time - that the WRAG was exposed. Let's see what actually happens in WRAG and what support is afforded. Let's see them blow the belief I have that WRAG is merely an excuse to pay claimants less money, out of the water.

Yes, it sounds like the WRAG support is mostly fictitious and inappropriate - these are physically disabled (and ill) people, not punks just out of high school with no job-seeking skills. If the WRAG was intended to help them, it would be aimed at ergonomics therapy, teaching disabled people to cope with their limitations, especially in the work place.

But that is individualized and time-consuming, hence pretending the problem is CV-writing is much cheaper. This illustrates that the bottom line really is about saving money, and that helping people to cope with their disabilities does not save enough money by finding them jobs to justify the expenditure. Which in turn suggests that the entire WRAG program is doomed to failure, especially with the dismal statistics IVI found, showing something like 0.2% of ESA participants get a job.

And Firestormm's quote of some politician suggest that 74% of ESA beneficiaries are in the WRAG group, and it used to be 89%. So a very very tiny amount of people labeled fit to work are actually getting work. It would seem that the fit to work label is very inappropriately over-used, and/or "fit to work" disabled people are still far too undesirable/unreliable for potential employers to make the WRAG program at all practical.

To reiterate what someone else said - they should be making their decisions based on whether anyone would actually be interested in employing these ill and/or disabled people, rather than on whether these ill and/or disabled people could theoretically perform an uncommonly accomodative job under ideal conditions.
 

Sasha

Fine, thank you
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I don't believe the DWP asks for evidence directly from medical professionals. I certainly couldn't afford to rely on his assumption.

I've applied for both ESA and DLA this year. They did ask my GP for a report for my ESA application and he promptly filled in the form on the basis of ancient and currently incorrect information which I had to get him to write a letter about during the appeal process. For my DLA application, it was stated on the form that I had to get the info from him and I had to pay him a fee for it.

I actually preferred the latter situation (not the fee, obviously) because it meant I could have a conversation with my GP about what my life is like in the kind of detail necessary to provide the info needed. I don't normally have that kind of conversation with him because it's distressing and he can't do anything about my condition that he hasn't already - normally, there's no point going into the details for clinical purposes.

I'd recommend anyone applying for these benefits to go to their doctor as soon as they get their application sent off and explain in detail how their illness affects them. I gave my GP written notes on what I can't do in terms of daily living for the DLA application and was awarded it at the highest mobility rate and middle personal care rate just on paper, with no Atos medical exam.
 

Sasha

Fine, thank you
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To reiterate what someone else said - they should be making their decisions based on whether anyone would actually be interested in employing these ill and/or disabled people, rather than on whether these ill and/or disabled people could theoretically perform an uncommonly accomodative job under ideal conditions.

I had a long period of remission, which I and my doctors thought was recovery, and worked during that time. I had a serious relapse, went on long-term sickness absence from my job, which obviously cost my employer in sick pay and disruption before I was let go, and have been unable to work for six years now. At this point, even if I 'recovered' I wouldn't have any faith that I wouldn't at some point relapse and I wouldn't want to burden an employer with me. I don't think it would be fair to an employer. I realise people might not have much of a choice but if I could go self-employed I'd try to go that route rather than make someone else carry the risk. It's unfair of the government, both on the sick and their potential employers, to make employers carry the risk of employing someone who isn't really fit for work.