Employment minister Mark Hoban has accused Parliament’s public accounts committee of “scaremongering” after it attacked the Department for Work and Pensions’ work capability assessment.
He said, according to the BBC: “Rather than scaremongering and driving down the reputation of the WCA, critics might like to acknowledge the fact that independent reviews have found no fundamental reforms are needed to the current process because of changes we’re making.”
That sounds a lot like self-justifying nonsense to me.
I wonder whether we may reasonably expect any better of him, when we know he edits comments on his own Facebook page to remove anything remotely critical. If you don’t believe me, just you go there and try it!
But okay, let’s give him the benefit of the doubt and try examining the committee’s criticisms at ground-level. We all know my partner, Mrs Mike, has been – and is continuing to go through – the assessment system. Let’s go through the committee’s conclusions with reference to her example.
The first conclusion was that “the decision-making process for new Employment Support Allowance applications and Incapacity Benefit reassessments all too often leads to the wrong decisions and is failing far too many people”. The decision after Mrs Mike’s assessment was that she should go into the work-related activity group for ESA. It was only after she had an interview with a WRA provider – six months after the assessment – that they told us the decision was wrong, she should be in the support group, and we should seek reassessment. So in our case, I find that the committee’s conclusion was ACCURATE.
Conclusion number two: “The Work Capability Assessment may unduly penalise people with specific health problems. The one-size-fits-all approach is not appropriate for particular groups, for example, people with mental health, rare or variable conditions. The process is too inflexible and makes it extremely difficult for individuals with particular conditions to demonstrate the impact of their conditions on their ability to work. Too often the process is so stressful for applicants that it can impact on their health.” Mrs Mike has fluctuating conditions – fibromyalgia, mental health problems, and a back condition that causes pain, although the level of that pain can vary from day to day. As I have demonstrated in my response to the first conclusion, she was put into the wrong group – in the opinion of a work-related activity provider employed by the Department for Work and Pensions. That’s pretty conclusive! I was present at the work capability assessment interview and can assure any doubters that it is an extremely stressful process – not just physically, because claimants have to prove the limits of their physical abilities, but also emotionally. It took her days to recover her composure after the assessment. There are continuing issues to do with mental health, as the current nature of the process – leaving people waiting for months at a time before a decision, or until they can move on to the next step, then the disappointment of being told there was a mistake and they have to go through the whole process again – seems engineered to create mental instability. Therefore I must find that in this case also, the committee’s conclusion was ACCURATE.
The next conclusion states: “The Department does not know the full cost to the taxpayer of the overall decision-making process for Work Capability Assessments. Whilst some costs are known, such as the £26.3 million paid to HM Courts and Tribunals Service for its work on appeals, there is little information on the cost and impact on the National Health Service or on some of the internal interactions within the Department.” Whilst it is true that Mrs Mike has been to see her doctors (physical and mental) since her assessment took place, and throughout the ensuing mess, I would not try to put a price on that extra process. Therefore I cannot say for sure whether this conclusion is accurate or not. However, we all know that a high proportion of appeals are won – more than 90 per cent of those in which the claimant has sought legal representation, in fact, so it is reasonable to believe that the government is paying a high price to the courts. On that basis alone, it is reasonable to question whether the government is getting value for money.
Conclusion four: “The Department has failed to develop a competitive market for medical services. The market for medical service providers is under-developed and Atos Healthcare is currently the sole supplier for all the Department’s medical assessments. It has also been awarded two of the three current contracts for the Personal Independence Payment. The Department is too relaxed about the risk to value for money resulting from a dependence on a monopoly supplier, and on the limitations this has on the Department’s capacity to remedy poor performance.” Personally, I am unhappy with the thought that a profit-centred marketplace should be created around people’s health. This is why I opposed the Health and Social Care Act that has caused so much harm to the NHS in England since it became law. However, the point that it is hard to remedy poor performance when a single company holds a monopoly on assessments is reasonable. Mrs Mike’s assessment was carried out by Atos. That assessment reached a wrong conclusion. Who will carry out her reassessment? Atos. You see the problem.
Worse than that, though, is the underlying issue – that Atos has been briefed to push as many people off-benefit as it can. This is why the work capability assessment is based on the “psycho” part of the biopsychosocial model, itself a discredited medical theory. The aim of the assessment process is to tell claimants that their illnesses or disabilities are all in their minds, and that in fact they are perfectly capable of work. Considering the Labour Party’s policy is reprehensibly shoulder-to-shoulder with that of the Coalition in this regard (Liam Byrne very recently said Labour would continue reforms of social security benefits along similar lines) there seems very little hope for people with disabilities in the future. I find the committee’s conclusion ACCURATE in the case of Mrs Mike, and note with trepidation that the future seems bleak, no matter what government we have in the future.
I do not intend to address the fifth and sixth conclusions as they seem to be operational matters within the Department for Work and Pensions. Before Mr Hoban claims any victories, I should add that all the reports I have seen tend to bear out the comments of the public accounts committee.
But the final conclusion states: “The Department must improve its internal processes to improve the quality of decision-making and contract management. The size of the Department and its impact on individuals and on the public purse requires us to have the utmost confidence in the capability of the Department to deliver. Robust systems are a crucial part of this. We are concerned that the Department is unduly complacent regarding the quality of the decision-making process, particularly given the hardship which can be caused to individuals when the decision is wrong.” Clearly, neither I nor Mrs Mike have any confidence in the DWP’s ability to deliver the right decision regarding a person’s ability to work. Therefore I find the committee’s comment about complacency ACCURATE. The hardship which can be caused to individuals is something my partner and I are being forced to face at the moment – as a possibility, should a reassessment decision go against her. We are all familiar with cases in which people have either died from the worsening of their health conditions (conditions denied by the DWP and Atos) or from suicide provoked by a worsening of their mental health due to the assessment process and fear for the future of themselves and their families. These are real issues.
By suggesting such fears are “scaremongering”, Mr Hoban hugely weakens his own case.