Call for evidence on Work Capability Assessment: My submission

Tell him about it: Dr Paul Litchfield is carrying out a review of the Work Capability Assessment and needs to know how you think the system could be improved. The Coalition government would like him to think that there is no need for any change at all; if you don't tell him exactly what you think of it, he won't know any different.

Tell him about it: Dr Paul Litchfield is carrying out a review of the Work Capability Assessment and needs to know how you think the system could be improved. The Coalition government would like him to think that there is no need for any change at all; if you don’t tell him exactly what you think of it, he won’t know any different.

An article on this site earlier today publicised the DWP’s call for submissions to its independent review of the Work Capability Assessment and called for anyone with experience of the process to contribute by answering the four questions at this web address:

https://www.gov.uk/government/consultations/fourth-independent-review-of-the-work-capability-assessment-wca

As someone with direct experience of the assessment procedure, I made my own submission shortly after writing the piece, and I am reproducing it here. I threw as much information into the submission as I could, and I would like to take this opportunity to beg everybody who has also experienced a work capability assessment to do the same. It is weight of numbers that will carry any changes to this diabolical, unfit-for-work assessment system; if you have been affected, you cannot rely on other people to get it changed for you.

Here are the questions and my responses:

1. If you have undertaken a WCA yourself or represented somebody who has, what has been your/their experience of the face-to-face assessment and follow up contact with the DWP?

Before the assessment we were not provided all the information we needed, such as details of how to arrange to have the interview recorded. I went along with a Dictaphone, expecting this to be allowed, but the Atos employees made a huge fuss about it and it was clear that they were not prepared to go ahead with the interview if we insisted on recording it. This would not have been our fault or theirs, but the fault of the DWP for failing to make the situation clear. The DWP claims to have only 31 recorders available to it, but this seems ridiculous when every work capability assessment is carried out on a laptop computer which is perfectly capable of running audio recording programmes and burning the resulting files to disc. Fears that someone might tamper with the files (hardly likely between finishing the interview and creating the disc minutes later) can be allayed with a simple time-check at the beginning and end of the recording; the length of the recording should match the time expired between the start time-check and the stop time-check. Microphones are extremely cheap – even more so if ordered wholesale – so there is no reason not to provide them in order to ensure sound clarity. The assessment itself was inadequate – not fit for purpose. The problem is that the questions have been devised in order to shoehorn ESA claimants into particular categories – therefore the assessor needs straightforward “yes” or “no” answers about conditions that are NOT straightforward, and for which such answers would be inappropriate. I attended my partner’s WCA and, with almost every question, she was trying to explain how her situation affects her. This was of no interest to the person conducting the assessment. The problem lies in the fact that the whole system was originally devised by an American insurance company – Unum – in order to find ways of refusing payouts to customers whose policies had matured. Despite the fact that this strategy led to the company being successfully prosecuted in its home country, the UK government enthusiastically hired Unum to transform the assessment of disability/incapacity benefit claimants along the same lines. The implication is always that the claimant’s illness is in his or her mind, and in fact they are perfectly capable of doing a job. There is no effort to find out the claimant’s actual medical condition – all effort is devoted to finding which category they can most easily be put into. There’s more but I’m out of space!

2. On the basis of your experiences, can you suggest any changes to improve the face-to-face part of the WCA? Please give details of why you think these changes would help.

Scrap the work capability assessment as it currently exists; it is a waste of time and money. The interview should be a genuine fact-finding exercise in which a genuine medical doctor gathers all the evidence possible about a claimant’s case, including evidence from their GP and other experts involved with it, and makes an assessment without having to conform to any requirements imposed by the government (which has its own agenda). My partner has mental health issues but there was no attempt to address them. She also has fluctuating health conditions but these were not explored either. New guidelines on these may have been brought in after her assessment but she was not contacted about them afterwards.

3. Thinking about the overall WCA process from when you make a claim for ESA to when you receive a notification of a decision from the DWP, what changes do you think are needed? Please give details of why you think these changes would help.

The ESA50 form should be scrapped and re-thought. The questions in the ‘descriptor’ section are bizarrely-worded and unfit for use as any means to judge a person’s fitness for work. For example, section 8, ‘Getting around safely’, is said to be about visual problems, but the request is “please tick this box if you can get around safely on your own”. I had to write “This is a misleading question. She can’t, but not because of sight problems”. The form provides an opportunity to mislead assessors about the issues they will face at the assessment. The decision notification must be much more detailed. Claimants need to see not only what the decision was, but why it was made. They do not currently receive a copy of the assessment/assessor’s notes, and must instead request it after receiving the decision notice, if they intend to appeal. Why? What does the DWP/Atos/the individual assessor have to hide? Making the recording of assessments mandatory and providing all the documents used to make a decision along with the decision notice itself would hugely increase transparency in the process, helping to prevent costly mistakes.

4. Please give us any further information and evidence about the effectiveness of the WCA, particularly thinking about the effect on claimants, that you consider to be helpful.

My partner was put in the work-related activity group of ESA and told she would be contacted about what she would be required to do. She had to wait FOUR MONTHS (out of a 12-month benefit period) before anybody got in touch. After an interview at the Job Centre, a work programme provider contacted her and established, within half an hour of telephone conversation, that there was nothing they could do with her. She was advised to request reassessment, which she did. That was six months ago and we have heard nothing. As her benefit period is coming to an end, she is currently undergoing reassessment anyway, but this does not excuse the DWP from its tardiness. You can see from this that the WCA, in my partner’s case, produced an inaccurate response. She is not the only one – statistics from the tribunals service show the number of appeals against WCA decisions between January and March have more than doubled, compared with the same period last year, and findings for the claimant have risen to almost half of cases (43%). The work programme has failed most WRAG members – as it failed my partner. Only 10% of them have found work, according to the DWP – around 1.7% of all ESA claimants. This conforms with the view that the rest have been misplaced and are too sick or disabled to work. Of course, the WCA has had a devastating effect on many claimants – statistics last year showed dozens were dying every week, while going through the process, while appealing, or after having been found ‘fit for work’. The DWP is refusing to release current figures, which implies that they have not improved. This proves that the system does not work and should be scrapped. The fact that claimants have DIED while going through this process, and ministers have done nothing about it, implies corporate manslaughter and I would certainly recommend that criminal investigations take place on this basis. Hopefully others will provide details of some of the deceased; otherwise I should be able to provide contact details.

That was my submission.

The web page is at https://www.gov.uk/government/consultations/fourth-independent-review-of-the-work-capability-assessment-wca

Over to you.

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16 Comments

  1. murray July 3, 2013 at 7:43 pm - Reply

    Dr Litchfield has been appointed by this govt,so most unlikely to change anything.

    • Mike Sivier July 3, 2013 at 7:46 pm - Reply

      All the more reason to get a submission in, if you can! If as many of us write in as are able to do so, and he says there’s no reason to change anything, we can all kick up a stink by demanding to know why he hasn’t taken our views into account.
      Sitting around saying he’s “unlikely to change anything” will ENSURE that nothing changes, and I’m sure you don’t want that.

  2. Charlie Fleming July 3, 2013 at 8:18 pm - Reply

    the more people who that have had the assessment and who comment on this article of Dr Litchfield and make their complaints heard then the better it is for those that cannot or have not had the assessment as of yet.

  3. michael pace July 3, 2013 at 8:29 pm - Reply

    my assessment ……she told lies about me …in her report about me . has made me so ill ….

  4. leonc1963 July 3, 2013 at 9:07 pm - Reply

    Reblogged this on Diary of an SAH Stroke Survivor.

  5. shirleynott July 3, 2013 at 10:20 pm - Reply

    Comments submitted. Amount of space allowed means having to be concise and to the point – and pages and pages wouldn’t be enough to say what needs saying. On the other hand – ‘scrap it and replace with something humane’ is the main point to make – which is going to be implicit/explicit in most replies they’ll receive. Whether anyone will read and act on our comments (at this fourth ‘independent’? review) we’ll have to wait and see but I think that I’m with murray on this, in that insofar as it’s been set up to be ‘what it is’ and is not this way by unfortunate accident – even if ‘they know we know’ It’s not likely any complete rethink/change in the overall angle/approach will happen?

    If I were even a tiny bit more cynical (& I’m getting there faster than I’d have thought possible, even as recently as a few years past) I’d suggest that the ‘review’ is a way to be seen to be ‘looking at the process to get it right’ etc. rather than a genuine call for ‘suggestions’. (Many ten/12 year-old’s would be able to look at what’s wrong with the WCA/Atos and see what could be done). People have commented often already that it’s in fact working very well, as far as those who’ve set it up are concerned and that a few deaths here or there aren’t of major concern. I never thought I’d be airing thoughts like these in my lifetime and not sure it was really something we might have foreseen ever coming within the remit of the welfare state as we had come to know and value it (Thatcher et al notwithstanding).

    • Mike Sivier July 3, 2013 at 11:02 pm - Reply

      Well, we’re into tens of thousands of deaths by now, and that number IS of major concern.

      Like you, I’m concerned that the government think the current system is the way to go forward and is just concerned with making it do what they want, as well as possible.

      But the evidence seems to show that it isn’t working, and that it won’t work, along the lines they want.

      Either way, there’s no harm in making a submission to the process and seeing what comes of it.

      It would probably be a good idea, when the report comes out, to ask Dr Litchfield for full details of his brief, and to describe what he understood to be the purpose of this work – and to make his description as full as possible, leaving no room for any ambiguity.

      • shirleynott July 3, 2013 at 11:54 pm - Reply

        Of course you’re right. Every one of these deaths is absolutely a major concern. (‘A few’ was meant glib shorthand referring to the way I imagine Ms McVey/IDS must at some level ‘explain’ their version of reality when talking amongst/to themselves) They have to be at the very least ‘in denial’ and if they have any concept of the increased ill-health, fear and distress for which they are answerable, let alone the deaths, they must realise at some level that they should be answerable. It was a sarcastic comment – probably more than anything due to being so very angry at a personal level, as well as in general terms about what’s being done. However we choose to try to understand it – & there really does seem to be only one way to do so by now – it’s too easy for disillusion/despair to set in. (Man’s inhumanity to man).

        Thanks for your reply – and for posting about the chance to submit comments. I wrote mine very quickly and saw the ‘we will consider all comments’ at the end. Most of what I tried to express in mine were along very similar lines to what’s been said below (by Nessie) – who perfectly expresses everything that’s wrong counter-intuitive and counter-productive as well as utterly barbaric about the WCA/Atos. (I have someone who is very close to me/my family who was initially placed into the WRAG group and afterwards into the support group post-appeal with ‘not to be re-assessed before 2 years’). The ‘in between’ period was stressful, to say the least.

        You are absolutely right about keeping up the pressure (it’s all too easy currently to lose any/all faith in the concept of democracy) – we have to shout as loudly and as often (& as coherently) as we possibly can. I think it was on here that I read first of all about Samuel Miller’s ongoing battle to make the case at the ‘highest level’? and that along with posts like the ones you and others are writing are what offers some hope that people are shouting loudly in all the ‘right’ places.

        At the same time it’s of huge concern that the similar approaches are being adopted across the board (benefits-related sanctions/NHS dismantling & etc). None of these are the battles we would choose to have to be involved in – It’s so clearly wrong that people’s lives are being picked up & put down again in this way. It’s not the world I want my nieces/nephews or my son to grow up in.

  6. Nessie (@wildcandytuft) July 3, 2013 at 11:03 pm - Reply

    My complaint had the opposite to your wife’s difficulty. The last thing I can cope with is work related activity. Before I’d even had chance to send in my appeal for the support group I’d been mandated onto the work programme by the unhelpful JCP advisor. They didn’t give me chance to dispute their incorrect decision. There is no way I can attend a group sessions with A4E in a nearby town for hours on end because, as you know, I’m agoraphobic and frankly what they’re demanding of me is impossible. There’s no way I can meet their conditions and I’m expecting to be sanctioned shortly. They have already reconsidered their decision, which they do automatically now before it’s sent to the tribunals service. They haven’t changed their decision. It’s clear that the ten year medical history I sent on later, because it took six weeks for the GPs surgery to copy it, and of course, you only have four to complete and return your ESA50, hasn’t even been looked at. It wasn’t attached to the report as it should have been. Where my intimate private medical papers have got lost to then, is anyone’s guess. My condition isn’t likely to clear up any time soon, unfortunately. Even the DWP’s own A-Z guidelines (which I also used as evidence) suggest people who have had agoraphobia for more than four years have a very poor prognosis, but the Atos HCP stated that I should be fine in the short term and ready to work. CBT and medication haven’t helped, so I’d like to know which crystal ball he used to predict my future. As you can imagine, my response in all other respects was much like yours. Scathing. I don’t know why the assessment is only geared towards work either. When people have been isolated, very sick for a long time, have life limiting conditions, they need to be taking baby steps towards recovery, or to manage their illness. They push you in at the deep end before you can swim. There’s no recommendation for useful support and care, it’s only pointing towards work, and doing it very badly at that. Individuals and their illnesses cannot be measured according to how many points they can score, based on flawed descriptors which exclude real life barriers to work. They should combine medical/psychological evidence, medical histories, GPs, consultants and therapists reports with an assessment decided on not by a rubber stamping clerk in an office, but a qualified, NHS trained doctor or professional, who is allowed to apply their discretion and knowledge to decide how fit for work you really are. Basically, it’s fundamentally flawed. It needs scrapping. Better to return to the Personal Capability Assessment that was, because it was fair and robust compared to this cruel process.

  7. thepositivevoice July 3, 2013 at 11:42 pm - Reply

    Reblogged this on thepositivevoice.

  8. […] Mike Sivier, journalist, campaigner, blogger and carer for his disabled girlfriend posted his submission here. […]

  9. Jean Cox July 4, 2013 at 3:49 pm - Reply

    Just sent in my experience of WCA & requesting the whole procedure be scrapped & complained about the media reporting that we’re all scroungers when they should be writing about the thousands of deaths caused by these insane assessments. A letter from your GP should be enough proof that you’re not fit for work & would also save a hell of a lot of tax payers money as well! Hope it helps. Keep up the good work Mike.

  10. Justin Pratten July 5, 2013 at 2:24 am - Reply

    I am heartened by your perseverance Mike. I have lost everything now, including my home, thanks to ATOS and am no longer able to confront the lunacy of these genocidal maniacs. Keep up the good work, maybe you can save some lives…eventually.

    • Mike Sivier July 5, 2013 at 9:39 am - Reply

      Have you been able to make a submission to the call for evidence? I think evidence such as yours could be vital.

  11. Briony Samson July 5, 2013 at 5:48 pm - Reply

    People that actually DO the assessments have been reported as not agreeing with them in their entirity, so, what hope do any of us have?

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