Nobody should believe for a single moment that a Conservative Government will pay any attention to the advice of the experts – especially when the Work Capability Assessment (WCA) is doing precisely what it was meant to do – clearing sick and disabled people off the benefit books with no regard for their future health.
That being said, the analysis of the WCA provided by the British Psychological Society, the British Association of Counselling and Psychotherapy, the British Psychoanalytic Council, the British Association for Behavioural and Cognitive Psychotherapies and the UK Council for Psychotherapy in a joint response to the Government’s consultation, ‘Improving Lives’, is very useful information.
So here it is:
We urge the Government to reform its approach and the assessment process. We also strongly recommend that this be developed utilising suitable psychological expertise as well as service users, and be subject to regular, independent and systematic evaluation.
We remain concerned that without an end to end redesign of the system from its assessment process to its outcomes, any attempts at culture change will be meaningless.
The WCA assessment and resulting categorisation of individuals into either “fit for work”, “work-related activity” or “support” groups, do not allow for sensitive and objective discrimination between individuals with different levels of functional impairment, whether they are physical, mental, cognitive or intellectual. This is producing inappropriate outcomes.
Such outcomes range from those with serious physical, mental, cognitive and intellectual disabilities being placed in the “fit for work” group or “work related activity” group, or those with transient, short-term, acute mental health conditions being placed in the “support group” category.
That the Government has now recognised that these binary outcomes are insufficient and inappropriate is an important development but it now needs to commit to addressing the fundamental flaws within the WCA.
We are extremely concerned that the WCA was not developed with a reference standard and with no testing of reliability or validity or involvement from expert health and social care professionals.
We understand that at no point has the WCA been subjected to systematic evaluation and review of its validity and effectiveness.
We do not believe that the WCA assesses work fairly or effectively. Determining ‘fitness for work’ for people with mental health conditions and disabilities is not only difficult, but it may also have adverse consequences on an individual’s understanding of themselves, their attitudes, behaviour and psychological wellbeing.
Ultimately, any process designed to support those in need must uphold or improve the psychological wellbeing of those individuals.
Moreover, a significant body of published psychological literature highlights that inappropriately labelling individuals as ‘unfit for work’ or “fit for work” can have significant and far reaching consequences on psychological wellbeing, impacting on self-esteem, self-image, self-belief and self-worth (Steele, 1997); as well as the ability (Rydell et al., 2009) or motivation of the individual to engage in the process (and specifically with the source of the perceived threat – Major et al., 1998).
By focusing on “fitness for work” or limited capacity for work, the system has the potential for detrimental impacts on the beliefs of many potentially employable people, as well as those who are seriously unwell.
It is therefore important that the Government understands the importance of these social aspects of work for those with health conditions and disabilities.
The concept of social support at work is recognised as an important element for individual well-being, and in the context of the Green Paper’s theme of changing attitudes towards disability this plays a vital part too.
The Government has missed an opportunity to effectively use psychological theory and practice within the benefits system, which has left it open to results that lack validity, efficacy, fairness and compassion for people’s mental health and wellbeing. We urge the Government to ensure that future reform of the JCP, the WCA and the commissioning of the Work and Health programme takes steps to correct that.
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