Paper exercise: To some people with disabilities and long-term health conditions, the sight of an ESA50 form is enough to trigger anxiety, panic, or even heart attacks.
This Writer was amazed – yes, dear reader, amazed – to discover a new wrinkle in the DWP’s web of deceit, while writing a letter in support of a friend’s appeal against an Employment and Support Allowance decision.
My friend – who has multiple conditions, both physical and mental – had been placed in the work-related activity group nevertheless, and at 2pm yesterday, Yr Obdt Srvt was staring in astonishment at the DWP decision-maker’s professed reason for doing so.
It was the same for all the descriptors: “I place greater weight on the evidence of the Health Care Professional because they are trained disability analysts and the advice they provide is both impartial and unbiased”.
The DWP decision maker had not based his (or her) reasoning on any evidence at all, of course.
Examining the wording of this statement, we see that the decision was in fact based on two unsubstantiated claims about an unnamed ‘Health Care Professional’ who has never met the claimant – my friend had been migrated onto ESA from another benefit in a paper exercise and had not been asked to take part in one of the DWP’s medical assessments (which, in any case, we know are unfit for purpose).
Who is this ‘Health Care Professional’? How do we know this person is a trained disability analyst? Because this was a paper exercise, the ‘Health Care Professional’ had gone unnamed and had never met the claimant. They had never been asked to produce any credentials so the claimant was left with no idea whether this person really was a “trained disability analyst” or not.
I knew their advice was not impartial or unbiased because it was wrong. They had not taken account of the evidence they had been given but had chosen to ignore it instead. Looking at the ‘mobility’ descriptor alone, I know that the claimant in question has significant problems with walking so the advice that “there was no evidence to indicate that you were unable to do this activity” is incorrect, therefore the decision is also incorrect.
Most pernicious of all is the fact that my friend’s disabilities make it extremely difficult to challenge this faked, falsified decision. My friend suffers from chronic anxiety, with poor concentration and memory, panic attacks, and a tendency towards stress. When dealing with authority figures, my friend tends to lose track of what they are saying, fixating on elements that are tangential to the main issues. This makes it very hard to fight wrong decisions, which is why This Writer was asked to step in.
How many other disabled benefit claimants are there, who don’t have recourse to somebody like me?
Reading between the lines, it seems possible, if not downright likely, that the DWP decision maker saw an opportunity to achieve benefit savings targets by pushing somebody, who is clearly not going to be ready for work within a year, into a group where they will lose benefit after that time and be forced to seek work anyway.
If you want to know what happens to people in that position, look at the case of Michael O’Sullivan.
Hoax: That’s how the DWP has described many people’s claims for PIP and ESA. In fact, it seems the assessment system itself is the hoax, and the government department the hoaxer. [Image: Getty Images]
If you have a long-term illness or disability but have wondered why you receive low scores on the government’s face-to-face ‘work capability assessment’, here’s why: The software is written to ensure that any information you provide may be ignored.
That’s right – the tick-box test program that the DWP took from criminal American insurance corporation Unum, which had been devised to make people ineligible for insurance payouts, does not take into account any of the claimant’s personal details.
David Daish, a programmer and software tester, went through the PIP assessment process and then provided his professional opinion on the software to Facebook pageAtos Miracles. PIP is the most useful benefit to discuss in this context because the onus is on assessment providers, rather than individual disabled people, to gather evidence from a list of health and social care professionals provided by the claimant.
He wrote: “The software is written so that whatever the assessor writes in the first part of the report, such as history, and anything the claimant tells the assessor, there is nothing whatsoever in the second part, the choosing of descriptors, that is connected to the first part.
“This means nothing is built into the programming to make sure the assessor uses all the evidence that was (hopefully) collected, or was provided elsewhere, and then can subsequently make the right descriptor choice.
“The assessor can basically say anything they like. Nothing in the software forces them carry out the assessment fairly.” [bolding mine]
He went on to describe the software as “little more than a glorified Word document: “A piece of programming that is not integrated in any way, has no checks and balances to make sure the business process it is supposed to support works as it should, that is, the PIP assessment itself, is in my view unforgivable. I’m inclined to think it is deliberate.”
That is a perfectly logical conclusion to draw.
This would suggest that the increased stress, the despair and hopelessness instilled in claimants by the loss of their benefit for no good reason, and the subsequent loss of life through suicide or exacerbation of the health conditions that the assessment system insists do not exist, are also deliberate.
It also makes sense of the apparently-illogical decisions being thrown out by the system all the time. Citizens Advice has stated: “Both Atos and Capita [PIP assessment providers] have made snap decisions about whether PIP claimants must attend a face-to-face assessment. Even when they do request evidence, providers only need to tell claimants who they have asked for it – not whether they actually received any or what it said.”
It seems that any such evidence would be ignored by the assessment software in any case, so it should come as no surprise that Citizens Advice continued: “In the absence of additional evidence, an astonishing 98 per cent of all assessments have been face-to-face… This is adding substantially to the delays and financial hardship experienced by disabled people.
“We now have two different systems for gathering independent evidence in PIP and in ESA, neither of which is working for claimants, assessment providers or the DWP.”
As someone with only limited knowledge of computer programmer, it is probably not for This Writer to comment. But my own knowledge suggests that a teenager from the 1980s could have produced a better program, using BASIC, than Unum and the DWP have managed here. A series of simple ‘IF… THEN’ loops would have ensured that all relevant information was taken into account.
Perhaps this is what we should do.
I don’t mean we should write a BASIC program to show up the inadequacies of PIPAT (the actual assessment system) – rather we should endeavour to produce our own program that performs in the way the public has been led to believe PIPAT does. Then we could run a few assessments through it (the DWP must provide full details of assessments and outcomes if these are requested, so they won’t be hard to acquire) and compare the results.
There’s more than a little of the piscine about the fact that our Conservative-led has set debt collection agencies onto poor families who have been overpaid tax credit due to errors made by HM Revenue and Customs.
Firstly, the move undermines the principle behind the tax credit system – that it is there to ensure that poorly-paid families may still enjoy a reasonable living standard. Tax credits are paid on an estimate of a person’s – or family’s – income over a tax year and the last Labour government, knowing that small variances could cause problems for Britain’s poorest, set a wide buffer of £25,000 before households had to pay anything back.
By cutting this buffer back to £5,000, the Conservatives have turned this safety net into a trap. Suddenly the tiniest overpayment can push households into a debt spiral, because their low incomes mean it is impossible to pay back what the government has arbitrarily decided they now owe.
And the sharks are circling. Instead of collecting the debt on its own behalf, HMRC has sold it on to around a dozen debt collection agencies who are harassing the families involved with constant telephone calls, mobile phone messages and letters to their homes.
In total, HMRC made 215,144 referrals to debt collectors in 2013-14. Of the working families involved, 118,000 earned less than £5,000 per year.
This takes us to our second area of concern. Remember how the Department for Work and Pensions has been encouraging people – particularly the disabled – to declare themselves as self-employed in order to avoid the hassle and harassment that now go hand in hand with any benefit claim? You know – the refusal of benefits based on arbitrary ‘descriptors’ that were originally devised by a criminal insurance company as a means to minimise payouts, and the constant threat of sanctions that would cut off access to benefits for up to three years unless claimants manage to clear increasingly difficult obstacles.
Both of these circumstances are likely to lead to a verdict of overpayment by HMRC, as the self-employment reported by these people is likely to be fictional, or to provide less than required by the rules – either in terms of hours worked or income earned.
Suddenly their debt is sold to a collection agency and they are suffering government-sponsored harassment, alarm and distress (which is in fact illegal) far beyond anything they received from the DWP; debt collection agencies are not part of the government and, as Dame Anne Begg pointed out in the Independent article on this subject, “The tactics they use to collect the debt are not tactics a government should use.”
Maybe not. So why employ such tactics?
Let’s move on to our third, and final, worry. By setting sharks on the hundreds of thousands of minnows caught in the government’s trawler-net (that was formerly a safety net – and I apologise for the mixed metaphor), the Tory-led administration is creating a handy distraction from the huge, bloated, offshore-banking whales who donate heavily into Conservative Party funds and who are therefore never likely to be pursued for the billions of pounds in unpaid taxes that they owe.
The government has promised to clamp down on tax evasion and avoidance, but ministers would have to be out of their minds to attack the bankers and businesspeople who pay for their bread and butter.
It seems some of your favourite bloggers – including Yr Obdt Srvt – have been hoodwinked by a hoax claim that assessment criteria for the new Personal Independence Payment have been made much more severe than has been the case until now.
If you were distressed by this article, please be reassured that – from what has been said over the last few hours – it is not accurate.
Vox Political only published the claims because they came here via a colleague of good character who in turn received it from a trustworthy source. There were telltale signs that it was a wrong ‘un – for example the fact that the story is based on unsubstantiated information allegedly provided by an anonymous Atos employee to an equally anonymous source – but here at VP it was felt that the possibility of another DWP betrayal merited a mention.
Much of the hoax article focused on the descriptors used to define the effects of their disabilities on a claimant. These are defined by regulations that can only be changed by Parliament (although not by an Act of Parliament, if I understand correctly) and that should have been evidence enough that the claims were false.
But we know that Iain Duncan Smith, Lord Freud and the other vipers infesting the Department for Work and Pensions like to change the conditions in which people receive benefit – especially if it helps them reach their savings targets. This goes for the rest of the Conservative-led government too; they hide information from us.
Look at the ‘negative resolution’ the government introduced last year, to open England’s health service to widespread competition. This happened after the Conservatives (Andrew Lansley in particular) promised on their honour that they would do no such thing. Their plan was that the new rules would not be discussed, and there would be no vote; instead they would automatically become law. How could any of us know whether the government was planning more of the same?
Let us decide, for the moment, that this was a hoax. Some commentators have suggested that it has been planted by fifth columnists working for the government but claiming to be acting for the people, in order to bring other, more substantial criticisms of DWP policies into disrepute. This seems unlikely.
Instead, it shows us that the policies put forward over the last four years by Mr Duncan Smith and his colleagues, together with the way they have been implemented, have shown ineptitude, underhandedness and treachery of such magnitude that people now believe they are capable of anything at all – even the bizarre and contradictory changes that were publicised yesterday.
This is the government department that changed the assessment rules for Employment and Support Allowance to such a degree that the death rate for people claiming the benefit rocketed. Iain Duncan Smith’s solution: Stop publishing mortality statistics for people claiming incapacity benefits.
This is the government department that, faced with a court ruling that its rules for mandatory work activity were illegal, simply changed the law in order to legalise them. This act alone made the Coalition government a criminal regime.
This is the government department whose behaviour shows only one area of consistency – continually making false or misleading claims about its work. Take a look at DPAC’s excellent Report on DWP Abuse of Statistics from June last year for no less than 35 examples of this.
When you are discussing liars it is easy to believe lies about them.
This is why it will be hard to believe any attempt by the DWP to discredit its critics on the basis of this single hoax.
If Iain Duncan Smith wants us to believe him, why doesn’t he give us those ESA death stats we’ve wanted for so long?
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:
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.
What we’re fighting: Not only are work capability assessments leading to many deaths every week (we don’t know how many because the DWP won’t release the numbers), but administrative idiocy has led to at least one of the deceased being harassed AFTER DEATH, for failing to attend an interview. And Mark Hoban says no significant reforms are required. Dream on…
The Coalition government is launching a call for evidence to help with its fourth annual independent review into the Work Capability Assessment process – and I, for one, will be delighted to be part of it.
The review will be carried out by Dr Paul Litchfield, a senior occupational physician replacing Professor Malcolm Harrington, who ran the review process for the previous three years.
According to the Department for Work and Pensions’ press release, it “will continue the process of monitoring whether the assessment is effective in identifying people who could be helped back to work, while ensuring financial support goes to those who are too sick or disabled to seek employment”.
Now – if you have had the same experience of the assessment process as I, and Mrs Mike, have – it is time for you to have your say.
If you are an individual or a member of an organisation with information on how the Work Capability Assessment is operating and further changes that may be needed to improve the process, then you can submit it using the online form on this web page:
It also includes links to more information about the reviews, large print and Easy Read documents. Audio and BSL versions “will be made available on this page shortly”.
The DWP press release has a lot to say about how well they have performed in changing the system so far. It is worth quoting here, just to show you the importance of the need to challenge this attitude. It states:
“In launching the call for evidence, Dr Litchfield will be considering both how the suggested improvements from previous reviews are working, and what further refinements can be made. Dr Litchfield is particularly interested in hearing how the WCA works for people with mental health conditions.
“Dr Paul Litchfield said: ‘This fourth review is an appropriate time to review the impact of the changes that have been made to the WCA in recent years, including those recommended by my predecessor Professor Malcolm Harrington. I will also be considering if more can be done to ensure that the assessment process is both effective and perceived as being objective by all stakeholders.
“‘I am keen to hear from people who have constructive and evidence-based ideas for improvement. The WCA touches many lives and it is in the interest of all of us to try and make it as good as we can.’
“Employment Minister Mark Hoban said: ‘Helping people who can work into a job, while giving financial support to people who need it, is one of my top priorities. That is why it is so important that the Work Capability Assessment is as effective as possible.
“‘Following the previous independent reviews we have already made considerable improvements to the assessment process, so this new review is a great opportunity to build on that progress.’
“This is the fourth in a series of 5 annual independent reviews into the Work Capability Assessment. The previous reviewer, Professor Harrington, made a number of recommendations, and in his third review found that – as improvements were starting to have an impact – no fundamental reforms were needed to the current WCA. Over 40 recommendations have been, or are being, implemented including:
Better communication with claimants, including phone calls from decision-makers to ensure all medical evidence has been provided
Introducing 60 mental health champions into assessment centres to provide advice to Atos healthcare professionals
Working with charities to test out new descriptors covering mental function and fluctuating conditions
Simplifying the process for people undergoing treatment for cancer – reducing the need for face-to-face assessments and ensuring more are placed in the Support Group.”
You’ll notice the possibility of having the Work Capability Assessment recorded is not mentioned, even though there was a debate within the last month. Does Hoban really think our memories are so short?
A submission from myself and Mrs Mike would include information on the run-up to the assessment, including the fact that we were not told we had to announce in advance our desire to have the interview recorded. When I arrived, dictaphone in hand, the Atos employees kicked up a fuss about it that could have stopped the interview taking place at all. That would not have been our fault but theirs, for failing to make the situation clear. We would also point out that claims by the DWP to have only 31 recorders are in error, as the tick-box assessment they use is carried out on laptop computers that can easily – and probably do – carry recording and CD-burning software. It would be simplicity itself to provide simple microphones for both assessor and assessee to use, to make questions and responses clear, and concerns over tampering with recordings may be addressed by a time-check at the start and finish.
I would raise issue with the ESA50 form, that includes ‘descriptors’ that are said to be intended to help describe a claimant’s condition. In fact they do no such thing. They are there to help Atos assessors fit you into the categories laid out by Unum when it originally devised the process as a way to avoid making payments to customers whose insurance policies had matured. It would be far better to allow claimants to describe their symptoms and provide medical evidence from their doctors; the fact that this would require the DWP staff reviewing the forms to use their brains in consideration of the individual situation, rather than slavishly follow instructions that try to shoehorn people into pre-defined groups, is of no concern to the claimant.
I would raise issue with the Work Capability Assessment itself, which also attempts to bypass explanations of the issues in order to shoehorn claimants into providing “yes” or “no” answers to its questions. We have seen from the Conservative Party’s own ‘voodoo’ polling that, if a question is framed in a particular way, the questioner will get the answer they want, and this would not necessarily be productive.
Mrs Mike has mental health issues. There was no concession to those issues during her assessment and I do not recall them being explored at all.
Mrs Mike has fluctuating health conditions. There was no inquiry into how those changes affect her daily life.
Changes for both of the above may have been brought in after the assessment, but they are still relevant to my partner. However, no attempt has been made to contact her or explore her situation in the light of these developments. That is a grave omission.
She was put in the work-related activity group and asked to visit her local Job Centre Plus for interviews. After doing so, and being passed on to a Work Programme Provider, it took just one half-hour telephone conversation to establish that this organisation could do nothing for her, and she was advised to seek re-assessment. This was six months into her one-year period on ESA (remember, those in the work-related activity group get benefit for one year only). Nobody had contacted her during the first four months she was on the benefit.
Mrs Mike did ask for reassessment but nothing was done about it. She is, in fact, going through the assessment process again, but this is because a year has passed since her initial assessment and it is therefore time for her to go through the whole torturous process again. The form went off in mid-May and we have yet to hear back from the DWP.
From our point of view, the whole situation has been a farce.
If you have been through the process, how did you find it?
A drop in the ocean: That’s what your taxes are, in comparison to the £30,450,000 owed by Thames Water in corporation tax this year. But Thames Water is paying nothing and, even though you’ve paid up on time and in full, if you have to claim PIP or ESA in the future, nothing is what you’re likely to get.
“Unum Provident is an outlaw company. It is a company that has operated in an illegal fashion for years.” – California Department of Insurance Commissioner, John Garamendi, 2005.
Is there really a connection between the roll-out of the government’s new Personal Independence Payment scam, outlawed (in the US) insurance company Unum, and the fact that Thames Water didn’t pay any taxes for the last financial year, despite profits totalling around £145 million?
Would any of you be surprised to read that the answer is yes?
PIP, the replacement for Disability Living Allowance, entered the second stage of its roll-out yesterday, when new claimants of working age, applying for disability benefit, were told they would be asking for it rather than DLA. New claimants in northern England have been applying for PIP since April.
The new system follows very closely the pattern established by the claim system for Employment and Support Allowance. ESA claim forms ask sick or disabled people to relate their symptoms to a series of ‘descriptors’, using ‘yes’ or ‘no’ answers (there is space to describe the individual issues but we have no proof that this receives any consideration at all).
The descriptors are based on a perversion of the so-called ‘biopsychosocial model’, created by American company Unum Provident to provide a defensible excuse for refusing to pay out on disability claims, at a time when the company was finding it hard to come up with the cash. Unfortunately (for Unum) the US legal system decided the excuse was not defensible after all and ordered Unum to reconsider 200,000 claims, back in 2006. Unfortunately (for British disability claimants) by then Unum already had its claws in the UK’s Department for Work and Pensions. For more on Unum, see Mo Stewart’s excellent series of reports, written over a three-year investigative period, here and here.
Official government figures put entitlement for the benefit at 99.6 per cent. Less than half of one per cent of claims have been found to be fraudulent.
So there’s a bit of a credibility gap in the government’s system, isn’t there? A gap spanning 69.6 per cent of claimants at best, and 86.6 per cent at worst.
That is the Unum influence. The government has taken this company’s criminal (in America) scheme to deprive insurance policyholders of their payouts and applied it to the national insurance scheme that is the British benefits system, in order to deprive UK citizens of their benefits and rob them of the rewards due to them for paying their taxes.
Let’s all remember, please, that the majority of people claiming ESA have paid their taxes, on time and in full. How many big businesses operating in this country can say the same?
Not Thames Water, that’s for sure. The BBC reported yesterday that the UK’s biggest water firm, which is privately-owned, paid no corporation tax in the last financial year, despite making £145 million in (it says here) pre-tax profit.
The company says this is because it has offset the interest payments on its debts against its tax liability, and claimed allowances on capital project spending. It has been seeking government support for a £4.1bn project to build a new “super sewer” under the Thames, as reported in Vox Political last year.
The total amount of tax owed but offset in this manner is around £1 billion – but let’s not forget that this amount may drop. Part-time Chancellor George Osborne has already cut corporation tax by a quarter (from 28 per cent in 2010 to 21 per cent now) and there is no evidence that he won’t carry on slashing it, to help out his big business buddies and royally screw up the public finances.
Thames Water increased its bills by 6.7 per cent last year. It has reported an increase in revenues of six per cent. Doesn’t that mean that it only needed to raise its bills by 0.7 per cent in order to maintain profits? Doesn’t that mean that the remainder of that increase is down to the greed of its private shareholders, amounting to nothing less than robbery of the 14 million customers who – in this great era of consumer choice, ushered in by David Cameron – have absolutely no alternative water suppliers at all?
I wouldn’t want to be living in the Thames Water catchment area and applying for PIP right now. Also, what if you’re in that position, but living on social housing that the government decides is too big for you, triggering Bedroom Tax payments? How are you going to pay what you’ll owe on the Council Tax Reduction Scheme (the Pickles Poll Tax)?
If you’re in that position, just remember it’s a Conservative-led government that put you there, in Coalition with the Liberal Democrats. Did you vote for either of them in 2010?
If so, will you do it again in 2015?
If you say yes, you’ll be entitled to PIP on grounds of insanity – but then the government will lose voters, so that won’t be allowed.
Mansel Aylward, former chief medical officer at the Department of Work and Pensions, now director of the (UnumProvident) Centre for Psychosocial and Disability Research at Cardiff University: Architect of misery?
If we know anything at all about the Work Capability Assessment for sickness and disability benefits, we know that it doesn’t work. In fact, it kills. There is a wealth of evidence proving this, and if any readers are in doubt, please take a look at the other article I am publishing today, MPs tell their own Atos horror stories.
Much has been made of this fact, without properly – in my opinion – addressing why it doesn’t work. The apparent intention is an honourable one – to help people who have been ‘parked’ on disability benefits back into work, if it is now possible for them to take employment again, and to provide support for those who cannot work at all. What went wrong?
Let’s start at the beginning. The WCA is, at least nominally, based on the biopsychosocial model developed by George Engel. He wanted to broaden the way people think about illness, taking into account not only biological factors but psychological and social influences as well. He contended that these non-biological influences may interfere with a patient’s healing process.
The idea has been developed to suggest that, once identified, the non-biological factors inhibiting healing would be neutralised via a variety of support methods. Stressful events in a person’s life or environmental factors are acknowledged as having real effects on their illness, and it can be seen that this confers a certain amount of legitimacy on symptoms that are not currently explainable by medicine.
Engel stated, in 1961, “Many illnesses are largely subjective – at least until we as observers discover the parameters and framework within which we can also make objective observations. Hyperparathyroidism… was a purely subjective experience for many patients until we discovered what to look for and which instruments to use in the search.” He also warned that people engaged in research should “see what everyone else has seen and think what nobody else has thought” – as long as they don’t automatically assume that their new thought must be correct.
The Engels theory forms the basis of the system of insurance claims management adopted by US giant Unum when its bosses realised that their profits were being threatened by falling interest rates – meaning the company’s investments were losing value – and a rise in claims for “subjective illnesses” which had no clear biological markers – Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), Fibromyalgia, Chronic Pain, Multiple Sclerosis, Lyme Disease, even Irritable Bowel Syndrome (IBS).
As I wrote on Wednesday, Unum adapted the biopsychosocial model into a new medical examination that stripped it of its ‘bio’ and ‘social’ aspects in order to concentrate on the ‘psycho’ – with a relentless emphasis on an individual claimant’s beliefs and attitudes.
The new test aggressively disputed whether the claimant was ill, questioning illnesses that were “self-reported”, labelling some disabling conditions as “psychological”, and playing up the “subjective” nature of “mental” and “nervous” claims. The thinking behind it was: Sickness is temporary. Illness is a behaviour – all the things that people say and do that express and communicate their feelings of being unwell. The degree of this behaviour is dependent on the attitudes and beliefs of the individual, as well as the social context and culture. Illness is a personal choice. In other words: “It’s all in the mind; these people are fit to work.” (as I mentioned in When big business dabbles with welfare; a cautionary tale)
Already we can see that this is a perversion of Professor Engel’s theory, using it to call an individual’s illness into question, not to treat it. Yet this is the model that was put forward to the Department of Social Security (later the Department of Work and Pensions) by its then-chief medical officer, Mansel Aylward, in tandem with Unum’s then-second vice president, John LoCascio.
Together they devised a new ‘All Work Test’ that would not actually focus on whether an individual could do their job; instead it would assess their general capacity to work through a series of ‘descriptors’. Decisions on eligibility for benefit would be made by non-medical adjudication officers within the government department, advised by doctors trained by Mr LoCascio. Claimants’ own doctors would be marginalised.
When New Labour came to power, Mansel Aylward was asked to change the test to reduce the flow of claimants with mental health problems. In came the ‘Personal Capability Assessment’, which again focused on what a person was able to do and how they could be supported back into work.
It is at this point that US IT corporation Atos Origin (now Atos Healthcare in the UK) became involved. The task of administrating the PCA was contracted out to a company which was taken over by Atos, meaning its employees – who had no medical training – could now assess claims for sickness and disability benefits, using the company’s Logical Integrated Medical Assessment tick-box computer system. These evaluations proved unreliable and the number of successful appeals against decisions skyrocketed.
So in 2003 the DWP introduced ‘Pathways to Work’, in which claimants – now labelled ‘customers’ – had to undertake a work-focused interview with a personal advisor. If they weren’t screened out by the interview, they would go on to mandatory monthly interviews where they would be encouraged to return to work and discuss work-focused activity. I can assure readers, from personal experience with Mrs Mike, that this activity remains a prominent part of the DWP’s sickness and disability benefit policy.
Mansel Aylward is no longer at the DWP, though. In 2004 he was appointed director of the UnumProvident Centre for Psychosocial and Disability Research at Cardiff University (it has since dropped the company title from its name). Was this as a reward for services rendered in getting Unum and its practices into the heart of the UK government?
Let’s have a look at some of the ‘descriptors’ that are being used to determine a claimant’s – sorry, customer’s – fitness for work in what is now called the ‘Work Capability Assessment’. I am grateful to Helen Goodman, Labour MP for Bishop Auckland, who provided this information during yesterday’s debate on the Atos WCA in the House of Commons. She said a person who…
“Cannot mount or descend two steps unaided by another person even with the support of a handrail”;
“Cannot, for the majority of the time, remain at a work station, either…standing unassisted by another person…or…sitting…for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion”
“Cannot pick up and move a one litre carton full of liquid”;
“Cannot use a pencil or pen to make a meaningful mark”;
“Cannot use a suitable keyboard or mouse”;
“Is unable to navigate around unfamiliar surrounding, without being accompanied by another person, due to sensory impairment”;
“Is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, not able to reach a toilet quickly”;
“At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration”;
“Has an epileptic fit once a fortnight”;
“Cannot learn anything beyond a simple task, such as setting an alarm clock”;
“Has reduced awareness of everyday hazards leading to a significant risk of…injury to self or others; or…damage to property or possessions such that they frequently require supervision”;
“Cannot cope with minor planned change” such as a change to lunchtime;
“Is unable to get to a specified place with which they are familiar, without being accompanied by another person”
… is “fit for work”.
A person in the following category is also deemed fit for work, if: “Engagement in social contact with someone unfamiliar to the claimant is always precluded due to difficulty relating to others or significant distress experienced by the individual.”
Kate Green, Labour MP for Stretford and Urmston, added: “My constituents told me categorically last week that they believe that the whole system was deliberately designed and operated to trick them — to make them incriminate themselves and to catch them out.
“They firmly believe that the system is deliberately designed, not to assess and then help them into work if they are fit for it, but simply to stop paying benefits wherever possible.
“There are far too many instances of trickery and misleading people and of distorting what they have done, said and reported and drawing conclusions from that. That is happening far too often.
“It is an absolute disgrace that we should run a public assessment process in such a discredited way.”
It seems to be a result of Professor Aylward’s work that the main influence on government welfare reform has been a perversion of a perversion of a theory that has not been shown to work. Authentic evidence is disregarded by those in power, who clearly continue to persecute the sick while feeding the profits of private concerns.
I wonder what he would have to say, if he were to be confronted by the evidence of what his policies have done to the sick and disabled of this country – as spelled out, in the House of Commons, by MPs from many parties.
Afterthought: It should be noted that Professor Aylward is on record as having expressed doubts about the Work Capability Assessment and the current system, as run by the government, with the caveat that he has not been involved for several years.
He told the Black Triangle Campaign: “I will make myself aware … but I think that I’m a man of integrity … and if I think that the Work Capability Assessment … test or whatever … is not proper … I will speak out against it.”
In the light of what happened while he was at the DWP, I leave it to readers to judge whether he will.
The most telling moment in today’s (September 4) Westminster Hall debate on Atos and Work Capability Assessments came when Chris Grayling was delivering his speech. A woman shouted, “You’re killing us!” and was immediately told to shut up or the public gallery would be cleared.
It was an act of insensitivity that put into a nutshell the Coalition government’s attitude to public discontent over its Work Capability Assessment regime for claimants of the new Employment and Support Allowance (and soon, the new Personal Independence Payment); it doesn’t care what we say, it will carry on doing what it wants, and it will lie to us about what that is.
I was listening to the debate and watching responses on Twitter. John McDonnell MP tweeted: “Protesters sum up exactly what this debate is all about. The Atos system is causing immense suffering & killing people.”
Mr Grayling did not address these concerns in his speech.
He said the DWP would not be changing the controversial ‘descriptors’, that are used in WCAs by the tick-box assessors, who need them to understand whether any person’s abilities mean they deserve a much-coveted place among the 13 per cent of claimants in the ‘Support Group’ – or whether they should be turfed out into the ‘Work-Related Activities Group’ or market “Fit For Work”.
But a potential new set of descriptors, more appropriate to the conditions suffered by the sick and disabled, is still being considered. Where’s the truth?
He said the assessment regime had “no financial targets”. This was a flat-out lie. We know there are targets because Atos trainers made that perfectly clear in the recent Dispatches and Panorama documentaries on the subject.
“Atos do not take decisions.” Another lie. The DWP decision-makers rubber-stamp Atos recommendations in the vast majority of cases.
He repeatedly told us the process was “not an exact science” before contradicting himself by stating that the government wants to “get it right”.
Before he got up to speak, the criticisms had been mounting up like a tidal wave against him. All to no avail, as he sailed on, oblivious.
“How many people have died between being rejected and their appeal, and how many committed suicide?” This was a question I was hoping to hear, as this blog has been criticised for using the “32 deaths per week” statistic. No response to that one, though!And what about corporate manslaughter? The issue wasn’t even raised, but the government – and Mr Grayling, together with his (now former) boss Iain Duncan Smith – might be guilty of killing thousands.
“Will claimants still get ESA while they ask for a reconsideration?” The current answer is no. Judging from the lack of response in the debate, that will remain the case.
Assessors’ lack of mental health knowledge came up time and time again.
One MP after another got up to speak, making it clear that they had all received multiple accounts of mistreatment at the hands of a company that clearly couldn’t give… well… Atos: “There cannot be an MP that hasn’t heard terrible constituent stories over WCAs.”
Labour MP Stephen Timms made some strong points. He pointed out the fluctuating nature of many claimants’ conditions, and warned that the work capability assessment does not take account of changes. “The WCA must not be a snapshot,” he said, and went on to add that the test needs “radical improvement”.
He admitted that Employment Support Allowance was a Labour initiative – but made it clear that the Coalition rolled it out before trials to ensure it was fit for purpose had been completed.
And Dame Anne Begg MP won praise for listing poor decisions by assessors and the failings at Atos, repeating, like a mantra: “When people feel this persecuted, there is something wrong with the system.”
She called for the contract to be re-written, saying it “can’t be fixed with a few tweaks here and there”.
Tom Greatrex, who opened the debate, said too many people were being found fit for work when they weren’t fit at all. He said the £60 million cost of appeals against assessment findings meant the taxpayer was effectively paying for a system that doesn’t work, then paying again to put it right. He said details of the Atos contract should be made public (a forlorn hope; confidentiality is a large part of many government contracts with private firms, although the Atos contract is particularly vague).
And he pointed out that, although Mr Grayling had said the transfer schedule for moving people off Incapacity Benefit and onto ESA was on-target, it was in fact very far behind, with waiting times up by 85 per cent.
Honourable mention was given to the disability campaigns Disabled People Against Cuts (DPAC) and Black Triangle. Dishonourable mention was made of police brutality at last Friday’s protest outside the headquarters of Atos and the DWP in London.
Calls were made to reduce unnecessary assessments (of people whose condition was unlikely to change), anger was expressed that Atos is a sponsor of the Paralympics. The debate heard that applicants find the process of going through the Work Capability Assessment terrifying (I can personally attest to this, having witnessed my girlfriend’s. Terrifying and humiliating) – and that it was felt to take away their dignity as human beings.
Sadly, nobody called for a comprehensive study of the mortality rate.
Not one single Coalition backbencher indicated a desire to speak.
Amid all this, one online wit tweeted: “I do hope Osborne comes in at the end to take the now-traditional booing” – a reference to an incident the day before, which has already become infamous, when the Chancellor appeared at the Paralympics to hand out medals and was booed by the 60,000-strong stadium crowd.
Sonia Poulton, the Daily Mail columnist who became a campaigner against Atos, summed up the event: “W-C-A….SEIZE THE DAY! Yes, Labour started it, we ALL know that now…but Con-Dems butchered like never before. Time to get rid!”
If only we could.
For another perspective on the debate, please see the BBC website’s report at – oh. There isn’t one.
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