Tag Archives: Kevan Jones

DWP/Atos/WCA: Unanswered questions demonstrate the Coalition’s cruelty

Mark Hoban, sending even his colleagues to sleep in another Parliamentary debate.

Mark Hoban, sending even his colleagues to sleep in another Parliamentary debate.

Citizens of the United Kingdom probably take it for granted that the quality of debate in the House of Commons is usually very high (Prime Minister’s Questions being the dishonorable exception) and that all the questions raised in that place receive an answer.

How sad to see that this is a comfortable lie.

The Minister of State at the Department for Work and Pensions, Mark Hoban, directly answered only 10 questions, among the dozens that were put to him at the debate on Atos’ handling of the Work Capability Assessment (WCA) for Employment and Support Allowance on Thursday.

He added a handful of ‘answers’ that were not related to specific questions, and left a great deal of very important issues hanging.

It is interesting that Mr Hoban was the minister who attended the debate. Here in the UK we do, in fact, have a minister dedicated to the needs of disabled people. At the moment, that minister is Esther McVey. Where was she on Thursday afternoon and why did she not take part in this important debate?

Let’s have a look at the questions that were graced with responses. I think we’ll see the reasons for Mr Hoban’s choices very quickly.

“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.

“Professor Harrington [Malcolm Harrington, who was hired by the DWP to lead three independent reviews of the assessment system] has made it quite clear that the WCA, designed as a first positive step for work, is the right concept for assessing people who need our support. There is a need to improve it. No one doubts that, which is why we have implemented Professor Harrington’s recommendations. The assessment we inherited needed refinement. That is why we accepted and have largely implemented more than 40 of his recommendations over the past two years. That is why twice as many people have gone into the support group in comparison with when ESA was introduced.”

His colleague, Charles Walker (Con, Broxbourne), did not seem to share Mr Hoban’s glowing opinion of these improvements to the system. He asked: “Does my hon. Friend share my fear that the reputation of Atos may be so damaged that it can never really be effective? Perhaps the time has been reached when we need to park Atos and move on in a different direction.”

In response, the minister said: “Let me deal with the issue of Atos’s capability. Atos deals with 100,000 cases every month and it consistency meets the quality thresholds. Only 3.6 per cent of assessments are below standard compared with a threshold of five per cent. It receives complaints about only 0.6 per cent of assessments. DWP decision makers return to Atos assessments that are inadequate for reaching a decision in only 0.2 per cent of cases.”

Note that we are not told what these quality thresholds may be, so let’s turn to the question from Natascha Engel (Lab, North East Derbyshire), who said: “The proportion of original Atos decisions that are overturned is shocking—it is about 30 per cent or 40 per cent. I would be grateful if the Minister replied to that point. Precisely how many people deemed fit for work by Atos have their decisions overturned on appeal and are signed off work?”

Get ready for a shock because this is where Mr Hoban departed from the script with which we’re all familiar: “Let me be clear about the rate of successful appeals. Of all the fit-for-work decisions taken by the Department, only 15 per cent are overturned on appeal. Only 15 per cent of all the decisions we take, then, are overturned on appeal, which I think demonstrates that while we need to ensure that there is a proper appeals process, we should not be bandying around figures that misrepresent the level of successful appeals.”

Only 15 per cent? Where did he get that figure? Other MPs quoted the 40 per cent figure in the debate, including some who had received it as a reliable figure in committee. Perhaps Channel 4’s FactCheckers should get onto this one!

Look, here’s Austin Mitchell (Lab, Great Grimsby) making that exact point: “As our Committee was told, 38 per cent of the cases that go to appeal—I advise all my cases to go to appeal—are successful in reversing the verdict. That demonstrates its inadequacy and the enormous cost in the reassessment process at appeal, a cost that is not taken into account in the Government’s estimates of the savings produced by the system. [We’ll come back to those costs later, although we won’t get an answer to that question] Those reassessments are usually done with the help of the patient’s own doctor, so I do not see why their doctor’s view cannot be invoked and used at an earlier stage in the process. After all, the Government are giving more power to the doctors and claiming that they represent the patients. The doctors know the long-term conditions—they are treating the patient—so why are their views not taken into account by Atos at the start?”

The closest I could find to a response was in fact an answer to a question from Sheila Gilmore (Lab, Edinburgh East): “When we asked judges why they overturned DWP decisions, they said that an error in the Atos assessment was the primary reason for an overturn in only 0.3 per cent of cases. However, although it happens very rarely, I agree with her on one point: I would like to get more information from the judges.” [I was later told that the prime reason for overturns is medical evidence from claimants’ doctors that was ignored by the Atos assessors and DWP decision-makers]

Moving on to specific issues, of the seven questions asked by Michael Meacher (Lab, Oldham West and Royton), Mr Hoban answered only one. That in itself should tell you how selective the responses were, and how little real information was in fact released. Mr Meacher asked: “Will the Minister accept that the current criteria and descriptors do not sufficiently—or even at all—take into account fluctuating conditions, especially episodic mental health problems? How will he rectify that?”

“That is not the case,” said Mr Hoban. “It gives people with a fluctuating condition the opportunity to explain how their condition varies over time. It is not a tick-box assessment, as some have suggested. There is a discussion between the health care professional and the person making the claim for ESA to determine how their condition varies over time. The questionnaire that customers are sent has been redesigned for that purpose, and people are now asked to give more details about how their fluctuating condition affects them as an individual. If a person cannot carry out a function repeatedly and reliably, they will be treated as unable to carry out that function at all. We all recognise that the capacity of people with a fluctuating condition can change, and it is important that proper regard should be given to that fact.”

How interesting, then, that Stephen Timms (Lab, East Ham) asked when changes to the descriptors for fluctuating conditions and mental health conditions, which were recommended months ago by the disability organisations, would be implemented!

Mr Hoban said: “We have committed to a review of the descriptors for fluctuating conditions, and we are working closely with charities on that. We also need to ensure that any new descriptors are as good as, or better than, the existing ones, for the purpose of assessing someone’s condition. That work is going on at the moment.”

So either people with fluctuating conditions already have a glowingly redesigned new questionnaire to help them make their condition understood, or it is being reviewed at the moment. Which is it?

Former Welsh Secretary Cheryl Gillan (Con, Chesham and Amersham) picked up on the mental health issue with some questions of her own. Firstly: “More than 2,000 people have signed a National Autistic Society petition to Atos, which was launched following the ‘Dispatches’ and ‘Panorama’ investigations, with which many of us are familiar, into the company last year. The programme claimed that Atos was working to internal targets on the numbers of people being put into the work-related activity group, the support group or as being fit for work. Atos has indicated that it is open to working with the National Autistic Society and other charities, including in the context of this petition, but I have a specific question for the Minister. Will the Minister provide assurances that no such targets are in place?”

He did: “Several hon. Members suggested that Atos had targets for finding people fit for work or placing them in a particular group. Let me be absolutely clear—let nobody in or beyond the House be in any doubt—there are no such targets. There are no targets for who should be put into which group. Instead—hon. Members would want this—there are quality-control checks.”

I do not believe this. I saw the ‘Dispatches’ programme mentioned by Mrs Gillan and it was stated loud and clear by an Atos trainer that there are targets, and they are harsh. A statement to the contrary by a representative of a government that has been more than economical with the truth? That’s not going to cut any ice with me.

Mrs Gillan went on to address the work of new ‘mental and cognitive champions’ employed to advise Atos assessors: “How many of the mental and cognitive champions currently operating at Atos assessment centres have specific autism training? Do WCA assessors receive autism-specific training? If so, of what does it consist?”

Mr Hoban’s response: “I can assure her that that is the case.” But he avoided details.

She asked how he will monitor the effectiveness of the introduction of those mental and cognitive champions, but Mr Hoban slithered away from that question: “It is not for me to dictate the work that Professor Harrington’s successor will undertake as part of the fourth review, but I think that that is a good suggestion. We need to look at the effectiveness of the recommendations that Professor Harrington has made.”

Picking up on the mental health issue, Madeleine Moon (Lab, Bridgend) asked: “We are told that specific support staff for mental health will be provided. Are they in place? Are they aware of the trauma of post-traumatic stress disorder?”

Mr Hoban chose to wax lyrical for a moment: “It has also been said that the work capability assessment does not take full account of mental health conditions. Let me say a bit about that important issue. We have sought to improve the process and the support for the health care professionals who are undertaking the assessments. All Atos health care professionals receive specific and additional training in assessing mental health conditions—Atos has 60 mental health function champions in place to spread best practice.”

Mr Hoban also went on to answer questions that were not, in fact, raised directly in the debate. Perhaps he has a guilty conscience! Let’s look at them briefly.

“It has also been suggested that Atos health care professionals make decisions on benefit entitlement. They do not. Those decisions are made by DWP decision makers.” We know from the previously-mentioned TV documentaries that DWP decision-makers just rubber-stamp the Atos assessors’ recommendations in the vast majority of cases. This is not a reassuring answer.

“It has been suggested that GPs should make the assessment. The British Medical Association has been prayed in aid. Let me quote what the BMA said about that idea: ‘However, it is not part of the GP’s role to provide any opinion…on the patient’s capability to work as part of this process. It is vital that these two roles are kept separate and that GPs are not asked to provide an opinion on their patient for the purpose of receiving the Employment and Support Allowance; doing so could damage the doctor-patient relationship.'” The BMA has already been approached to repudiate that remark; or at least to provide an explanation of what it meant.

“My hon. Friend the Member for Stafford [Jeremy Lefroy] talked about quality. The tribunal service can refer substandard reports back to Atos as an appeal for further action. It has exercised that right only 23 times in the past year. Rigorous checks are in place to ensure that quality applies.” But this number does not include the amount of appeals that they allowed without reference back, of course.

Now here’s his summing-up, with a few things he wanted to shoehorn in but didn’t have the opportunity anywhere else: “Overall, the proportion of people with mental health conditions being awarded ESA has risen from 33 per cent to 49 per cent. We are seeing improvements and more will be introduced later this month on the categories of cancer treatment that allow people to go straight into the work-related activity group. These changes are happening. We should recognise that change is important and that it is happening.

“This is the right approach,” he said in conclusion. “Demonising the work capability assessment does not help our constituents and does not address their concerns.”

If you weren’t shocked by that last sentence, you haven’t been paying attention to the Atos debate. The whole point is that it is the Work Capability Assessment that does not help our citizens or address their concerns. Demonising it (he’s stealing the word from protestors, who have been using it to describe the government’s attitude to the sick and disabled it is persecuting) is the only way to fight what is happening. But I refer you to the Skwalker blog for a detailed analysis of that statement.

Those were all the questions that were answered by the minister. He did his best to paint a rosy, “nothing’s wrong” picture of the system. But he did so by ignoring important statistics and questions raised by them.

Perhaps he hoped that nobody would notice – or that we would not be cheeky enough to put him on the spot.

Too bad. If that is the case, I intend to misbehave! In this spirit of mischief, let’s look at the questions for which Mr Hoban had no answer, starting with those raised by Mr Meacher:

“How can pursuing with such insensitive rigour 1.6 million claimants on incapacity benefit, at a rate of 11,000 assessments every week, be justified when it has led, according to the Government’s own figures, to 1,300 persons dying after being put into the work-related activity group, 2,200 people dying before their assessment is complete, and 7,100 people dying after being put into the support group?” (NO RESPONSE)

“Is it reasonable to pressurise seriously disabled persons into work so ruthlessly when there are 2.5 million unemployed, and when on average eight persons chase every vacancy, unless they are provided with the active and extensive support they obviously need to get and hold down work, which is certainly not the case currently?” (NO RESPONSE)

“It is true that Harrington has produced minor adjustments—implemented at a glacial place—but the underlying system remains largely undisturbed. The BMA and the NAO have therefore called for a thorough, rigorous and transparently independent assessment of the suitability of the work capability assessment. Will the Minister now implement that?” (NO RESPONSE)

“Will the Minister provide full and transparent details of the Atos contract? They should not be hidden by specious claims of commercial confidentiality when Atos is the sole provider of what is clearly a public service. Better still, given that Atos has failed so dramatically, why does he not in-source the work back into the NHS?” (NO RESPONSE)

“How will the Minister ensure that the medical expertise of disabled persons’ doctors and related professionals is fully taken into account before assessments are completed?” (NO RESPONSE)

“I want to provide a full dossier to the Secretary of State so that he fully understands what is being done today in his name, and to bring a small delegation to see him from some of the excellent organisations of disabled people who have heroically battled to highlight and tackle the distress and pain caused by Atos. Can I please be assured that the Secretary of State will see such a delegation?” (NO RESPONSE)

Mrs Gillan asked: “What steps will the Government take to ensure that Atos collects existing evidence relating to a claimant’s capability to work, which would create a more cost-effective and streamlined system?” (NO RESPONSE)

Natascha Engel asked: “How many people deemed fit for work who do not take their cases to appeal then find work?” (NO RESPONSE)

“Is it really for the best to sign people as fit for work when there are no jobs to be had?” (NO RESPONSE)

“How many of them are getting a job, and how many of them are just being signed over to destitution?” (NO RESPONSE)

Pamela Nash (Lab, Airdrie and Shotts) said: “The Minister’s predecessor, the right hon. Member for Epsom and Ewell [Chris Grayling], made it clear in a Westminster Hall debate last September that he felt that Atos “should make recording available on a voluntary basis”. However, not a single constituent of mine who has come to see me about work capability assessments has told me that they have been offered the prospect of having it recorded. In fact, one constituent told me that she had asked for her assessment to be filmed, following her previous assessment, which resulted in a report that bore little resemblance to that assessment. On that occasion she was found fit for work, but she subsequently won her appeal. She was informed that recording would indeed be possible, but that she would have to pay for a private, independent company to come in to record her assessment. Equipment was not made available to her. She had hoped to take a family member in to film the assessment, but was told that this would not be allowed or appropriate. How on earth is a person living on benefits—living on the breadline—supposed to be able to afford to pay a private company to record their assessment?” (NO RESPONSE)

“Will Atos reschedule an assessment date if the person concerned is told that equipment is not available on the original date?” (NO RESPONSE)

“In the event that a claimant refused to go through with an assessment without a recording, would they be sanctioned in terms of their benefits?” (NO RESPONSE)

Debbie Abrahams (Lab, Oldham East and Saddleworth) asked: “Why does the hon. Gentleman think the Department for Work and Pensions and Atos have been unable to accept the recommendations of the British Medical Association and the Royal Colleges for more specific diagnostic tests that would make the assessments more appropriate?” (NO RESPONSE)

Kevan Jones (Lab, North Durham) asked: “The first contract with Atos was introduced by the previous Government, but why did the present Government renew and extend that contract even though they knew about all the problems that he and others have raised in the House?” (NO RESPONSE)

“The system is also costing the taxpayer money, not only through the additional health care provision for those with mental health conditions but through the extra work load on GPs, the tribunal system, which is at breaking point, and the reassessment system. The other week a 60-year-old nurse with osteoporosis, who has spent 38 years in the NHS, came to see me. She failed the work capability test. She is 61 in April and is now being told that she will be retrained for a new career until she is 62, when she gets her pension. What on earth is the point in wasting money on individuals like that?” (NO RESPONSE)

“There are also cases such as the 21-year-old young lady who ended up in the local psychiatric hospital because she failed the Atos interview. What is the cost of that to the NHS?” (NO RESPONSE)

Kevin Brennan (Lab, Cardiff West) asked: “The head of Atos was recruited from Unum in the United States. Is it not disturbing that the lieutenant governor of California has stated that Unum was operating ‘claims denial factories’ for working men’s compensation?” (NO RESPONSE)

Mrs Moon asked: “Atos received £112.8 million in 2010-11 for its DWP services. About 60 per cent of all claims are judged fit to work; 41 per cent of those people appeal, and 38 per cent of those appeals are successful. Last year, appeals cost £54 million. How can that be seen as value for money? How can this be seen as evidence of a supportive and caring Government in action?” (NO RESPONSE)

“Is sensitivity training available, because it has certainly not been made available to the ex-GP who works as an Atos assessor in my area?” (NO RESPONSE)

“Has the DWP looked at the cost—to Members, to citizens advice bureaux and to welfare rights organisations—of fighting this iniquitous system?” (NO RESPONSE)

Jeremy Lefroy (Con, Stafford) asked a couple of real questions, besides the non-existent one that Mr Hoban answered. They were: “There are cases in which people have had to wait for up to a year before winning appeals and then immediately face another work capability assessment, so the whole process starts again. Why cannot such people be given at least a considerable period of grace?” (NO RESPONSE)

And: “Do the health care professionals employed by Atos always take account of the fact that people have to get to work in the first place, or that, while they may be able to perform an action once, they may not be able to perform it repeatedly when it causes severe pain?” (NO RESPONSE)

Andrew Stunell (Liberal Democrat, Hazel Grove) asked: “Would not speeding up the appeal process also relieve stress and bring about certainty much more quickly?” (NO RESPONSE)

Sarah Newton (Con, 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.” (NO RESPONSE)

Ian Mearns (Lab, Gateshead): “The Minister for disabled people, the hon. Member for Wirral West (Esther McVey), told this House that by October 2015 560,000 claimants will have had their assessments, and 160,000 will get a reduced award, 170,000 will get no award, and 230,000 will get the same support. How can we know the assessments are valid when we have had such a prediction?” (NO RESPONSE)

Iain McKenzie (Lab, Inverclyde): “What does the Minister think of Citizens Advice’s detailed year-long study “Right first time?” on the controversial work capability assessment run by Atos, which has revealed evidence of widespread inaccuracies in the medical reports that help to determine whether individuals are eligible for sickness benefits? Citizens Advice also tracked a group of people through the process of claiming employment and support allowance and looked at how their claims were handled. The report’s conclusions are stark: 37 individuals were tracked and had their reports examined, with serious levels of inaccuracy revealed in up to 43 per cent of the reports. That level is significant enough to have an impact on the claimant’s eligibility for benefits—surely our sick and disabled deserve better than this.” (NO RESPONSE)

“Is it not better to have an accurate, fair and just system of medical assessment, one that claimants know will treat them fairly and with the humanity they deserve, rather than a system that is, frankly, unfit for purpose and that uses a company, Atos, that instils fear and loathing in people, resulting in a system where people are continually appealing against decisions? We have already heard that the success rate against the decisions is about 60 per cent.” (NO RESPONSE)

Heather Wheeler (Con, South Derbyshire): “When someone drops down dead within three months of being assessed as being perfectly capable of going back to work, what is the review process for Atos?” (NO RESPONSE)

Julie Hilling (Lab, Bolton West): “Why are Atos and the Department for Work and Pensions cruelly finding people fit for work or putting them in the work-related activity group when they are clearly unable to work?” (NO RESPONSE)

“People being placed in the work-related activity group is the next scandal. When people score 15 points and are found not fit for work, but are put in the work-related activity group, they will lose their benefit after 365 days. Is that another way of saving money, but one that also puts disabled people into abject poverty and causes them terrible stress?” (NO RESPONSE)

“Why do the assessors give more weight to work capability assessment descriptors than to professional medical assessments?” (NO RESPONSE)

“Why do they reassess people who have just won their appeal?” (NO RESPONSE)

“Why do they not record the number of people who die through illness or suicide when being rejected for disability benefit?” (NO RESPONSE)

“Why do they not track people who have been found fit for work and people who no longer receive benefit?” (NO RESPONSE)

“How much do all the botched assessments cost us?” (NO RESPONSE)

And Sheila Gilmore asked: “Research commissioned by the previous Government, which I understand is not being continued by this Government—the Minister might reassure us on that—found that 43 per cent of those found fit for work were neither in work nor in receipt of an out-of-work benefit a year later. We must ask where they are. What is happening to them?” (NO RESPONSE)

The conclusion? This is a government that is perfectly happy with a system that is throwing thousands of sick and disabled people to the wolves. It has made – or is making (Mr Hoban wasn’t all that clear) – cosmetic changes in the hope of diverting our attention. As long as the claimant figures are coming down, they will be happy.

As long as claimant figures are coming down.

Yesterday, in my article The High Street implosion is just beginning, I advocated the ‘constructive dismissal’ of the Coalition government by making its work so difficult that it couldn’t go on. If I was feeling mischievous, in the light of the evidence, I think I would suggest that we all ruin that drop in claimant figures by going out and filling ESA50 forms of our own – whether we deserve the benefit or not.

Clearly this government intends to keep Atos in work, so we may as well make it work hard!

MPs tell their own Atos horror stories

Atos: Welcome to HellWhat follows are the stories told by members of Parliament about their constituents’ experiences of the Work Capability Assessment that is conducted by the private contractor Atos, which uses a tick-box computer system to assess the fitness for work of Employment and Support Allowance claimants (and soon, claimants of the Personal Independence Payment as well).

The system is itself based on one that was devised by the insurance company Unum, notably to cut down on payouts of insurance claims. Unum’s system was based on a theory known as the biopsychosocial model, devised by a Professor Engel.

This article is intended to be read in tandem with the other piece I am publishing today, Unum, Atos, the DWP and the WCA; Who gets the blame for the biopsychosocial saga?, in which I discuss the origins of the Atos assessment and hope to demonstrate that it is a perversion of a perversion of an original theory which – in any case – has not been proved. The aim of this article is to show what such distortions can cause.

The many cases quoted here are just a fraction of the total, but I believe they were representative of what is happening across the UK, and illuminated a high-quality debate that was let down only by the response of the Minister at the end (quoted in Persistent misdirection will perpetuate the Atos nightmare published yesterday). I urge you to read to the end, if you can bear it, because this should give you a good grounding in the issues facing sick and disabled people across the country.

Michael Meacher (Oldham West and Royton) (Lab): I have been sent nearly 300 case histories, many of which make heart-rending reading. I cannot begin to do justice to their feelings of distress, indignation, fear, helplessness and, indeed, widespread anger at the way they have been treated.

The first example concerns a constituent of mine who was epileptic almost from birth and was subject to grand mal seizures. At the age of 24, he was called in by Atos, classified as fit for work and had his benefit cut by £70 a week. He appealed, but became agitated and depressed and lost weight, fearing that he could not pay his rent or buy food. Three months later, he had a major seizure that killed him. A month after he died, the DWP rang his parents to say that it had made a mistake and his benefit was being restored.

The second example, also from the Oldham area, concerns a middle-aged woman who was registered blind and in an advanced stage of retinitis pigmentosa. She was assessed at 9 points—well short of the 15 that are needed—and her incapacity benefit was withdrawn. On review by a tribunal, the Atos rating of 9 points was increased to 24.

The third case—I could have chosen from hundreds of others—also comes from the north-west and concerns an insulin-dependent diabetic with squamous cell cancer, Hughes syndrome, which involves a failed immune system, peripheral neuropathy, which meant that he had no feeling in his feet or legs, heart disease, depression and anxiety. Despite his life-threatening condition, he was placed in the work-related activity group.

Cheryl Gillan (Chesham and Amersham) (Con): More than 2,000 people have signed a National Autistic Society petition to Atos, which was launched following the “Dispatches” and “Panorama” investigations, with which many of us are familiar, into the company last year.

Ian Mearns (Gateshead) (Lab): I am sure that my hon. Friend will not be surprised to learn that in Gateshead, of the 1,400 cases taken to appeal by the citizens advice bureau, more than 1,200 were successful.

Stephen Gilbert (St Austell and Newquay) (LD): 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.

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.

Pamela Nash (Airdrie and Shotts) (Lab): I have had a frail lady sitting in my office who had only recently finished chemotherapy but had been told she was fit for work. I have had a lady who suffered 90 per cent burns to her body—she spends every day in severe pain—and was told that she was now ready to join the Work programme. I could list hundreds of others—sadly, these are very familiar stories. I am sure [Caroline Lucas, who had just spoken] has had the experience, as I have, of seeing people who have claimed employment and support allowance as a result of a physical disability or illness ending up with mental health problems owing to the stress of going through the system.

Madeleine Moon (Bridgend) (Lab): My caseworker, like those of many Members, is inundated with cases that are tragic and heart-rending. The telephone line to my office is often clogged with crying people. They often ring several times a day, as they are unable to cope with the stress that they are facing. Many have mental health problems, and are unable to cope with the paperwork. They are unsure what to do with it, and they ring me to ask for help in the most tragic and personal way.

I want briefly to describe some of the cases that I have been dealing with. I shall start with 53-year-old Mrs E, who was employed as an accounts officer. She was a very able and capable woman. She suffered a vicious sexual attack, and was diagnosed with post-traumatic stress disorder. Her health problems caused her difficulties with working, and she was forced to take redundancy. She started claiming employment and support allowance, and attended her Atos assessment. The doctor who saw her is well known to me. I have received many complaints about him. I regularly receive complaints about his rudeness, arrogance and total lack of compassion towards the people whom he is assessing. He made unprofessional remarks to Mrs E, and bluntly told her carer to shut up, saying that he did not want to hear from him.

An official complaint was made, but Mrs E was found fit for work. An appeal judge overturned the decision maker’s decision and she was placed in the support group.

Three months later, she faced another Atos medical, and it was decided that she would be fit for work in six months. She was then placed in the work-related activity group. A month later, because of the stress, her mental and physical condition had deteriorated, and medical advisers told her to apply for disability living allowance. DLA was refused because of the original Atos report. When it was pointed out that the report was negative, but had been overturned on appeal, a reconsideration was requested. The DWP insisted that the information from the first Atos assessment was sound and that the only option was to appeal to the first-tier tribunal.

My constituent then faced two tribunals. We should remember that this is a lady with post-traumatic stress disorder. She faced two appeals. The first was for DLA. The decision to award the lower rate for mobility and care was backdated. Since then, another DLA application has raised the mobility and care components to the higher rate. The second appeal tribunal was for the employment and support allowance. She was placed in a support group and her benefit was backdated.

That was not the end of this lady’s trauma. Her mental health had deteriorated to the extent that she attempted to take her own life. Her carer has to remain constantly vigilant. A few months later, she received a letter saying she had been transferred back to the ESA work-related activity group from the support group. Payment for the ESA support component was stopped. Following some investigation, the DWP apologised and said that that was a random “administrative error”, but it affected the lady very badly and her mental state became even more fragile.

Despite that, incredibly, on Christmas eve last year the same “administrative error” occurred. My office was contacted, and I have to say that we were extremely angry. The additional stress was placing this lady in a suicidal position again. The application process started again, and yet again there has been an apology for an “administrative error”. This lady is being hounded by the state: there is no other way of describing it. There is no excuse for this behaviour. This is a company that is not playing fair by this country’s most vulnerable people.

Annette Brooke (Mid Dorset and North Poole) (LD): Let me read out a few comments from one of my constituents, who says: “I do not believe that the WCA is working for people with mental health problems. Too many people are found fit for work when they are not, and are becoming trapped in a distressing and expensive cycle of appeals and reassessments. Too much of the decision making is inaccurate and too often the WCA and related processes worsen people’s mental health.”

Valerie Vaz (Walsall South) (Lab): Constituents have come to me in their wheelchairs with their carers because they have wanted me to know about the difficulties that they are experiencing. They cannot understand why, in the face of overwhelming medical evidence, they are still being called in for interviews. Some cannot understand why they have been told “If you make it to this interview, you must be fit for work.”

SD has cancer and is undergoing radiotherapy; she has been declared fit for work.

SH suffered seven strokes, and also suffers from type 2 diabetes and a liver condition; she has had to appeal against a decision.

KH was placed in a work-related group; she has incontinence of bowel and bladder as well as diabetes, and is partially sighted.

CS has received zero points despite having a spinal disc prolapse.

SA suffered a stroke and is blind, but has still been declared fit for work.

LM has arthritis of the spine, and has had to appeal against a decision.

Stephen Nye was so angry that he came to see me on behalf of his father, and said “I want to let you know what is going on. Sick people are being persecuted: the assessment system is flawed, and they are being harassed by the jobcentre.”

MD came to see me with her husband, who is blind and deaf. They told me that the work capability assessment did not take account of the issues faced by blind and partially sighted people. I wrote to the Minister’s predecessor, who replied that Professor Harrington had had considerable engagement with the Royal National Institute of Blind People, Sense, and Action on Hearing Loss. However, that was only at the time of the professor’s third review—it should have happened before the assessments had even been devised—and only at the time of his second review did he suggest the introduction of sensory descriptors and an additional descriptor addressing the impact of generalised pain and/or fatigue.

Nia Griffith (Llanelli) (Lab): Does my hon. Friend share my utter despair at the sheer amount of money that is wasted on calling in people whose well-documented histories clearly show that they suffer from conditions which, sadly, will not improve in any way, rather than being spent on trying to find ways of helping those who are in a better position to go back to work?

Jonathan Edwards (Carmarthen East and Dinefwr) (PC): In my surgeries, I have heard several harrowing and very sad accounts from constituents who have been subjected to impersonal and inhumane work capability assessments by Atos. One has been diagnosed with an aggressive brain tumour, which cannot be completely removed because that would leave her paralysed. In August and September of last year she had radiotherapy to slow down the growth of the tumour, but in October she was told that it would grow back even more quickly, and that she would have to have further radiotherapy or she would die. I should add that this lady also has polyarthritis and asthma. Why has this lady been placed in the work-related activity group? Her doctors and consultants have specified that she should be placed in the support group as she is fighting for her life. Her only concern should be winning that battle.

Another constituent contacted me who had been ill for two years and was eventually diagnosed with cancer following a serious bout of pneumonia. Prior to her illness, she had an unblemished employment record. She was certified as unable to work by her GP and had attended many DWP hearings about the employment and support allowance, with the final one being in April 2012. She won her tribunal hearing against the Atos decision. She had not received a single penny in state benefits from before April 2012 until she died at the end of November. She faced immense distress and was denied any financial assistance at a time when she was vulnerable and in desperate need of assistance.

Iain McKenzie (Inverclyde) (Lab): Let me outline briefly some of the cases that have been brought to my surgeries, on the back of a recurring issue now being referred to by my constituents as the “Lazarus letter”. This is a letter they receive instructing them to make their way to Glasgow for assessment and containing many connotations about what will befall their benefits. A constituent who suffers from severe cerebral palsy and could not travel was refused a home visit and told to go to Glasgow to be tested. Another constituent who was recovering after being seriously injured in an accident was advised to attend an Atos assessment in Glasgow. Both those constituents could not possibly travel because they were in so much pain, and I had to get involved and ask for a home assessment for them. It does not end there because they then had their benefits cut or stopped because Atos sent the assessment forms to the wrong address. If it cannot get the address right, what chance does it have with assessments?

Dr Eilidh Whiteford (Banff and Buchan) (SNP): The very first constituent who came to me for help and who had been found fit for work was a man who could not climb the stairs in his own house to go to the toilet. He came to one of my surgeries which had disabled access, but he needed help from relatives to do so and it was quite an ordeal. His GP rather euphemistically told me that the man had “a poor prognosis”, and the man has absolutely no prospect of getting back into the labour market. He successfully appealed against the decision, but it emerged in that process that no account had been taken of his GP’s documentation or of the evidence supplied by his hospital consultant.

I have encountered incontinent patients being asked to make four-hour round trips on public transport.

I have also encountered constituents who have had to make very long journeys by public transport only to find that their appointment is not double-booked, but triple-booked.

Heather Wheeler (South Derbyshire) (Con): Long-term disabled people have come back into the work arena; unbelievably, within three months of being told that they are perfectly fit for work, they have dropped down dead.

John McDonnell (Hayes and Harlington) (Lab): I […] refer Members to Calum’s List, which has a website. It is a list of people who have died, including by suicide, as a result of, or where there has been a contribution from, the loss of benefits. The first example on the list was that of Paul Reekie. Some Members may have known Paul, an award-winning writer and poet in Leith, Scotland. He did not leave a suicide note, just two letters on the table beside him. One was about his loss of housing benefit and the other was about his loss of incapacity benefit. He died.

The other example is that of Mark and Helen Mullins from Bedworth. They could not access their benefits. They were walking 10 miles a day to a Salvation Army soup kitchen. They committed suicide together because they could not access their benefits. Read Calum’s List, which has example after example of the brutal effect of the system.

Kevan Jones (North Durham) (Lab): A lot of constituents come to see me at my surgery about this, and I should like to give an example. The individual I mentioned is a 59-year-old who suffers from severe schizophrenia. He failed the Atos interview and is now being told by the DWP that he should be retrained as a security guard because that was the last job he did 10 years ago. What a waste of resources. This is despite his GP writing a letter on his behalf, which I have seen. I know his GP, because he is my GP as well.

The other week a 60-year-old nurse with osteoporosis, who has spent 38 years in the NHS, came to see me. She failed the work capability test. She is 61 in April and is now being told that she will be retrained for a new career until she is 62, when she gets her pension. What on earth is the point in wasting money on individuals like that?

There are also cases such as the 21-year-old young lady who ended up in the local psychiatric hospital because she failed the Atos interview. What is the cost of that to the NHS?

Helen Goodman (Bishop Auckland) (Lab): Mr H, a double-leg amputee, was told to undertake an 80-mile round trip for his work capability assessment.

Mr W, who has serious mental health problems, had a panic attack and was physically sick during his WCA but was told he was fit for work. His wife believes that he is being victimised by Atos.

Mrs D, a district nurse who broke her back at work, was told that she is fit for work. Her appeal will not take place until next month.

Mr E, who is one of the people the RNIB is worried about, had been completely blind for 16 years and forced to give up work, but was told by Atos that he was fit for work.

Iain Wright (Hartlepool) (Lab): A constituent of mine—let us call her Mrs J—is 51-years-old and suffers from diverticular disease. This leads to a compacting of her bowels, which means that she soils herself on a daily basis, requiring a change of clothes. Often she requires hospital treatment because when her bowels are heavily compacted she is unable to deal with the matter without medical intervention. She was on contribution-based ESA, but was allowed to be on it for only 365 days, and that period expired in 2012. She asked to be reassessed on the basis of her condition, and her assessment stated that she was fit for work. She appealed against this decision, but the appeal was declined. She had to go down the tribunal route but, as she told me in an e-mail last September: “So I’m now faced having to go to a tribunal which I was told today will take months. I’ve got no representation. I’m unable to go to the CAB as when I attempted to do this I’d soiled myself on route so ended up going home in tears. What can I do? I’ve not got a penny to my name. I’ve borrowed just to survive since April…I’m now faced with another 3-4 months with a tribunal decision again without money…I don’t know what to do and cannot carry on like this. Surely this isn’t how you expect people who legitimately cannot work. And the likelihood is I’ve failed my appeal just because I’ve not worded my appeal correctly when clearly my medical records and specialist have stated otherwise. Please, please help before I end up on the streets.”

A gentleman in my constituency—let us call him Mr D—served in the forces for many years and is now in his late 50s. In the past 18 months, he has undergone extensive surgery to the brain, following a tumour, and in November 2011 he was informed that he required further surgery, this time to his neck, to remove the growing tumour. At the same time—in precisely the same month—Atos assessed Mr D as being fit for work. That assessment was undertaken by someone who was not trained as a doctor at a time when Mr D was going to assessments with a gaping wound in his head and still undergoing treatment.

Another woman in my constituency—let us call her Mrs M—left school at 16 and worked diligently for 33 years. She paid her taxes. She was made redundant a couple of years ago at just the time that she was starting to suffer from ill health. Mrs M suffers from Crohn’s disease, which has led to severe diarrhoea, incontinence and abdominal pain. She has had surgery to remove a large section of her bowel, but the symptoms are getting worse. As Members may know, there is no cure for Crohn’s disease. Mrs M will not recover. There will be a gradual and irreversible increase in the severity and frequency of her symptoms. Mrs M is a proud and dignified woman who is embarrassed by her condition. She wants to do nothing more than work, but is unable to do so. She suffers from about two bouts of diarrhoea a day, for which she has no more than a second’s notice, and she cannot leave the house unaccompanied. Mrs M was assessed as having 15 points with limited capability for work. Her assessment and appeal were degrading, insensitive and unprofessional. She was described throughout her appeal notes as a man. Incorrect dates and fictitious telephone calls were placed on her files—in other words, lies. Mrs M was told that she could wear a nappy for work. What sort of country have we become? What sort of ethical values do the Government have, if that is the degrading and crass way in which decent, law-abiding constituents of mine are being dealt with?

Julie Hilling (Bolton West) (Lab): Sylvia’s husband came to see me because she was too ill to come. She had a subarachnoid haemorrhage four years ago, but aged 41, has now been found fit for work. She suffers blackouts, cannot dress herself, cannot self-medicate, cannot climb stairs by herself and cannot go out alone because she cannot remember where she lives or where she is going. Three to four times each month, she gets hemiplegic migraines, which last between two and six days, and mean that she becomes paralysed on her right side and loses her speech. Despite that, she has been found fit for work. The jobcentre, however, will not sign her on because it says that she is not fit for work. Needless to say, the stress sets off her migraines. One wonders what is the matter with her assessors.

Susan, a sufferer of fibromyalgia and hypermobility syndrome, told me that she felt like she was on trial for benefit fraud at her assessment.

Bill, a former long-distance lorry driver, had chronic obstructive pulmonary disease, heart disease and diabetes. He thought the fact that he could not breathe would be reason enough to find him unfit for work, but of course he was wrong. He did not tell the assessors about his cerebral brain ascension, which means that he has terrible memory problems, because he is ashamed of having the condition. Of course, he has now had to tell them. He waited for nine months and then the decision was overturned.

Clare […] has severe mental health issues and scoliosis. She scored 15 points and was placed in the work-related activity group, even though she will clearly never be able to work. She appealed the decision and had to wait for 12 months, which made her condition far worse. She was then put in the support group.

Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op): One constituent got in touch with me when he found out about this debate. He states: “Getting a copy of the ESA85 report…to which everyone examined is entitled was like getting blood out of a stone.” The man was found fit to work despite being on crutches and in constant pain at the time. He said: “When I eventually received a copy I found that the examiner had stated clearly that I was found unfit for any kind of work and would remain so for at least two years.” He tells me that when he tried to follow that up via the DWP, he was left with the distinct impression that staff had been advised, encouraged or instructed that everyone was to go into one of the employment support groups rather than be deemed completely unfit for work.

I have one example of a gentleman who was brought to my constituency office by a neighbour. He had had his third WCA in May 2012 and was zero rated. On the previous two occasions he appealed, and his appeals were upheld on the basis that the tribunal decided that he had reduced awareness of everyday hazards, leading to a significant risk of injury to him or others, and was therefore not fit for work. That gentleman was brought to my office in August 2012 because he was awaiting his third appeal and was distressed by the process. Obviously, we gave him advice. On 8 October, the neighbour contacted me to say that the gentleman had passed away.

A constituent […] contacted me this week. He says: “I have been treated by my GP for over seven years for this illness, he is aware of the ups and downs, and the debilitating effects I am subject to. How can a registered nurse make a decision on my mental health in 41 minutes, most of which was asking questions about my physical health? This is what happened at my Atos WCA…There must be a change to the way people with mental health problems are dealt with by the system. I have spent the time since my WCA in June in misery, and the weeks leading up to the tribunal hearing in a mix of terror and stress. I was terrified at the tribunal itself.” That is no way to treat people in a civilised society. The gentleman says that he is “part of the last generation of ‘stiff upper lip’ and ‘put the best face on it’ people.” He says that that “works against” him because he does not fit what he describes as the stereotype of someone with a mental health problem.