Tag Archives: Malcolm Harrington

Educating Dr Litchfield – a few facts about the Work Capability Assessment

Dr Paul Litchfield.

Dr Paul Litchfield.

Ignorance is most definitely not bliss for Dr Paul Litchfield.

The man was hand-picked by the Coalition government to review its hated Work Capability Assessment system of handling Employment and Support Allowance claims, amid rumours that previous incumbent Professor Malcolm Harrington had been unhappy with political decisions that ran against his findings. But he delivered a woeful performance to the House of Commons’ Work and Pensions committee last month.

He claimed to have no information about the staggering number of people who have died after going through the assessment system he is being paid to review, totalling 10,600 between January and November 2011 – that’s 220 per week or three every four hours. “I don’t have any information of that type; I haven’t seen numbers on that. Clearly every case would be a tragedy,” he said.

Clearly this expert has yet to gain access to some very important information!

Fortunately, help is at hand.

In advance of the fifth and final review of the WCA, lead researcher and disabled veteran Mo Stewart has written to offer him the benefit of four years’ detailed research evidence.

“The lacklustre 4th review of the WCA left a great deal to be desired,” she told Vox Political. “Now, with the news that Litchfield worked with Unum Insurance on the Technical and Consultative Working Group involved with the creation of the WCA, it can’t be too much of a surprise that Litchfield claims that the WCA had been designed ‘…with considerable rigour’.”

Mo Stewart’s lengthy letter to Litchfield has been distributed to a long list of distinguished experts and professionals, and it will be interesting to see if Dr Litchfield takes the time to respond and to react to the detailed research evidence Mo exposed – evidence that has been frequently quoted during welfare debates in the House of Lords and the House of Commons over the past three years.

You can read her letter for yourself, because Mo has sent Vox Political a copy. Just click on the link here.

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How can the government’s new ESA specialist claim he knows nothing about all the deaths?

Dr Paul Litchfield, here pictured giving evidence at another committee meeting, so it's probably another load of tripe.

Dr Paul Litchfield, here pictured giving evidence at another committee meeting – so it’s probably another load of tripe.

An evidence session on Employment and Support Allowance and Work Capability Assessments was held by the House of Commons Work and Pensions Committee on Wednesday – and was notable for the fact that the ‘expert’ hired to review the system claimed to know nothing about the thousands of deaths taking place because of the current system.

Dr Paul Litchfield OBE was hired to take over from Professor Malcolm Harrington to carry out the fourth annual independent review of the assessment process. It seems Prof Harrington was replaced amicably, but evidence has come to light that he was not happy with political decisions that ran against his findings.

A claim that the government was taking “appropriate steps” in areas singled out for improvement by Prof Harrington was disproved when it was revealed that almost two-thirds of the 25 recommendations he made in his year one review were not fully and successfully implemented.

The government also claimed, repeatedly, that Prof Harrington had supported the migration of Incapacity Benefit claimants to ESA. When fellow blogger Sue Marsh contacted him for confirmation, he responded: “I NEVER—repeat–NEVER agreed to the IB migration. I would have preferred that it be delayed but by the time I said that, the political die had been cast. I then said that I would review progress of that during my reviews. The decision was political. I could not influence it. IS THAT CRYSTAL CLEAR?”

The vehemence of his response suggests some friction with his former employers at the very least – and over “political” decisions.

Now we have Dr Litchfield, who claims to have no information about the staggering number of people who have died after going through the assessment system he is being paid to review. Doesn’t that seem – at the very least – a little odd?

He could have, at least, looked up the government’s own statistical release ‘Incapacity Benefits – Deaths of Recipients’ from July 2012. It is long out-of-date and pressure on the government for fresh figures has been stonewalled for two years, but it does show that 10,600 people died between January and November 2011 – including an average of 73 people every week, when the system claimed they were still being assessed or should be getting better. These figures are believed to be inaccurate measures as the government does not monitor deaths of people who have been refused the benefit – the vast majority of claimants.

It seems we are dealing with another Tory yes-man, hired not to improve ESA, but to make it and the government look good.

Dr Litchfield’s attitude is revealed on the video record of the meeting, which is available on the Parliament UK website, starting two hours, 11 minutes and 41 seconds into the recording.

Committee member Debbie Abrahams (Labour) had just received a Tweet stating: “Litchfield doesn’t want to come out and say scrap WCA because 10,600 dead or he’ll be out of a job, slime bag.”

Turning to Litchfield, she said: “I’ve just been contacted by someone who is commenting on the number of people that are dying every week as a result of being found fit for work after an assessment. I don’t know if you’d like to comment on that?”

The response – from the man who is supposed to have every scrap of information about ESA, let us remember – was as follows: “I don’t have any information of that type; I haven’t seen numbers on that. Clearly every case would be a tragedy.”

That is infuriating for campaigners – one of whom contacted Vox Political and stated: “The wicked toad said he had no knowledge of the deaths. What a lie, how evil – it’s common knowledge, it’s DWP’s own figure, it’s been brought up many times in House of Commons debates… They should sack him and not believe a word he says… no impartiality whatsoever.”

It seems the tragedy, in this case, is the hiring of Dr Litchfield.

Thanks to Katy Marchant for flagging this up.

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DWP’s shame: Facts reveal how ministers duped the press

Lest we forget: We know that, on average, 73 people died every week between January and November 2011 - after undergoing the DWP work capability assessment administered by Atos. Who knows how many are dying now?

Lest we forget: We know that, on average, 73 people died every week between January and November 2011 – after undergoing the DWP work capability assessment administered by Atos. Who knows how many are dying now?

Today the DWP finally released its press release claiming that huge numbers of people who wanted Employment and Support Allowance have been found fit for work instead.

Interestingly, the DWP story differs from that published by the BBC, even though the corporation must have used a version of the press release provided to it in advance.

In the BBC story, released on Saturday, “More than a million others withdrew their claims after interviews” – but the DWP press notice, released today, claims “More than a million others withdrew their claims before reaching a face-to-face assessment”.

In addition, the DWP release features a long section on its Disability Confident roadshow, and there is another statistic which claims that the proportion of disabled people in work has reached 45 per cent.

Disability Confident, designed “to encourage more employers to hire disabled people”, “to showcase the talents of disabled people and highlight their tremendous value to the British economy” is, on the face of it, a good idea.

But I wonder if it isn’t a smokescreen to hide how the DWP is pushing thousands of disabled people into saying they are self-employed and taking tax credits rather than ESA, in order to fudge the figures and make it seem as though good work is being done.

Vox Political reported on this before ,and it is worth adding that the BBC itself ran the original report that work advisers were pushing the jobless into self-employment.

Oh, what a tangled web we weave, when first we practise to deceive…

Of course, the best source of ESA-related statistics is on the iLegal site where the figures behind the press release have been picked apart by an expert who doesn’t have a vested interest in saving ministerial face.

They show that an average of 83 per cent of the 1,078,200 Incapacity claimants who were assessed qualified for ESA between October 2012 and May last year, while 88 per cent of the 1,332,300 ‘repeatedly assessed’ were re-qualifying.

While the DWP and the BBC have claimed 1.8 million people have magically disappeared from the Incapacity/ESA claimant count, the DWP’s own figures confirm that overall numbers have reduced by only 156,630 since May 2010.

The iLegal article makes it clear that “the claimant count is far from a static number; each month thousands of claimants come on and off all benefits”. But it seems clear that the BBC/DWP figure is a conflated total, simply adding up all new claims – rather than claimants – from 2008 onwards.

This is exactly why UK Statistics Authority chief Andrew Dilnot chastised the government after the Conservative Party released an almost-identical press release last year, using then-current (but still inaccurate) figures and not mentioning Disability Confident.

Let’s go back to the number of people found ‘fit for work’ after assessment. Has everybody forgotten the hammering that the government took during a debate on Atos’ handling of the Work Capability Assessment, exactly a year and a week ago today? If you have, don’t worry – you can read all about it here.

The debate demonstrated time after time that the work capability assessment, as devised by the DWP’s Conservative ministerial team and run by its employees at Atos, was not fit for purpose; that the overwhelming majority of those who had been found ‘fit for work’ were nothing of the sort; and that “this is a government that is perfectly happy with a system that is throwing thousands of sick and disabled people to the wolves”.

The government refused to listen. Then-Employment minister Mark Hoban (standing in, conspicuously, for Esther McVey, who was minister for the disabled at the time) said the independent reviews conducted by Professor Malcolm Harrington had identified areas of improvement and appropriate steps were being taken.

This claim was false. Out of 25 recommendations made by Professor Harrington in his year one review alone, almost two thirds were not fully and successfully implemented.

The government also claimed, repeatedly, that Prof Harrington had supported the migration of Incapacity Benefit claimants to ESA. When fellow blogger Sue Marsh contacted him for confirmation, he responded: “I NEVER—repeat–NEVER agreed to the IB migration. I would have preferred that it be delayed but by the time I said that, the political die had been cast. I then said that i would review progress of that during my reviews. The decision was political. I could not influence it. IS THAT CRYSTAL CLEAR?”

I’d say so – to everybody but the Coalition government.

Now:

A good reporter at the BBC would have had all this information to hand. They would have known that the work capability assessment was extremely controversial and had been shown, many times, to be unfit for purpose. They would have known that the government had been slapped down by the UK Statistics Authority after releasing an almost-identical press release last year. They absolutely should have known that other reporters in the same organisation had revealed that the DWP had been pushing disabled people into claiming they were self-employed in an effort to cook the books.

With all that information to hand, it begs the question: Why did they then go ahead with the propagandised misrepresentation of the facts that appeared on the BBC News website on Saturday?

And, before reporters at Business Standard (“A million Britons found lying for illness benefits“?), the Belfast Telegraph, International Business Times UK, Metro, The Times, Channel 4 News, Press TV, Descrier, SME Times, AoI Money, The Mirror, Gloucester Citizen, Huffington Post, Evening Standard, and especially the Daily Mail, whose article was hysterical in both senses of the term, allow me to ask…

What’s your excuse?

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Call for evidence on Work Capability Assessment: My submission

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

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

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

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

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

Here are the questions and my responses:

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

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

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

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

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

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

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

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

That was my submission.

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

Over to you.

Work Capability Assessment: Time to make your experience count

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...

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”.

We all know that the WCA is a total failure in those terms. Recent Work Programme and appeal tribunal statistics are unequivocal in making that clear.

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:

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

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.”

If “no fundamental reforms are needed”, then why is the DWP refusing to provide details of the number of people who are dying while going through the assessment process, appealing against its decision, or after having been thrown off-benefit? Clearly it seems to have something to hide and until we find out what that is, such claims should be considered to be wild fantasies with no basis in reality.

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?

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

Don’t just tell us – tell the independent assessor.