Fit-for-work tests are exposed, again – change this shocking tactic now
A report written by people who have serious illnesses or disabilities,The People’s Review of the Work Capability Assessment, contains 70 first-hand accounts of taking the fit-for-work test, which in large part determines eligibility for employment and support allowance (ESA).
ESA replaced incapacity benefit four years ago. These testimonials about the eligibility test clearly show how ministers have misled the public and used the press to demonise this most vulnerable of groups.
For the first time, the report exposes the extent of the opposition to the ESA and proves, beyond any doubt, that not only is it “unfit for purpose” but that it is also one of the most shocking betrayals of those most in need that has ever been allowed to go unchecked.
Since the test’s introduction in October 2008, more than 400,000 people with serious illnesses and profound disabilities have appealedagainst the decision to strip them of state support, and 40% have been successful; a great many disabled and sick people have died after being found “fit to work” and a survey has found that 6% of GPs have come across a patient who has attempted to take or taken their own life as a result of undergoing, or “fear of undergoing” the test.
It should have been so different. When the then Labour government introduced the ESA as a new benefit for those unable to work due to long-term illness or disability, the eligibility test was intended to look at what the disabled person could do, not what they couldn’t.
The assessment would have three possible outcomes: the person was too ill or disabled to undertake any kind of paid work so they would go into the long-term support group (SG) and would not be expected to look for work; the person had a significant illness or disability but might be able to work, or would like to work with the right support. They would go into the work-related activity group (WRAG) and have access to training or adaptions and experts to help them find a job; or the person would be found immediately able to work and would move to jobseeker’s allowance (JSA).
Charities and campaigners representing sick and disabled people supported this concept and indeed, the principle is still one we accept and would like to see today.
But the politicians have made the test far too limited. It has ignored whole classifications of illness or disability; people with mental health conditions, learning difficulties, autism or Asperger’s and conditions that fluctuate. Cancer patients have found themselves at the job centre between chemo treatments, paraplegics have been told that they are fully mobile.
Politicians and the media also stopped talking in warm, empowering terms and suddenly, an obsession with “scroungers”, “skivers” and “cheats” that had no basis in fact took over. Despite having one of the lowest rates of support for sick and disabled people in the developed world, despite the toughest criteria in the developed world and despite a broadly average number of people claiming support, ministers and the media painted a picture of a country held back by an army of lazy shirkers who could work if they wanted to but chose not to.
In fact, UK sickness and disability benefits have the lowest fraud rates of any benefit at less than half of 1%; a full one-third of sick or disabled people live in poverty and 60% of disabled people already work.
Luckily, the new benefit was tested first in two pilot studies and it became immediately apparent that the test could not accurately access claimants. At this point, the ESA should have been stopped and redesigned. Politicians should have seen that the language they were using was doing great damage to a vulnerable group and returned to the original concept of the ESA.
But far from pausing the ESA, the coalition government not only rolled it out nationwide, it limited the WRAG to just one year. Any last sense that the WRAG was a secure place for nurturing the untapped potential of those with significant barriers to the workplace was gone.
The coalition did at least ask professor Malcolm Harrington to lead an independent review into ESA and recommend improvements. A year later, Harrington suggested many sensible changes that wereaccepted but as yet, little progress has been made in rolling them out.
How many more seriously ill people must suffer mentally, physically and financially before the ESA is withdrawn and redesigned? Four years is long enough – indeed far too long. This report proves it beyond any doubt.
A scheme to get claimants off long term disability back to work is turning into something of a PR nightmare for the government. The sight of disabled protesters and their growing number of supporters taking to the streets, after a widely acclaimed Paralympics, is one it might wish to avoid.
At the heart of this controversy is something called the ‘Work Capability Assessment’ (WCA) which determines if you are entitled to Employment Support Allowance (ESA). This benefit is paid to those with limited capability to work because of ill health or disability.
To many who have been through the contentious ‘medical assessment’, part of the WCA carried out by ATOS Healthcare on the Department of Work and Pensions’ (DWP) behalf, it is a blunt instrument which, they argue, makes a mockery of their illnesses and can be demeaning.
Having to apply for ESA is causing unnecessary stress for some claimants who feel the extent of their disability speaks for itself. This is not how policy strategists see it, however.
The WCA is an integral part of the new system as is the more demanding medical assessment. But when up to 40%of appeals by unhappy claimants to overturn initial assessments were successful then something is clearly wrong, adding weight to concerns the process is more than simply flawed.
Indeed, rarely has implementation of any new policy caused so much outrage. Media is awash with reports of claimants dying after being declared fit to work, MPs on about the sheer injustice of it, olympic protests against ATOS, suicides and terminal cancer or even psychotic patients being told they are fit for work.
With the Universal Credit being rolled out in 2013 the distrust generated by the ongoing controversy over ESA won’t help endear sceptics to another package that could, in spite of concerns about readiness, make life easier for many welfare recipients. Sorting out the Employment Support Allowance mess first might help.
Excepting those who clearly are too ill or disabled, the default premise of the present strategy introduced in 2008 appears to be that huge numbers on disability are able to do some work, and the onus is on them to show they can”t.
But a common grievance with the scheme is that it is work, not ‘condition‘ oriented. It emphasises what you can, rather than what you can’t do and makes a virtue of looking beyond your limitations, concentrating, unrealistically some feel, on your capabilities.
Claimants undergoing WCA fill a questionnaire some find confusing, even duplicitous. Such is the unfortunate level of mistrust trust surrounding the whole thing that support groups frequently tell their clients to consider how they respond to even informal, friendly queries like “did you come by car?”or “did you walk from the bus stop?” as these reveal snippets about the physical capabilities of the informant.
Many have a medical assessment which is nothing like the illness-orientated clinical exam they are used to when they visit their own doctor. This can be disconcerting for some more attuned to pouring hearts out to healthcare professionals they trust and know.
The focus of proceedings is very much on all that is right, like checking how long you can stand or sit for, if you can move your arms freely or pick something off the floor without too much discomfort. If you can complete these and other tasks, and pass basic clinical tests then you may be deemed fit to work and lose entitlement to ESA..
But many patients complain that distressing symptoms they intermittently complain of, or other illnesses they suffer from, appear to be ignored or are described as not being relevant when they bring them to an examiner’s attention
Although the present strategy is justifiably framed to encourage those capable of work break the cycle of dependence many feel that the rigid, impersonal way it is implemented signals a divisive plan to slash social welfare spending by targeting those in no position to complain.
There is no doubt that some claimants, unable to withstand the bureaucratic onslaught conveniently fronted by what they perceive as a medical inquisition they do not comprehend, will succumb and give up without a fight. This, critics suggest, could be part of the agenda
If we are to challenge a decades-long ‘culture of dependence’ then we need to tread carefully, know its extent and not confuse ‘dependence’ with ‘disability’.
An aggressive strategy aimed at helping the genuinely disabled unable to work which lumps many of them in with those who possibly can, on top of a very small minority of shirkers is bound to be problematic. Not recognising this is a serious failing in its own right.
It is the silent minority you don’t see or hear complaining on social media, but who accept ‘judgements’ that they are ‘fit to work’ when clearly many are not and have little prospect of ever finding it, who are the hidden victims of a policy being implemented with the finesse and speed of a runaway freight-train.
An equitable system would help those who need assistance and challenge those – there are many – who don’t. It will work if there is trust but won’t if there is not. Certifying dubious cases – and this lies at the heart of the present debate – is nearly always a matter of clinical judgement. But it can be done fairly, effectively, authoritatively and with consensus.
A one cap fits all approach to a complex social issue involving disability is not ideal. Factors like opportunity, unemployment, discrimination, exploitation in the workforce or ongoing medical support simmer in the minds of many concerned about being forced back to work. And these concerns need to be addressed, not just talked about. That takes time and patience, something which is missing from the present debate.
Follow Vincent Brogan on Twitter: www.twitter.com/@DrBrogan
A SEVERELY disabled Scot has “written his own death certificate” after stopping his medication in a protest against government red tape.