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Posts Tagged ‘WCA’

Do Atos mental function champions really make WCAs “better”?

July 3, 2013 Leave a comment
Categories: Mental Health Tags: ,

Sue Marsh, The Guardian: Fit-for-work tests are exposed, again – change this shocking tactic now

November 12, 2012 1 comment

Fit-for-work tests are exposed, again – change this shocking tactic now

http://www.guardian.co.uk/commentisfree/2012/nov/12/fit-for-work-tests-employment-support

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.

The Green Benches: The Tory Party has received £1.3 million in donations from donors linked to ATOS.

November 1, 2012 Leave a comment

Get ready for work: what woman who needs constant care was told

October 3, 2012 Leave a comment

The Guardian, Wednesday 3 October 2012 18.38 BST

Cecilia Anim with her daughter Ruth

Cecilia Anim with her daughter Ruth, 27, from north London, who attends classes to learn life skills such as making a cup of tea or a sandwich. Photograph: Linda Nylind for the Guardian

Ruth Anim needs constant one-to-one care, has no concept of danger and attends life skills classes to learn practical things like how to make a sandwich or a cup of tea. So it came as a considerable surprise to her mother, Cecilia, that an official assessment of her daughter’s abilities classified her as someone who would be capable of finding work in the near future.

The report contained a number of factual errors, perhaps most remarkably the assessor’s description of the 27-year-old as a “male client”, but more disturbing for Anim was the conclusion of the doctor who carried out the test: “I advise that a return to work could be considered within 12 months.”

Anim says: “For Ruth to go to work is actually totally unimaginable. She can’t even cross the road without someone going with her; she doesn’t know that if a car hits you it will kill you; she has no concept of danger.” Her daughter was born with complex medical needs, learning disabilities, a heart problem and epilepsy. “She is somebody who has a one-to-one carer – is she meant to go to work with her carer?”

As a result of the assessment, Ruth was assigned to a category known as the work related activity group, and required to attend the jobcentre regularly to begin mandatory preparations for going to work.

Cecilia Anim’s amazement at the written report, describing her daughter’s work capability assessment (WCA), the test to determine fitness for work, echoes the shock felt by hundreds of thousands of former claimants of incapacity benefit over the last three years, after undergoing the stringent new computerised test to check their continued eligibility for benefit payments.

Since the test was introduced in 2008 more than 600,000 people have appealed against the assessments; the cost to the state of those appeals has risen from £25m in 2009-10 to £60m in 2011-12. About 38% of those who appeal against an initial fit-for-work finding see that decision overturned on appeal and benefits granted. Welfare rights organisations and charities have voiced consistent unease about the test and the way doctors employed by the private IT firm Atos, which is paid £100m a year by the government to carry out the test, have implemented it.

Last week Labour called for a “fast and radical” overhaul of the system, admitting the policy it introduced when in government was not working.

As deputy president of the Royal College of Nursing, Anim can project her fury about the experience her daughter endured far more powerfully than most individuals going through the system. This awareness has heightened her desire to talk about the “injustice of the process”, to educate people about how inaccurate the assessments can be.

“I am able to fight back, but what about the people who are not able to fight back? It’s causing a lot of problems for a lot of people,” she says. “My daughter’s consultant neurologist was beside himself with fury when I told him. The first question he asked was, ‘Have they done a risk assessment?’ ”

Ruth’s case is by no means exceptional. Mencap, the charity which supports people with a learning disability, says it has seen countless similarly surprising cases of misclassification of vulnerable clients, many of whom are told they are not eligible for any sickness or disability benefit and must seek work immediately.

The principle underlying the WCA is that a health condition or disability should not automatically be regarded as a barrier to work, and in theory the policy is designed to ensure that support is available to help people find work. Anim says there is nothing she would like more than for her daughter to find a job, just as she would like her to get married and have the kind of life her contemporaries have, but she argues that, given the severity of her daughter’s condition, this approach is not realistic.

The 45-minute examination was chaotic from start to finish, Anim says. Her daughter was extremely anxious and kept asking the doctor if he was going to take a blood test. She refused to sit down and hopped on and off the medical examining couch when the doctor was talking to her. Anim points to a line in the partly computer-generated report which notes “client was able to sit on a chair with a back for 45 minutes”.

“The whole examination was very chaotic and bizarre because she was not co-operating. But in his report he has put that Ruthie sat for 45 minutes. She never sat down for more than three minutes. She was all over the place,” she says. “At one point she went to the tap and washed her hands and started spraying the water everywhere. He raised his voice and said ‘Stop doing that!’ I said no, no, don’t speak to her like that. She’s got learning difficulties; she doesn’t understand.”

A few questions the doctor asked, about her daughter’s condition and her schooling, made Anim doubt his familiarity with the British care system. He noted in his report that her daughter’s speech was normal, although Anim had done most of the speaking. The few questions Ruth managed to respond to were answered inaccurately. “He asked her how old she was and she said 18, despite the fact that she is 27,” she says.

A few months after the medical assessment Ruth was called to an interview at the jobcentre to discuss finding work. She went with her mother, who was aghast when she understood why they had been called in. “I said ‘Are you having a laugh?'” The jobcentre adviser realised very quickly that a mistake had been made. “We sat down, and every question she asked her, Ruth raised her palms as if she didn’t know the answer. She asked ‘What day is it?’; Ruthie said Thursday, but it was Tuesday. She asked ‘What time is it?’. She said 5.30pm, but it was 2.30pm,” she recalls. “Ruth was rummaging through the tray on her desk and being disruptive. She kept saying, ‘What’s your name?'”

“They said she must come every three weeks to show that she is actively seeking work,” Anim says; but the adviser also told her that she could appeal against the decision. “It only took her 10 minutes to realise that the decision was wrong.”

Anim spent her summer holiday trying to sort out the problem, marshalling the support of her local MP, Glenda Jackson, and a welfare rights organisation, Brent Association of Disabled People, as well as contacting Atos and the DWP.

The decision caused immense stress to the whole family, she says. “As a nurse I know what effect this has on families. You have to constantly struggle to get the support to meet her basic needs. After all we have gone through, then to be told she needs to look for work. She was totally oblivious to what was going on, as usual, but we felt disbelief, frustration, stress and shock.

“It was a barmy decision. People with learning disabilities need all the support they can get. [They should] not be put in this situation where there is total ignorance about their ability to work, safety and wellbeing.”

Although the Royal College of Nursing has no official position on the WCA, Anim is clear that the policy needs urgent reform. “The system needs to be overhauled and reviewed.”

The DWP says that it has introduced numerous improvements to the testing process, but charities state that serious problems continue. A report published by Citizens Advice earlier this year found a “worryingly low” level of accuracy in the assessments. The charity, which supports many people who feel they have been wrongly denied benefits through the appeals process, has seen a 71% increase in workload relating to the employment and support allowance (the replacement to incapacity benefit) over the past two years.

Campaigners blame both the design of the policy and the way it has been implemented for the problems. The headquarters of Atos have been repeatedly targeted by disabled protesters, angry at the company’s involvement in the assessments, and the company’s sponsorship of the Paralympics caused widespread controversy.

The National Audit Office criticised the Department for Work and Pensions in August for not having “sought financial redress for contractor underperformance” and recommended that it “tighten performance requirements with Atos in relation to the quality of medical assessments”.

Earlier this year delegates at the BMA conference passed a motion stating that the “inadequate computer-based assessment” performed by Atos had “little regard for the nature or complexity of the needs of long-term sick and disabled persons”, and proposed that the WCA should be halted “with immediate effect”.

Jane Alltimes, senior policy officer at Mencap, said Ruth’s case was not particularly extreme. Mencap has submitted recommendations for improvement to the system to the DWP, and is arguing for greater recognition of employers’ unwillingness to employ people with learning disabilities. Just 7% of people who receive state support for their learning disabilities are in work.

“The evidence we’ve seen suggests an assessment process that isn’t working for lots of people with a learning disability. An assessment designed to determine a person’s ‘fitness for work’ needs to take into account the realities of the barriers experienced by disabled people in getting a job – things like job availability, the prejudices of employers, the support people need to overcome the barriers they face. The assessment in its current form just doesn’t do that.”

An Atos Healthcare spokesperson said: “We apologise for any discrepancy in our report and any distress this may have caused. We carry out around 15,000 assessments each week and work hard to provide the DWP with as much detailed information as we can to contribute to them making an accurate decision on benefits.”

A DWP spokesperson said: “The work capability assessment is under constant review to ensure it is both fair and effective, and it is in everyone’s interest to get the system right. We are committed to help thousands of people move from benefits and back into work while giving unconditional support to those who are most in need.”

Categories: Disability, Health Tags: ,

Huffington Post: Universal Credit and Disability Allowance Controversy

September 14, 2012 Leave a comment

http://www.huffingtonpost.co.uk/vincent-brogan/disability-allowance-universal-credit_b_1869194.html

Vincent Brogan

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

Petition: Exclude Vulnerable Severe & Enduring Mental Health Sufferers from DLA Assessments in 2013

August 26, 2012 Leave a comment

National Audit Office Expresses Doubts about Fitness for Work Tests

August 17, 2012 Leave a comment

http://www.bbc.co.uk/news/uk-19244639

 

Watchdog finds ‘weaknesses’ in sickness benefit system

 

Auditors have found “weaknesses” in the contract between the government and Atos, the private firm paid to carry out fit-to-work medical assessments.

The contract underpins the Department for Work and Pensions’ efforts to move people from sick benefits into work.

The National Audit Office said the DWP had failed to penalise Atos for “under-performance”, and had not set “sufficiently challenging” targets.

The DWP said it was committed to making the Atos agreement a success.

French firm Atos was paid more than £112m in the last financial year to carry out about 738,000 face-to-face medical tests on benefit claimants.

Wrong decisions

The DWP used the test results, known as work capability assessments, to decide whether people were fit to work or eligible for Employment and Support Allowance (ESA).

The assessments were first introduced on a pilot basis by Labour in 2008 and rolled out across the country by the coalition government.

Officials at the DWP have got many decisions wrong, with nearly four out of 10 appeals upheld at tribunals.

The NAO said it was unclear whether the quality of the tests was to blame for the number of wrong decisions.

In a letter to Tom Greatrex, MP for Rutherglen and Hamilton West, seen by the BBC, the NAO’s Comptroller, Amyas Morse, said it was hard to know whether changes to the tests were needed.

“It is difficult to assess, as the department does not routinely request feedback on the rationale for tribunal decisions.

Continue reading the main story

“Start Quote

People who are genuinely sick and disabled need to be helped, not hounded”

Tom Greatrex Labour MP

“Without such data it is not clear whether any changes in the medical process are needed,” Mr Morse added.

The DWP had previously admitted that Atos had not carried out some fitness testing within the agreed time limits, and performance had been “below the standard” since mid-2011.

The NAO criticised the DWP for not seeking “financial redress” for these delays.

It said just 10% of the penalties triggered by poor performance had been applied.

The spending watchdog added that the DWP’s negotiating position has been undermined by “inaccurate forecasting” of the number of people likely to need a medical test.

A DWP spokesperson said the contract had “changed considerably” since it was signed by the Labour government and as it evolved remained under constant review.

“In 2010, the Work Capability Assessment was not working properly and since then we’ve substantially improved it.

“It is a complicated area but we are committed to making it a success to ensure it is both fair and accurate for the user and value for money for the taxpayer.”

Mr Greatrex asked the NAO to carry out the review of the contract, saying the coalition government had failed to get value for money for the taxpayer and “properly hold Atos to account”.

“The taxpayer is effectively paying for this service twice – once through the £112m a year Atos receives from the DWP, and then again through the £60m a year spent on appeals and clearing up the mess that results from Atos assessments.

“Yet as the NAO makes clear, the Government has failed to claw this money back from Atos to reimburse the taxpayer.

“The principle of assessing a claimant’s fitness to work is a sound one. But people who are genuinely sick and disabled need to be helped, not hounded,” the MP added.

‘Challenging contract’

Mr Greatrex has called on ministers to reflect on the report and consider reforming the system.

A spokesperson for Atos said it worked very closely with the DWP on a “complex and challenging contract” to “fulfil all our contractual obligations”.

“We have also been flexible within the contract, for example implementing changes and recommendations from the Harrington report.

“Where changes to the contract have resulted in slower processing times we have worked alongside the department to address this.”

Complaints that the medical test causes distress have been made since they were first introduced.

In May 2011, six charities – including the MS Society and Parkinson’s UK – urged the government to make the tests fairer for patients whose symptoms vary in severity over time.

A month later, campaigners claimed in a letter to the Guardian newspaper, that assessments were causing “huge” distress, and had even resulted in suicides.

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