Category: Illness and disablility

DWP destroyed reports linking benefit sanctions and cuts with suicide

errol

Errol Graham, who starved to death in 2018, following his social security support being cancelled by the Department for Work and Pensions. He left a heartbreaking letter which described his circumstances leading up to his death. His family found the letter after he died, weighing less than five stone.

Department for Work and pensions (DWP) officials have admitted that up to 50 reviews into deaths following harsh social security cuts and sanctions have been destroyed.

The government has been accused of a ‘cover-up’ after destroying the reports which link suicides to sanctions and peoples’ benefits being stopped. Around 50 reviews into deaths following the loss of social security payments before 2015 have been shredded, officials have blamed data protection laws. 

However, the data watchdog has said there was absolutely no requirement to destroy the reports by any particular date and that a “public interest” exemption could have been used.

The Department would have known that. 

Labour MP Stephen Timms, the chairman of the Commons work and pensions committee, agreed it was a possible cover-up, saying: “I’m very sympathetic with that”

Timms, who said his committee would demand answers about the shredded reports, pointed out a scathing National Audit Office report (NAO) had warned the DWP was unable to show it was learning lessons.

Having been “very secretive”, it was now “very reluctantly” becoming more open, he said – but “trying to keep things as hush-hush as possible – and it’s not good enough”.

“It all underlines a lack of seriousness by the department about putting things right when they go wrong.”

The NAO investigation into the information DWP collects on deaths by suicide of social security claimants found that the department has internally reviewed 69 cases in which “alleged department activity” may have been among the reasons for such death. However, it said ‘gaps in reporting’ meant the actual figure was likely to be higher. The report said  said the department did not seek to draw trends from the findings of internal reviews, meaning that “systemic issues which might be brought to light through these reviews could be missed.”

The government seems determined not to adequately monitor or to learn lessons from the adverse impacts of their draconian policies. 

Timms added: “The law does not specify five years or six years and this kind of information should be held for longer,” in response to the DWP’s claim that data rules required the destruction of old investigations.

“In any case, the lessons learned from these reviews, there’s no reason why they should be destroyed. They should be kept and progress on implementing improvements monitored.”

A freedom of information (FoI) response to a campaigner revealed that up to 49 secret reviews carried out before 2015 were destroyed.

More than 100 have taken place over the last decade, amid growing concern over deaths linked to harsh benefit cuts and sanctions introduced by the Conservatives.

Labour MP Debbie Abrahams fought back tears in the Commons as she read out a list of 24 people who died after problems with their benefits, this week.

Regarding the 69 reviews since 2015, she told ministers: “This is just the tip of the iceberg. We do not even know the actual number of people who have taken their own life as a result of what they went through.”

In a statement, the DWP said: “We take these reviews extremely seriously and ensure cases are investigated and concluded and any lessons learned.”

However, that is clearly untrue. In fact the department and government ministers have consistently denied a ‘causal link’ between their policies and an increasing mortality rate, while also refusing to allow an independent investigation into the deaths.

The NAO criticised the DWP for lacking clear guidance on when a case should be investigated and for not having any “robust record” of contact from coroners about suicide cases, which it said meant some cases flagged up by coroners may not have resulted in an internal review being initiated.

It’s worse than disgraceful that people are dying because of  draconian policies and the actions of a system that should be supporting them. 

Many of us have called for the DWP to be held accountable through robust independent inquiry and regulation. The department has shown a consistent lack of transparency when reporting on systematic problems that have put people at risk, and has refused to open itself up to meaningful independent scrutiny.

Earlier this month, I reported that the DWP has been accused of altering disability assessment reports, to reduce or end peoples’ lifeline support. It was alleged that officials within the Department for Work and Pensions (DWP) have edited or entirely removed thousands of work capability assessment reports submitted by privately contracted ‘independent’ healthcare professionals. This is another indication of the complete lack of transparency around DWP decision making.

The consequences of this government’s draconian social security policies

Many people have died since the welfare ‘reforms’ were hammered through parliament, despite wide opposition. 

Relatives of a man who starved to death after his social security was cut are taking legal action against the DWP.

Errol Graham’s family said they hoped the case would overhaul the system “to better protect vulnerable claimants”.

Errol’s daughter-in-law Alison Turner has sent a pre-action protocol letter to the DWP, arguing the termination of benefits for someone in Mr Graham’s circumstances were unlawful.

She also argues secretive investigations and reviews being conducted by the DWP into benefit-related deaths are unlawful and must be reformed.

Errol Graham weighed just four-and-a-half stone when his body was found by bailiffs who had knocked down his front door to evict him. He had just a couple of out-of-date tins of fish left in his flat, because the DWP had wrongly stopped his ESA. He starved to death, and his rent support had been stopped as a consequence of his ESA claim being ended. The DWP failed to follow safeguarding rules in their haste to end his claim. He was also denied PIP, which left him without any income whatsoever. 

DWP civil servants had failed to seek further medical evidence from his GP, just as in many other tragic cases that have sparked repeated calls for an independent inquiry into links between the deaths of claimants and the actions and failings of the DWP. The government have consistently refused to acknowledge a correlation between their actions and the death of disabled people, so have no intention of investigating the evidence. 

Assistant coroner Dr Elizabeth Didcock, who heard the inquest, was told that the DWP stopped Graham’s ESA entitlement – and backdated that decision to the previous month – after making two unsuccessful visits to his home to ask why he had not attended a face-to-face work capability assessment (WCA) on 31 August 2017. The inquest heard that it was standard DWP procedure to go ahead with stopping the benefits of a claimant marked on the system as vulnerable after two failed safeguarding visits.

However, the DWP (somehow) managed to stop an ESA payment that had been due to be credited to his bank account on 17 October, the same day officials made the second unsuccessful safeguarding visit.

DWP’s own rules state that it should make both safeguarding visits before stopping the benefits of a vulnerable claimant.

Because Errol lost his ESA entitlement, his housing benefit was also stopped. His family says he had also been found ineligible for PIP. Deprived of all financial support, experiencing significant mental distress and unable or unwilling to seek help, he slowly starved to death. He was 57. His body was discovered on 20 June 2018 when bailiffs arrived at his Nottingham council flat to evict him for non-payment of rent. 

His benefits had been stopped even though he had been receiving incapacity benefit, and then ESA, for many years as a result of enduring mental illness and distress that had led to him being sectioned. Errol was clearly extremely vulnerable.

He had also told the DWP on an ESA form three years earlier that he could not cope with “unexpected changes”, adding: “Upsets my life completely. Feel under threat and upset…”

He added: “Cannot deal with social situations. Keep myself to myself. Do not engage with strangers. Have no social life. Feel anxiety and panic in new situations.”

The assistant coroner said: “There simply is not sufficient evidence as to how he was functioning, however, it is likely that his mental health was poor at this time – he does not appear to be having contact with other people, and he did not seek help from his GP or support agencies as he had done previously.”

She concluded in the narrative verdict, delivered last June, that the “safety net that should surround vulnerable people like Errol in our society had holes within it”.

Those ‘holes’ are a consequence of deliberate, ideologically driven anti-welfare policies. They have intended consequences. The government assumes that people treated unfairly will appeal wrong decisions. Firstly, many people are far too ill to cope with the stress of that process. Secondly, it should never be primarily the role of courts to allocate social security fairly. That is the official role and purpose of the DWP.  However, the government department is clearly failing to fulfil its role. This is because the neoliberal ideology that drives austerity policies is incompatible with the central principles of social security. 

She continued: “He needed the DWP to obtain more evidence [from his GP] at the time his ESA was stopped, to make a more informed decision about him, particularly following the failed safeguarding visits.”

She said that a consultant psychiatrist had told the inquest “that Errol was vulnerable to life stressors” and that it was “likely that this loss of income, and housing, were the final and devastating stressors, that had a significant effect on his mental health”.

But she decided not to write a regulation 28 report demanding changes to DWP’s safeguarding procedures to “prevent future deaths” because the department insisted that it was already completing a review of its safeguarding, which was supposed to finish last autumn.

The DWP had promised her it would “listen to clients and to those representing them, and… ensure that the DWP was focused on support and safety for vulnerable people”.

Dr Didcock insisted that this commitment “must be converted into robust policy and guidance for DWP staff” and that the DWP must ensure that “all evidence that can reasonably be gathered is put together about a client, before a benefit is ceased”.

Disability News Service also highlights that the death of Errol Graham closely mirrors other tragedies caused by the DWP’s repeated refusal to make significant improvements to its safeguarding policies and practices.

Denise McKenna, co-founder of the Mental Health Resistance Network (MHRN), said the network was “absolutely devastated and saddened beyond words to hear of the circumstances surrounding the death of Mr Graham”.

She said: “We are enraged that the DWP continues to treat the lives of people who live with mental distress as disposable.

“This level of cruelty is outside of anything that would happen in a civilised society.

“The fact that Mr Graham had not responded to attempts to contact him following his failure to attend the work capability assessment (WCA) should have raised alarm bells over his safety, but instead the DWP took the opportunity to stop his social security entitlements.”

And there’s the truth: the government have created a hostile environment for disabled people that is heavily weighted towards preventing successful claims, taking its lessons from rogue multinational insurance companies such as Unum, who have systematically employed strategies to pay out insurance only as the last resort, rather than on the basis of need. 

Furthermore, the DWP and Conservative ministers have consistently demonstrated a refusal to acknowledge the widespread distress, harm and death that their policies are causing, despite many challenges to their narrative of denial. Nor is it likely the government will address the complete lack of honesty, transparency and accountability operating at the centre of the DWP, of their own volition.

The government’s indifference and lack of remorse related to the clear correlation between policy and increased mortality is extremely worrying.

That is why we must continue to campaign, raise awareness and stand up for ill, disabled and vulnerable citizens in the UK. 

Errol's letter

Errol Graham’s letter, which was released through his daughter-in-law’s lawyers, Leigh Day , is a moving window into the world of someone with severe mental illness trying to cope with the hostile environment imposed on vulnerable citizens because of government policies. (Picture from the Mirror).


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DWP accused of altering disability assessment reports to cut or end successful claims

gail

Pictured: Gail Ward, who was told that she did not qualify for Personal Independence Payment, despite living with a rare and potentially life-threatening heart condition – Prinzmetal’s angina – attacks can occur even when she is resting. She also had other health problems. Remarkably, Gail was told by the DWP that she doesn’t qualify for PIP. She won her appeal after waiting 15 months for her case to be heard at a social security tribunal.

It has been claimed that officials within the Department for Work and Pensions (DWP) have edited or removed thousands of work capability assessment reports submitted by privately contracted healthcare professionals.

It’s alleged that officials reduced qualifying points awarded during face-to-face assessments, delivered by ‘independent’ private firms, and in some cases disposed of the reports entirely.  

The Daily Record reports that during the last year paperwork was altered or amended in around 1,840 cases, while a further 460 applications were branded ‘unacceptable’ and simply binned.

In 2018, I raised concerns that the DWP were quietly editing people’s assessment reports for Personal Independence Payment (PIP) and Employment and Support Allowance (ESA), to reduce or end claims for disability support. I reported that a man with multiple sclerosis and mental ill health lost his PIP award after his original assessment report was dishonestly edited during a DWP ‘audit.’

Officials had clearly tampered with the assessor’s original report. The man only discovered the ‘audited’ version of his health assessment report when he asked for copies to make an appeal. He had been in receipt of the basic level of support for two years when he was summoned to be re-assessed for PIP, which is non-means tested and designed to help with the extra cost of living with debilitating conditions.

The original assessment document said the man, has “regular specialist input”. The ‘audited’ version says he does not. The report outlines the patient’s MS, depression and anxiety and tells of his difficulties with tasks including cooking, dressing and washing. The nurse noted his clothes were dirty and his top inside-out. The ‘auditor’ had removed the second point.

The ‘auditor’ changed a part which said the man needed supervision or prompting to wash or bathe, and a section on preparing food. The original said he “needs prompting” but the ‘audited’ version said he could prepare and cook a simple meal himself. In every section of the report where the man scored points towards his PIP award, the ‘auditor’ had reduced his score to zero, without contacting him to ask for information. This tampering with the original report was done without informing the claimant, and therefore without giving him an opportunity to clarify the original report or challenge the altered version of his account. 

He was accidentally sent ‘before and after’ audit copies of his assessment, highlighting the DWP editing designed to trivialise the impact of his medical conditions on his day to day living circumstances, and to remove points for his award eligibility. 

The Daily Record reports than an estimated 11,760 assessment reports were secretly graded by DWP officials as acceptable, unacceptable, or amended.

DWP officials graded around 980 health assessments per month, with up to 200 of these being amended every month, while 20 to 50 were deemed “unacceptable” and rejected outright.

However, the number of amended reports is likely to be much higher because the DWP only publishes data from Independent Assessment Service forms (formerly known as Atos).

The Daily Record also says that 33,670 assessments in total were audited from two private companies contracted by the DWP to carry of disability assessments for PIP. 

SNP MP Marion Fellows commented: “It is concerning that thousands of health reports are being tampered with each year by people who weren’t even present for the assessment.

“There must be a complete halt to audits and an inquiry into the UK Government’s rigged health assessments.

“DWP auditors, who aren’t present during assessments, should not be able to mandate changes which could bear heavily on peoples’ lives.

“Changes should not be made by so-called health professionals who didn’t even carry out the original assessment. This is a clear injustice that must be corrected.

“People have spoken to me about how they feel they are degraded in their assessments.

“For the whole process to be a sham and for the assessment to be undermined by auditors is infuriating.”

The DWP said: “We are absolutely committed to ensuring people receive the support they are entitled to.

“That is why assessments are carried out by qualified health professionals and we continue to work with them to ensure quality is continuously improving.

“Sometimes assessment reports are returned to providers to ensure we have as much information as possible to reach an accurate decision.”

That’s clearly untrue. Information is most often actually removed at ‘audit’ by the DWP.  And inaccurate decisions are unacceptably high. The high success rate of claimant appeals indicates that clearly, something is seriously wrong with the system.

Last year, around two thirds of cases heard at tribunal in Great Britain found in favour of the claimant. In Northern Ireland, the figure was around 54% in 2018-19. The rise in the percentage of successful appeals came despite a drop in the overall number of cases being heard at court.

This raises concerns about the overall quality of decision-making in the DWP – both on PIP and ESA, in the apparent push to remove support unlawfully from as many disabled people as possible in the name of austerity.

The hostile environment

The introduction of mandatory reconsiderations in 2013 and cuts to legal aid have deterred many people from appealing. Mandatory Reconsideration don’t seem to function as a genuine check to ensure the original decision is fair and accurate, instead it is an administrative hurdle for claimants to clear, leaving them without any support while the DWP review the original decision. Furthermore, there were targets in place for DWP decision-makers to uphold around 80% of the original DWP decisions.

The DWP have claimed that the largest single reason for the high success rate of those claimants appealing DWP disability benefit adverse decisions. However, the Department has failed to explain why it takes until the appeal stage for evidence to come to light. In almost half of cases the “new evidence” presented was oral (not medical) evidence from claimants, which arose most often during the appeal process. It is difficult to understand why this information was not, or could not have been elicited and reported by the assessor.

The DWP’s attempt at explanation does not absolve the Department of responsibility. It certainly fails to address or explain how a target for upholding original decisions is compatible with ensuring that questionable reports are thoroughly investigated, and clearly flawed, inaccurate decisions identified and corrected.

Government guidelines for assessments are aimed at invalidating disabled peoples’  accounts of their experiences of illness and disability

The government produced guidelines that says assessors must look for ‘inconsistencies’ in disabled people’s accounts. Assessors are told: “All evidence must be interpreted and evaluated using medical reasoning, considering the circumstances of the case and the expected impact on the claimant’s daily living and/or mobility. When weighing up the evidence, it is important to highlight any contradictions and any evidence that does not sufficiently reflect the claimant’s health condition or impairment or the effect on their daily life.”.

This means that rather than focusing on written medical evidence and verbal evidence provided by the claimant, the assessor is looking for any evidence that may be used to discredit the claimant’s account of their disability from the start. 

Disabled peoples’ benefits assessments are carried out on behalf of the Department for Work and Pensions by the private contractors Capita, the Independent Assessment Services (formerly called Atos) and Maximus. However, it is the DWP that makes the decisions regarding a person’s eligibility for social security support.

The government guidance document for PIP assessments (section 3.4 onwards) says that “audit processes are in place for auditing the quality of assessments through:

• DWP Lot-wide audit (random sample); and
The provider – Approval-related audit (for trainees).

And: “Audit has a central role in ensuring that decisions on benefit entitlement, taken by DWP, are correct. It supports this by confirming that independent Health Professional advice complies with the required standards and that it is clear and medically reasonable. It also provides assurance that any approach to assessment and opinion given is consistent so that, irrespective of where or by whom the assessment is carried out, claimants with conditions that have the same functional effect will ultimately receive the same benefit outcome.”

It goes on to say: “The DWP Independent Audit Team carries out lot-wide audit, which is an audit of a controlled random sample from across each contract Lot, feeding in to routine performance reporting for DWP.”

Where a report is deemed ‘unacceptable’: “Any changes made to forms should be justified, signed and dated. It should be made clear that any changes are made as a result of audit activity. Where necessary a new report form should be completed.”

The government guidelines also say that: “Any challenge to the reason DWP has returned a case to the Provider for rework must be made via the nominated rework Single Point of Contact (SPOC).”

In the event of a dispute regarding a request for an assessment report to be changed, “the final decision on whether the case requires rework rests with DWP and not the assessor.” 

So ultimately, an official at the DWP who was not present when a person was assessed, may decide that the assessment report is ‘reworked’, and use non-transparent criteria to change the facts established and recorded during the assessment.

This means that the person making the claim has no opportunity to challenge the changes made to ‘reworked’ reports before the decision is made regarding the claim. 

Over the last few years, evidence has mounted that disability benefits are being reduced or removed from people on fabricated grounds. Disability News Service (DNS) has  carried out an investigation into claims of widespread dishonesty in the disability benefit system. The research found more than 250 PIP claimants who have alleged assessors repeatedly lied, ignored written evidence and dishonestly reported the results of physical examinations. It’s a regular occurrence for disabled readers to read the reports of their benefit assessment, and find a statement of their circumstances, an event or comment that never happened.

For example, one person with a serious spinal injury who is wheelchair-bound was baffled by the comment on her assessment report which said she could bend to feed her dog and could take it out for a walk. She said she doesn’t have a dog, and has never had one. 

The government produced guidelines that says assessors must look for ‘inconsistencies’ in disabled people’s accounts. For example, if a person says they lack dexterity in their hands, but they are wearing jewellery, it will simply be assumed that they can open and close the clasp. They won’t be offered an opportunity to clarify that this is the case. 

In my own PIP assessment report in 2017, it said that the HP had to prompt me several times because of my lack of concentration. She also acknowledged that I needed aids to remember to take my medication. Yet the report is riddled with inconsistencies and inaccuracies. It was concluded that there is no evidence that I have any ‘cognitive difficulties’ because I have a degree (from 1996), and worked as a professional – social work (before I became too ill to work in 2010.) 

It was also mentioned that I had a driving licence as further justification for removing a point, but the report failed to mention I have not been able to drive since 2005 because of flicker-induced seizures, even though I made that clear. I therefore lost one point – which meant I was not awarded the enhanced rate. The reasons provided were not justified, since the assessor referred to events and periods of my life when I was not ill and disabled.

As well as widespread allegations of fabricated reports, secret filming has produced claims of a culture of targets, in which assessors are allegedly monitored to ensure they don’t find excessive numbers of disabled people eligible for benefits, and mounting evidence of toxic punitive measures. As one former jobcentre adviser put it when describing her role with benefit claimants, there were “brownie points for cruelty”.

Consequences of the DWP’s hostile environment

The Conservative’s welfare reforms have led to “grave and systematic violations” of disabled people’s rights, a United Nations (UN) inquiry has concludedChanges to social security “disproportionately affected” disabled people, the United Nations Committee on the Rights of Disabled Persons (CRPD) found.

The UK was the first country to be investigated under a UN convention it has been signed up to since 2007.

However, the government said it “strongly refuted” the committee’s findings and its “offensive” view of disability. Many disabled people, charities and campaigners submitted evidence to the United Nations for the inquiry. The government’s response was offensive.

The committee launched an investigation in 2012 after receiving evidence from individuals (I submitted evidence) and disability organisations about an the adverse impact and harm of government reforms on disabled people. The government have refused to act upon the findings and recommendations of the UN report.

Last year, the DWP disclosed that over 21,000 ill and disabled people died waiting for their PIP assessment to be completed, between April 2013 and 30 April 2018.

Sarah Newton, then Minister of State for Disabled People, published the figures on 11 January following a question raised in parliament by Labour MP Madeleine Moon in December: “How many people have died while waiting for their personal independence payment assessment to be completed; and what were the conditions those people died from?”

Newton responded: “All benefit claims can be made under the special rules for people who are terminally ill which will mean that they are fast tracked. These are currently being cleared within 6 working days for new claimants to PIP. The Department would encourage all claimants with a terminal illness to let the department know and to apply using the special rules.

The cause of death of PIP claimants is not collated centrally by the Department.”

Over 3.6 million applications to PIP were made between April 2013 and 30th April 2018. Of these:

  • 4,760 claimants died between their case being referred to, and returned from, an assessment provider;
  • 73,800 claimants died within 6 months of their claim being registered; and
  • 17,070 claimants died after registering but prior to the DWP making a decision on their claim. Details of the claimant’s primary medical condition, where recorded, are in the accompanying spreadsheet.”

The total number of PIP claimants who died was 95,000. But Newton’s response does not indicate at what stage of their claim the 73,800 people, who died within six months of it being registered, were at. Nor does it indicate what those people who did not have terminal or degenerative illnesses died of – including those with mental illness. For example, 270 of those mortalities are listed as having had anxiety and/or depressive disorders as their primary disorder.

Of those who did have terminal illnesses, we need to ask why these people were  cruelly left waiting so long for their assessment, if, as Newton claims, they are ‘fast tracked’ through the claim and assessment process.

Prior to the introduction of PIP, Esther McVey stated that of the initial 560,000 claimants to be reassessed by October 2015, 330,000 of these are targeted to either lose their benefit altogether or see their payments reduced. Of course the ever-shrinking category of “those with the greatest need” simply reflects a government that has made a partisan political decision to cut disabled people’s essential income to fund a financial gift to the wealthiest citizens. There is no justification for this decision, nor is it remotely “fair”, as the government claims. 

We also need to ask how and why McVey had those figures in advance of the assessments taking place.

It’s become very evident since that ‘those in the greatest need’ are not being served by social security.  Disabled people are suffering distress, harm and some are dying as a consequence of government policy. The DWP end disabled people’s support any way they can, it seems. And when they can’t find a reason, they edit the evidence to attempt to justify their brutal and incoherent decision making.

In August 2013, Mark Wood starved to death at his home in Oxfordshire after his ESA was stopped.

David Barr, from Glenrothes, Fife, also died that month, having taken his own life following an assessment that deemed him “fit for work”, resulting in the withdrawal of his ESA. He had a long history of serious mental health problems. 

On 23 September 2013, a father-of-two, Michael O’Sullivan, took his own life at his flat in north London. He had a long history of significant mental ill-health.

In November 2015, Paul Donnachie killed himself at his home in Glasgow. His ESA was stopped in error, but the letter informing him of the DWP’s mistake arrived too late. His body was found when the council came to evict him.

All of these people had significant mental health problems, and there are countless others, many whose names are never likely to be known, other than by grieving family and friends. These deaths are inextricably linked to decisions and actions taken by Conservative ministers and senior civil servants from the early days of the 2010 coalition government.

Every one of their deaths could and should have been avoided.

The Disability News Service (DNS) reported more recently that Errol Graham weighed just four-and-a-half stone when his body was found by bailiffs who had knocked down his front door to evict him. He had just a couple of out-of-date tins of fish left in his flat, because the DWP had wrongly stopped his ESA. He starved to death, and his rent support had been stopped as a consequence of his ESA claim being ended. The DWP failed to follow safeguarding rules in their haste to end his claim. He was also denied PIP, which left him without any income whatsoever. 

DWP civil servants had failed to seek further medical evidence from his GP, just as in many other tragic cases that have sparked repeated calls for an independent inquiry into links between the deaths of claimants and the actions and failings of the DWP. The government have consistently refused to acknowledge a correlation between their actions and the death of disabled people, so have no intention of investigating the evidence. 

Assistant coroner Dr Elizabeth Didcock, who heard the inquest, was told that the DWP stopped Graham’s ESA entitlement – and backdated that decision to the previous month – after making two unsuccessful visits to his home to ask why he had not attended a face-to-face work capability assessment (WCA) on 31 August 2017. The inquest heard that it was standard DWP procedure to go ahead with stopping the benefits of a claimant marked on the system as vulnerable after two failed safeguarding visits.

However, the DWP (somehow) managed to stop an ESA payment that had been due to be credited to his bank account on 17 October, the same day officials made the second unsuccessful safeguarding visit.

DWP’s own rules state that it should make both safeguarding visits before stopping the benefits of a vulnerable claimant.

Because Errol lost his ESA entitlement, his housing benefit was also stopped. His family says he had also been found ineligible for PIP. Deprived of all financial support, experiencing significant mental distress and unable or unwilling to seek help, he slowly starved to death. He was 57. His body was discovered on 20 June 2018 when bailiffs arrived at his Nottingham council flat to evict him for non-payment of rent. 

His benefits had been stopped even though he had been receiving incapacity benefit, and then ESA, for many years as a result of enduring mental illness and distress that had led to him being sectioned. Errol was clearly extremely vulnerable.

He had also told the DWP on an ESA form three years earlier that he could not cope with “unexpected changes”, adding: “Upsets my life completely. Feel under threat and upset…”

He added: “Cannot deal with social situations. Keep myself to myself. Do not engage with strangers. Have no social life. Feel anxiety and panic in new situations.”

The assistant coroner said: “There simply is not sufficient evidence as to how he was functioning, however, it is likely that his mental health was poor at this time – he does not appear to be having contact with other people, and he did not seek help from his GP or support agencies as he had done previously.”

She concluded in the narrative verdict, delivered last June, that the “safety net that should surround vulnerable people like Errol in our society had holes within it”.

Those ‘holes’ are a consequence of deliberate, ideologically driven anti-welfare policies. They have intended consequences. The government assumes that people treated unfairly will appeal wrong decisions. Firstly, many people are far too ill to cope with the stress of that process. Secondly, it should never be primarily the role of courts to allocate social security fairly. That is the official role and purpose of the DWP.  However, the government department is clearly failing to fulfil its role. This is because the neoliberal ideology that drives austerity policies is incompatible with the central principles of social security. 

She continued: “He needed the DWP to obtain more evidence [from his GP] at the time his ESA was stopped, to make a more informed decision about him, particularly following the failed safeguarding visits.”

She said that a consultant psychiatrist had told the inquest “that Errol was vulnerable to life stressors” and that it was “likely that this loss of income, and housing, were the final and devastating stressors, that had a significant effect on his mental health”.

But she decided not to write a regulation 28 report demanding changes to DWP’s safeguarding procedures to “prevent future deaths” because the department insisted that it was already completing a review of its safeguarding, which was supposed to finish last autumn.

The DWP had promised her it would “listen to clients and to those representing them, and… ensure that the DWP was focused on support and safety for vulnerable people”.

Dr Didcock insisted that this commitment “must be converted into robust policy and guidance for DWP staff” and that the DWP must ensure that “all evidence that can reasonably be gathered is put together about a client, before a benefit is ceased”.

Disability News Service also highlights that the death of Errol Graham closely mirrors other tragedies caused by the DWP’s repeated refusal to make significant improvements to its safeguarding policies and practices.

Denise McKenna, co-founder of the Mental Health Resistance Network (MHRN), said the network was “absolutely devastated and saddened beyond words to hear of the circumstances surrounding the death of Mr Graham”.

She said: “We are enraged that the DWP continues to treat the lives of people who live with mental distress as disposable.

“This level of cruelty is outside of anything that would happen in a civilised society.

“The fact that Mr Graham had not responded to attempts to contact him following his failure to attend the work capability assessment (WCA) should have raised alarm bells over his safety, but instead the DWP took the opportunity to stop his social security entitlements.”

And there’s the truth: the government have created a hostile environment for disabled people that is heavily weighted towards preventing successful claims, taking its lessons from rogue multinational insurance companies such as Unum, who have systematically employed strategies to pay out insurance only as the last resort, rather than on the basis of need. 

And if the evidence doesn’t suit the politically desired outcome – as outlined by the likes of Esther McVey –  it can always be edited or disposed of by the DWP.

Hostile environment McDonnell

 


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I have engaged with the most critical issues of our time – from the often devastating impact of almost a decade of Conservative policies and growing, widespread inequality to the influence of big tech on our lives. At a time when factual information is a necessity, I believe that each of us, around the world, deserves access to accurate reporting with integrity and the norms of democracy at its heart.

My work is absolutely free from commercial and political interference and not influenced one iota by billionaire media barons.  I have worked hard to give a voice to those less heard, I have explored where others turn away, and always rigorously challenge those in power, holding them to account. 

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Every reader’s contribution, however big or small, is so valuable and helps keep me going.  Thanks.

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Call for research evidence: would UBI mitigate the social & economic disadvantages experienced by disabled people?

download (3)

Jane Mathieson is conducting research for her dissertation, which aims at reflecting on current experiences of those of us with invisible disabilities claiming disability benefits. She is exploring how Universal Basic Income (UBI) may improve our quality of life, potentially addressing social and political prejudice, removing barriers from disabled peoples’ socioeconomic inclusion and participation. 

Universal Basic Income is a regular payment made to every individual, which is not means tested, non-withdrawable and is paid without work conditions.

It would:

  • Guarantee everyone a secure base  
  • Replace the draconian, complex benefits system with a scheme fit for the 21st century 
  • Provide us all, including people who need extra income related to illness, disability and housing, with the freedom to develop our potential, to be included in society, to contribute our talents and to have the dignity we all deserve.

UBI would greatly reduce the ghastly punitive bureaucracy of the welfare system and give people more choice about which kind of work they take. It would also promote the idea of universality more generally, since it is an unconditional form of income. In non-universal welfare states, the state is primarily concerned with directing resources to “the people most in need”.

This requires a tight bureaucratic control in order to politically determine who is eligible for support and who is not. Furthermore, “those most in need” is a somewhat vague category of people, and as we have observed over the past decade, it comes with a bureaucracy that constantly re-defines ‘need’ and perpetually shifts the goal posts to suit the neoliberal austerity agenda.

People have been refused Employment and Support Allowance, on the grounds they are “fit for work”, for example, and therefore, not among those in the greatest need of support. However, many have died within weeks of being deemed fit for work by the state, indicating clearly they were not capable of working, and that they were in fact among those most in need of support. 

Beverage’s idea of the welfare state was universal and comprehensive one. He saw the role of the state as one of protection, which promotes the economic and social well-being of citizens, based upon the principles of  democracy, equal opportunity, equitable distribution of wealth, and public responsibility for citizens unable to avail themselves of the minimal provisions for an adequate standard of living. Social insurance is a system where people pay towards their own social security, should they need it. The vast majority of ill and disabled people have worked and therefore contributed to their own support. However, that support provision has become increasingly conditional and precarious.

I’m distributing this questionnaire to support Jane’s work.

It’s useful to explore in particular how UBI may work for those who need more support, such as those with caring responsibilities, as well as disabled people.

Here is an introduction to Jane’s research. You can click on the hyperlink highlighted in blue at the bottom of the page to participate in the survey: 

Taken for Granted: the implications of Universal Basic Income on those with Invisible Disability and a cost-benefit analysis for the State

You have been invited to be part of research to consider the experiences of those with invisible disabilities claiming benefits under the current system and how the implementation of Universal Basic Income may affect them. 

Please read this information sheet to find out more about the research and why I am doing it. 

My name is Jane Mathieson and I am currently in my final year of a BSc (Hons) Degree in Applied Social Science. One aspect of the course involves conducting academic research for which I have chosen to focus on Universal Basic Income and how its implementation may affect those with invisible disability in terms of well-being, social inclusion and work-related activities. 

The concept of true Universal Basic Income is that it is a benefit given to a large proportion of the population, regardless of household or family structure, age, employment status or disability. It is defined as a financial support which is sufficient enough to meet a family’s basic needs without earnings or additional sources of income. It would be seen to replace all income related benefits in their entirety, but not additional financial support such as Personal Independence Payment which is paid to compensate for the additional costs of being disabled. 

An online questionnaire will be distributed among members of Disability and Welfare Rights organisations through their online forums and social media. Hard copies will be made available on request. Participants may be invited to volunteer to take part in semi-structured interviews via Skype or another face-to-face communication platform. Please note there is an open comments box at the end of the questionnaire for you to share any additional comments or personal experiences. 

Confidentiality and anonymity: If you are happy to take part, please complete the consent form. I may write about what I find out in reports, conference papers, journals and books. I will also share any findings with other people who arrange similar activities, as well as other researchers.

It will not be possible to know who said what in anything made public. You can ask for feedback about our findings if you would like. If you choose to proceed, please complete the following questionnaire. On submission all data will be anonymised. All data collected will be stored on a password protected, private laptop, hard copies will be stored in a locked filing cabinet. 

Right to withdraw: You have the right to stop taking part in the research at any time during the questionnaire up to the point of submission when your details will be automatically be anonymised. Should there be a face-to-face interview, you also have a right not to answer specific questions or to ask for any audio and video ­recording to stop. 

Thank you in advance for your time and participation. Should you have any further questions regarding this research please contact me by email at jm158340@truro-penwith.ac.uk 

You can access the information sheet and questionnaire here.

Related

 


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More people, like you, are reading and supporting independent, investigative and in particular, public interest journalism, than ever before.

I don’t make any money from my research and writing, and want to ensure my work remains accessible to all.

I have engaged with the most critical issues of our time – from the often devastating impact of almost a decade of Conservative policies and growing, widespread inequality to the influence of big tech on our lives. At a time when factual information is a necessity, I believe that each of us, around the world, deserves access to accurate reporting with integrity and the norms of democracy at its heart.

My work is absolutely free from commercial and political interference and not influenced one iota by billionaire media barons.  I have worked hard to give a voice to those less heard, I have explored where others turn away, and always rigorously challenge those in power, holding them to account. 

I hope you will consider supporting me today, or whenever you can. As independent writers, we will all need your support to keep delivering quality research and journalism that’s open and independent.

Every reader contribution, however big or small, is so valuable and helps keep me going.  Thanks.


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Woman with rare heart condition that causes unpredictable multiple health problems is denied PIP

gail

Gail Ward. Photo: Facebook

A woman with a rare heart condition, which can cause her to collapse unpredictably at any moment, has spoken about her battle with the Department for Work and Pensions (DWP) to get the support she desperately needs.

Gail Ward was told that she did not qualify for Personal Independence Payment (PIP), despite living with the potentially life-threatening heart condition called Prinzmetal’s angina, a rare form of angina where attacks can occur even when she is resting. Remarkably, Gail was told by the DWP that she doesn’t qualify for PIP.

Prinzmetal’s angina can cause arteries in the heart to spasm during times of stress or cold weather, which severely limits a person’s independence and can also be life-threatening. It causes cardiac arrhythmias and can lead to heart attack if the blood flow to the heart deprives the organ of oxygen. The condition may sometimes arise when someone already has a serious form of Raynaud’s phenomemon, where the blood supply to the extremities is closed down because of cold or stress, causing a painful spasm. But it is a relatively rare condition.

Gail, who many of my readers will know, is also a respected disability rights campaigner. She had been claiming Disability Living Allowance for 20 years, but after being ordered to attend a mandatory reassessment for PIP, she was told that her support would stop because she ‘failed to meet the qualifying criteria.’

Gail told the Chronicle Live about her condition: “It occurs when you are resting and you don’t get any warning. It is not like normal angina.

“I can be in the sitting room having a conversation and the next minute I have collapsed.

“I need to wear a pendant bracelet in case I collapse but sometimes I don’t even get to press that.

“It has such an impact on my life. If I have a severe attack I could not even put a sentence together but find that if I rest up it allows the body to repair itself.”

Gail, who also has arthritis and hip dysplasia, among other health problems, say’s that living with the condition leaves her feeling tired and drained and that this has been exacerbated by her battle with the DWP.

She appealed the DWP’s decision. After waiting 15 months for her case to be heard at a social security tribunal, Gail was told that her appeal had been successful and that her benefits would be reinstated.

Commenting on her own experience and that of other people who struggle to get the support they are entitled to, Gail said: “Disabled people are losing their mobility cars, losing disability entitlement when they are moving to PIP.

“It is a different criteria. It is basically about what you can and can’t do. It is a disability analysis, not a medical.”

In 2013, the government began to rollout PIP for adults to replace Disability Living Allowance (DLA). One of the purposes of PIP was to reduce spending, with the intention of costing 20% less. Therefore, the conditions to satisfy in order to be entitled to the support were made stricter.

Gail is right. The assessments are not remotely ‘medical’ in nature, and the evidence from doctors employed within the NHS, including diagnosis and details of symptoms, are often ignored. Instead, the DWP contracted assessments are geared towards “objective” snapshot accounts of how someone’s disability affects their day to day living.

It also emphasises the professional gap between NHS medical professionals and the “health professional” employed by the state to carry out these functional capacity assessments in the context of a neoliberal welfare state, and medical health professionals, whose wider work is generally not directly linked to the politically defined conditionality of welfare support.

That said, PIP is a non-means tested support to help people maintain as much independence as they can, whether in work or not. It stands to reason that someone who is too ill to work will need more support because of their loss of earnings. 

Gail said: “People with severe disabilities are losing their DLA after being on it for 20 or 30 years.”

She added: “I would like the DWP to clarify why they refuse to address poor quality assessor report failings and decision maker decisions, which put disabled people at risk of financial hardship.

“I would like answers as to why the DWP stop the mobility component money from date of applying.

“I applied in July 2018 but the assessment was in October 2018, yet if a claimant is successful the mobility component is paid from decision date.”

A DWP spokesperson said: “We are committed to ensuring that disabled people get the support they’re entitled to.

“Decisions to award PIP are based on all of the evidence available to us at the time.

“Ms Ward has been awarded the enhanced rates to PIP for daily living and mobility after additional evidence was provided.

“She continued to be supported with Employment Support Allowance while awaiting the outcome of her PIP tribunal.”

This standard response doesn’t offer any explanation as to why the DWP decided that someone who they have already deemed more than once as not being well enough to work somehow failed to qualify for Personal Independence Payment.

Gail was subjected to a loss of income, her motability entitlement and high levels of stress for almost a year and a half. It’s a well known fact that stress exacerbates illness, and particularly her heart condition.

Furthermore, it is the decision of the ‘health professional’ (HP) to “determine whether any additional evidence needs to be gathered from health or other professionals supporting the claimant.”

Often at the appeal stage, it turns out HPs frequently decide not to ask for further evidence.  The DWP must take all medical evidence into account when making a decision about PIP claims. Yet the DWP say: “In many cases, appeals are granted because further medical evidence is provided.” 

This indicates that people are having to go to court, often waiting months for their appeal to be heard, because of deliberately under-informed, poorly evidenced DWP decisions. 

Furthermore, it says in the government guidance to GPs: “Your patient should complete the forms to support their [PIP] claim using information that they have to hand, and should not ask you for information to help them do this, or to complete the forms yourself.” “

After all this time, you would expect that this problem would have been addressed, especially given that the person who suffers as a consequence is always the ill and disabled person. 

Anyone would think this is part of a broader enduring government strategy to ensure as few people as possible are awarded the disability support they are entitled to. After all, it takes immense strength for someone who is very ill to fight unfair decisions at tribunal, and not everyone does so.

Many die while awaiting the outcome of their claim for PIP.  Up to January 2019, more than 17,000 people died while waiting to hear whether their claim had been successful, it emerged.

Among those were people with terminal conditions, but who did not meet the government’s strict ‘six month’ rule – people can only be ‘fast tracked’ for support if they are expected to die within six months. However, doctors cannot predict the precise timing of terminally ill people’s demise. Many campaigners have been pushing for this restriction to be lifted, because it’s irrational, inhumane and unreasonable. 

Ministers have been accused of “failing people at the most vulnerable point in their lives” after the figures revealed 17,070 disability claimants have died while waiting for decisions on their PIP claims since 2013.

One in four (4,330) of those who died were suffering from a form of cancer, while 270 had anxiety or depressive disorders. In more than half of cases (9,020), the main disability was not even recorded.

Last year, shadow disabilities Marsha de Cordova accused the government of allowing a “cruel and callous” PIP assessment process to create a “hostile environment for disabled people”.  

She is absolutely right.


 

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DWP stop man’s PIP support after assessor claims amputated foot has ‘healed’

weir

Tommy Weir says the reference in his Personal Independence Payment (PIP) assessment report to his left foot was either ‘gross incompetence or simply a lie’ because he doesn’t have a left foot.

A man who had his foot amputated because of a health condition has had his social security support cut after an assessor claimed a wound on his non-existent foot had “completely healed”.

Despite the evident error in the Department for Work and Pensions report, Tommy Weir’s £479 a month payments were immediately stopped last month.  

Weir suffered from a bone infection which led to life-threatening sepsis and an eventual amputation of his leg under the knee in October 2017.

He was initially examined at his home and awarded a Personal Independence Payment (PIP) as he cannot walk without the aid of a prosthetic leg. Before becoming too ill to work, Weir was a swimming pool manager.

The assessment was carried out by Independent Assessment Services (IAS), previously known as ATOS.

Weir said, referring to the assessor’s later claim: “The reference to my left foot was either gross incompetence or simply a lie because I don’t have a left foot. 

“I honestly believe I’m yet another case where IAS have quotas to fulfil that rely on refusing people’s applications for PIP or other benefits, no matter what kind of disability is put in front of them.”

In the IAS assessment, it is recorded in a “current symptoms” section that “the wound on his left foot has healed”.

Weir, who has worked at the local authority leisure centre in Renfrew for 35 years, said: “My employers have been great and they have made adaptations at work to allow me to do my job.

“I believe IAS takes the opposite view, that they are set up to take things away, not to help.”

A spokesperson from IAS last night apologised to Weir

The spokesperson said: “We are looking into this, we understand this was an error and would like to apologise to Mr Weir, as the wording should have read that his wound had healed.

“We are unable to say if his PIP will be reinstated as it is the DWP who will make that decision.”

A DWP spokesperson said: “PIP is awarded based on someone’s needs arising from a disability or health condition and those needs can change over time with rehabilitation or, in the case of amputees, with the use of prosthetics.

Decisions are made following consideration of all the information provided, including any assessment report and supporting evidence from a GP or medical specialist. If someone disagrees with the decision, they can of course ask for it to be looked at again.

“Mr Weir has asked us to reconsider our decision and we will contact him as soon as we have looked at his case again.”

Source


 

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Sarah Newton lied to parliament and the public about the DWP’s standardised letter to GPs following ‘fit for work’ assessment

newton

Sarah Newton, former minister of state for disabled people. However, it’s very evident that neither she nor her party actually support disabled people. They prefer oppressing them.

Last month and previously, I reported about the controversial issues raised by the Department for Work and Pensions’ standard ESA65B GP’s letter template, which was only relatively recently placed on the government site, following a series of probing Parliamentary Written Questions instigated by Emma Dent Coad, addressed to the minister of state for disabled people. Her responses to the questions were repetitive, vague, unevidenced and did not address the questions raised. 

Campaigners and MPs have called for the Department for Work and Pensions’ (DWP) amended letter to GPs to be scrapped after it emerged that ill and disabled people appealing against unfair work capability assessment (WCA) decisions were left in near destitution after their GPs refused to provide further ‘fit notes’, because they were instructed that they did not need to by DWP officials.

It emerged that ministers ordered changes to the standard-issue letter to remove references that made it clear to GPs they may have to issue a medical statement if their patient wished to appeal against a WCA decision. The DWP claims this was not intended to dissuade GPs from issuing fit notes. 

However, it’s highly unlikely that government ministers ordered the amendment to the letter for another purpose, as there are none. This was a calculated strategy to deter people from appealing DWP decisions, by leaving them in severe financial hardship.

The mandatory review was also introduced for similar reasons, since people are left without any income while the DWP reviews its decision, a process which can take longer than six weeks.  

Those people who challenge WCA decisions are entitled to continue to receive employment and support allowance (ESA) at basic rate, worth £73.10 a week while they await their appeal hearing, but to do so they must obtain fit notes from their GPs to provide evidence that they are too ill to work.

They must also first await the outcome of a mandatory review before submitting their appeal. Before a claimant may lodge an appeal, they must first ask the DWP to ‘reconsider’ their original decision. There is no limit on how long the DWP may take to reconsider the original decision about their award. 

The DWP has a stated target of upholding 80% of their original decisions, so the majority of people then have to appeal following the review outcome, since the . The law says that the claimant may claim basic rate ESA following mandatory review if they wish to proceed with an appeal.

So the misleading change to the template letter routinely sent from the DWP to GPs has led to people who have lodged an appeal against an unfair decision being stopped from claiming basic rate ESA while awaiting the appeal hearing. This prevents many low-income disabled people from accessing any financial support while they wait for months on end to go to tribunal. Furthermore, we know that catastrophically inaccurate decisions following the assessments within the DWP are pretty much the norm. Nationally, 72% of people who appeal against their work capability assessment decision are successful.

Entitlement to ESA pending appeal is enshrined in the ESA Regulations to cover the whole of the period leading up the hearing. It is also possible to have the payment backdated to cover the Mandatory Review waiting period too – it can take over six weeks for the DWP to review their original decision, over which time people are left without welfare support.

ESA pending appeal is not paid automatically – people usually have to ask for it, and must provide fit notes from their GP, presenting these along with their appeal acknowledgment letter from the Tribunal Courts to their local Job Centre. The Job Centre should report back to the DWP who will arrange for ESA pending appeal to be paid.

From last year, then minister for disabled people, Sarah Newton, responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an Employment and Support Allowance (ESA) claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008.

That is partly untrue, since the original wording has been amended. 

Newton went on to say: “Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

The decision to change the letter template was made without any scrutiny from or consultation with parliament or the public.

The standard template letter, titled Help us support your patient to return to or start work says: “We assessed [Title] [First name] [Surname] on and decided that [select] is capable of doing some work, but this might not be the same type of work [select] may have done before.

“We know most people are better off in work, so we are encouraging [Title] [First name] [Surname] to find out what type of work [select] may be able to do with [select] health condition or disability through focused support at [select] local Jobcentre Plus.

“In the course of any further consultations with [Title] [First name] [Surname] we hope you will also encourage [select] in [select] efforts to return to, or start, work

“Please do not give [Title] [First name] [Surname] any more fit notes relating to [select] disability/health condition for ESA purposes.

Newton responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an ESA claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008. 

“Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

Professor Helen Stokes-Lampard, the chair of the Royal College of GPs (RCGP), said the lack of clarity over when GPs should issue fit notes could put patients’ finances and health at risk. “No GP wants that, and it only serves to threaten the long-standing trust that patients have in their family doctor.”

Until 2017 the standard letter advised GPs that if their patient appealed against the WCA decision they must continue to provide fit notes.

However, on (undisclosed) ministerial orders, the letter now states that GPs “do not need to provide any more fit notes for ESA purposes”. It does not mention the possibility that the patient may appeal, or that a fit note is needed for the patient to obtain ESA payments until the appeal is heard.

Frank Field, the chair of the work and pensions select committee, also raised the issue with Newton back in January. Newton replied that the wording was amended “to make the letter simpler and clearer”, adding that DWP communications were intended to be “clear, understandable and fit for purpose”.

The purpose appears to be to deter people from appealing unfair DWP decisions concerning the loss of their social security disability award.

Field replied that the wording was “not having the desired effect”, and urged her to revise it to make clear ESA claimants on appeal were entitled to fit notes. “This simple step could greatly ease the stress and worry that people who are awaiting an appeal experience.”

Newton told Field: “We are committed to ensuring our communication is clear, which is why the wording of this letter was cleared by both the British Medical Association and the Royal College of General Practitioners (RCGP). However, we will of course consider feedback when revising the letter.”  Newton tends to stick to a script in her responses, though. She told Emma Coad Dent exactly the same thing, almost word for word last year, in her response to a Written Question.

As I commented in a previous article, it was extremely unclear on what basis the RCGP agreed to the new wording as the change was agreed at a DWP stakeholder meeting for which, according to Newton, there are no formal minutes.

Newton confirmed this in the correspondence between herself and Field, as well as in her responses to Emma Coad Dent’s long series of Written Questions on this issue.

Firstly, on 16 May, last year, Newton says: “The Cabinet Secretary first issued the requirement to revise the ESA65B letter in November 2014.

“The wording of the ESA65B was changed to emphasise the benefits of work and to ask GPs to encourage their patients in their efforts to return to some form of work.”

Then, according to Newton: “The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016.” 

However, in June last year, she also said, in response to a Written Question from Emma Dent Coad: “DWP’s Legal Service cleared the revised wording on 29 July 2016 and the then Secretary of State for Work and Pensions subsequently authorised the changes.”

Yet when asked in November last year what written evidence her Department holds on the British Medical Association and Royal College of General Practitioners agreement to the revised wording of the ESA65B letters sent to claimants’ GPs when they fail the work capability assessment, she replied: “There is no written evidence relating to the agreement obtained from the British Medical Association and the Royal College of General Practitioners on the revised wording of the ESA65B letter.

“In accordance with the Answer of 30 May 2018 to Question 146987, agreement on the final wording of the ESA65B was obtained via the regular meetings DWP holds with both organisations.” 

She was being conservative with the truth. In other words, she was telling lies.

Following a series of distressing reports about people dying as they await the result of the Personal Independent Payment (PIP) and ESA assessments, the Work and Pensions select Committee has published the Royal College of GPs’ (RCGP) and the British Medical Association’s (BMA) views on DWPs controversial advice to doctors on “Fit Notes” for people awaiting the outcome of an ESA appeal.

The Committee asked both  organisations (PDF PDF 163 KB)Opens in a new window  (PDF PDF 163 KB)Opens in a new window for their input, following DWP’s repeated claims that they had approved the advice, given in a letter (form, ESA65B) to the GPs of people who have been denied ESA after assessment: PIP and ESA Assessments.

The Committee has described the assessment processes for disability/incapacity benefits as “gruelling” and “error-ridden”, potentially forcing claimants into DWP’s “arduous, protracted” reconsideration and appeals process. People who have been denied ESA at the assessment stage, but who are awaiting the results of their appeal are entitled to an “assessment rate” of ESA, in recognition of the hardship they may endure during the potentially lengthy wait for their appeal.

However, in recent months the Committee has been investigating concerns (PDF PDF 1.41 MB)Opens in a new window that the advice DWP is giving to doctors about the system and process is causing confusion, leading directly to people being left without the lifeline income they are entitled to.

I have reported previously that people have died soon after being declared ‘fit for work’ by the DWP, after the Department have contacted a patients’ doctor without notifying  them, telling the GP not to issue any more ‘fit’ notes. 

Comments from RCGP and BMA

The Department has claimed in response to the Committee (PDF PDF 219 KB)Opens in a new windowthat Agreement on the final wording of the revised ESA65B was obtained via the regular meetings DWP holds” with both the British Medical Association and Royal College of GPs”, (PDF PDF 84 KB)Opens in a new window and that the wording is the outcome of “close and extensive working between DWP, BMA and RCGP.” (PDF PDF 165 KB)Opens in a new window

Both medical professionals’ associations’ have now written to the Committee – and in the case of the RCGP, directly to the Secretary of State (PDF PDF 199 KB)Opens in a new window – expressing their concerns about both DWP’s advice to GPs and its characterisation of their approval or endorsement. The RCGPs said:

“Without a fit note from their GP, claimants who are awaiting the outcome of their appeal will not be able to receive ESA. They would therefore have to seek Universal Credit or Jobseekers Allowance, and subsequently try and meet the work-seeking requirements of those benefits, potentially endangering their health in the process. As such the College is deeply concerned about the potential impact of this on doctors and their relationships with potentially vulnerable patients.”

As the BMA describes in its response to the Committee (PDF PDF 164 KB)Opens in a new window:  

“By way of background the BMA attends meetings with the RCGP and the DWP where information is shared with the aim of improving working practices between the DWP and clinicians. While the BMA may act in an advisory capacity it does not have the authority to clear, approve or otherwise sign off any DWP correspondence or policies and would see this as being clearly outside of our remit…At a meeting with the DWP and RCGP a BMA representative was given sight of the ESA65B amended letter. The BMA considers that sight of this letter was for the purposes of information sharing and did not agree or otherwise sign off the content of the letter.”

The Royal College of GPs put the same point to the Committee (PDF PDF 197 KB)Opens in a new window:

We are aware that the Department claims that ‘The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016’. However, there is some ambiguity about what was said in the referenced meeting with the DWP. Since the DWP did not keep any written records of what was said at this meeting [as DWP admits in its latest letter to the Committee (PDF PDF 165 KB)Opens in a new window], we are unable to provide further clarity.”

The RCGP statement continues:

“Since these changes were made, significant evidence has come to light about the negative impact that these changes have had in relation to patient care, leading to some patients being denied fit notes by their doctors. We are concerned that the current wording of ESA65B does not sufficiently clearly indicate that there are circumstances in which GPs may need to continue to issue fit notes for their patients. It is essential that communication with GPs is as clear as possible, to uphold the high levels of trust that exist between GPs and their patients. As a minimum we would want to see the wording of the ESA65B letter urgently changed to its previous wording.”  

This means that ministers have once again mislead both parliament and the public in claiming that both medical professional organisations agreed to the wording of a controversial letter which told GPs not to provide benefits officials with proof that seriously ill patients were unfit for work.

I’ve reported on this particular issue more than once, and highlighted the parliamentary dialogue between Newton, who resigned in March, and the DWP, who have said in separate statements that the document wording “was cleared by both the British Medical Association and the Royal College of General Practitioners”.

Both organisations have now dismissed Newton and the DWPs’ claim. In the letter, the BMA,  said that they did not “clear” the wording, they were simply been shown the letter template during a meeting at the DWP.

When the organisation wrote to Frank Field, Pensions select committee, the letter states categorically that: “The BMA considers that sight of this letter was for the purposes of information sharing and did not agree or otherwise sign off the content of the letter.” 

The RCGP has told work and Pensions secretary Amber Rudd  that the letter “does not clearly indicate that there are exceptions to this wording, including if a claimant is appealing against the decision”. 

The Royal College raised fears that vulnerable patients awaiting the outcome of appeals may further harm their health by trying to meet the requirements of other benefits such as Universal Credit or Jobseeker’s Allowance.

However, a DWP spokesperson told me: “We have regular discussions with the BMA and RCGP to ensure we deliver effective support to disabled people and those with health conditions.

“The wording of this letter was discussed as part of these meetings, as both organisations confirm, as was the release of the final letter.

“Of course we recognise the concerns of GPs which is why we are discussing a revised letter with the BMA and RCGP and have issued clear guidance for GPs in the meantime.”

So, not only did the DWP and Conservative ministers lie and get caught out, they have continued to repeat the lie following its exposure.

Meanwhile citizens who are ill and disabled are left in dangerous situations with unacceptable levels of hardship, and some have died as a consequence, yet the government continues to present and mechanically repeat crib sheeted PR and strategic comms responses to limit the political damage of justified concern and criticism of their cruel, miserly, punitive, discriminatory, robotic neoliberalism and authoritarian policies that target those with the least in any way they can to prevent them from accessing the support that their taxes and National Insurance have contributed to creating. 

When David Cameron said the Conservative party was going to address the ‘culture of entitlement’, and ‘change the relationship between citizens and the state’ this is precisely the kind of underhand, targeted discrimination he had in mind. The ‘low tax, low welfare society’ is one where the wealthiest pay very little tax and the poorest citizens – in work and out – simply go without the means of meeting their most fundamental needs. 

The wider political aim is to systematically dismantle every single welfare and public service and to normalise the brutality of this process by almost inscrutable degrees, by telling lies that attempt to neutralise the serious concerns raised by campaigners, opposition MPs, academics, charities and medical professionals. This method of political gaslighting is much worse than lying, because it is a calculated, deliberate method of psychological manipulation and abuse.

 

 


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The government are challenging independent disability assessment appeal decisions

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In 2017, the then minister for disabled people, Sarah Newton, said that the Department for Work and Pensions (DWP) was “recruiting, training and deploying” approximately 150 presenting officers (POs) to attend Personal Independence Payment (PIP) and Employment and Support Allowance (ESA) tribunals “in order to present the Secretary of State’s case and support the first tier tribunal in arriving at the right decision”.

The question is the ‘right decision’ for whom? It’s certainly not disabled people.

Given that, at the point of appeal, the Secretary of State’s case has already been presented twice –  at the first DWP decision following assessment and again during the mandatory review – it seems that the government is using an incredibly oppressive and authoritarian approach to prevent successful appeal outcomes for ill and disabled people trying to access disability-related social security alone, without legal aid and support in the majority of cases. 

Last week I spoke to someone who won her PIP appeal following a reassessment which had resulted in the loss of her PIP award. After waiting two weeks for some communication from the DWP,  she rang to see when her award would be reinstated. She was informed that the DWP had requested the full written reasons for the tribunal’s decision, and that they were considering challenging the court’s decision. If the DWP decide to proceed with their challenge, they must apply for permission to appeal.

The application must be made within one month of the date of the tribunals’ written statement of reasons. So far, the claimant has been left without her award for 13 weeks, and she is very distressed. Having gone through mandatory review and appeal, she is utterly exhausted and the stress of the process has significantly exacerbated her illness – she has multiple sclerosis. Since her assessment, she has also needed treatment for anxiety and depression.

The claim for PIP was in relation to her physical disabilities, but she has become mentally unwell as a direct consequence of her extremely distressing experiences. The DWP will be permitted to appeal the tribunal’s decision only if it is considered that the decision resulted from an error of law. Once the tribunal have received the request the chair of the tribunal will provide a written statement to the claimant and the DWP explaining why they awarded PIP.  It can take up to 12 weeks for the written statement to be sent out.  

I co-run a support group online for people going through ESA and PIP claims, assessments, mandatory review and appeals. We are seeing a rise in the number of cases where the DWP are requesting written reasons for the decision of the tribunal, but quite often, it eventually emerges that they are not proceeding with an appeal. 

This leaves people waiting many months with the fear they may lose their lifeline award, causing a lot of additional and unnecessary distress. Furthermore, the DWP are not keeping people informed of their intentions in a reasonable and timely manner, which adds significantly to the distress and uncertainty that the whole awful process has created.

There are two people who have waited over 12 months after they won their appeal, while being told by the DWP that they are still awaiting the judge’s decision as to whether the DWP can proceed with a challenge. Meanwhile, the DWP refuse to discuss the details of the matter any further when people ask for details and an idea of a timescale.

One person told me he felt that the DWP are “intentionally playing mind games to demoralise and scare people”, and that leaving people feeling precarious was “a deliberate strategy” to undermine people’s expectation of support, and 

Someone else who won their PIP appeal has been left for four months without any payments, the DWP claim he owes them money for an overpayment, and refuse to release the money he is owed. However, he told me that he does not owe any money, and has never been overpaid, as prior to his relatively recent claim for PIP and ESA, he was in work and received no social security. He ahs also been forced to appeal the DWP’s decision not to award him ESA. 

The DWP were allocated £22m of public money to hire the “presenting officers” to “support” the DWP at disability benefit tribunals. Disability campaigners warn that these 180 presenting officers, rather than helping judges to make fair decisions about whether to overturn the DWP’s rejection of someone’s claim for benefits, will inevitably argue as forcibly as possible in the government’s favour. The aim is to cut the number of successful appeal outcomes for claimants. The reality is that PO’s are sent by the DWP to try to discredit claimants’ accounts and to argue forcibly for the DWP’s interpretation of the law to be accepted. 

A freedom of information request by Disability News Service resulted in them being sent forms that have to be completed by presenting officers after each tribunal they attend.

Included in the documents are the following questions for presenting officers attending ESA and PIP tribunals, respectively:

“PO impact – Was SG [support group] award averted”

“PO impact – was enhanced PIP award averted?”

DNS quotes a DWP insider, saying that presenting officers are being given the ‘target’ of stopping enhanced PIP payments and that this was placing ‘immoral pressure’ on presenting officers. (See the full article: ‘Truly appalling’ revelations ‘show DWP is subverting justice’ at appeal tribunals.)

The DWP outline says: “The PO must be confident that the decision is accurate and prepared to lapse appeals where this is not the case. They must highlight inconsistencies and take appropriate action when new evidence comes to light, including making a critical assessment of its validity.

But surely that is the role of an independent court.

At the time, Marsha de Cordova, Labour’s shadow minister for disabled people, described the DWP’s admission as “truly appalling”.

She said: “The idea that the ‘impact’ of DWP staff is being assessed on whether they managed to get ESA support group or enhanced PIP awards ‘averted’ is truly appalling.

“Presenting officers are supposed to be there to provide fair and balanced evidence of a claimant’s needs.

“In May last year [2017], freedom of information requests revealed that the DWP was setting targets to reject 80 per cent of social security appeals at mandatory reconsideration.

“They clearly haven’t changed their approach.”

She added: “The whole system is broken: from assessments where, for example, only eight per cent of claimants think assessors understood their mental health, through to appeals where judges are overturning over 67 per cent of initial ESA and PIP decisions.

“Labour will scrap the current PIP and ESA assessments, bringing an end to the Conservatives’ failed, privatised assessment system.

“Instead of enforcing a culture of distrust and cost-cutting, we will work with disabled people to ensure that they have personalised, holistic support to live full and independent lives.”

The assessment process, from beginning to end, is almost entirely about providing opportunities for assessors and DWP decision makers to manufacture as many far fetched ‘inconsistenciesas they can to prevent awards and deter as any higher rate awards as possible.

This means that PIP is not about meeting the needs of disabled people, it is about how little the state can get away with paying out from public funds, regardless of a person’s needs and entitlement.

It was acknowledged in my own PIP assessment report that I had cognitive difficulties because of my illness. The HCP said that I had difficulty focusing when asked questions and needed prompting. She acknowledged that I rely on a 7 day pill organiser to ensure I take my medication safely and correctly.

However, the report said that I had a degree (I graduated back in 1996), I had worked in a profession – as a social worker (until 2010, when I became too ill to work) and I had a driving licence in 2005 (I haven’t been able to drive since 2005 because of flicker-induced partial seizures). The assessment took place in 2017. I was not awarded a point for cognitive problems, and was just one point short of an enhanced PIP award. The reasoning behind not awarding the one point was unreasonable, irrational pretty thinly stretched, given that I cannot drive, I was forced to give up work in 2010, and I graduated in 1996. The decision at mandatory review was exactly the same, with the same woefully incoherent reasoning presented again.  

In November 2017, POs attended 23% of all first tier PIP tribunals, but the aim back then is to increase this to 50%.

It would seem likely that presenting officers are being used primarily to target claimants who are likely to be seeking enhanced rates of PIP or the support group of ESA. In which case their presence has nothing to do with improving decision making by feeding back to colleagues and everything to do with taking awards from disabled people, regardless of the high price disabled people have to pay in terms of loss of independence, loss of income to meet their basic and additional needs, placing them in unacceptable situations of severe hardship. 

A claimant who secretly recorded his personal independence payment (PIP) assessment and provided a transcript to a tribunal has won his appeal against a disability living allowance (DLA) to PIP transfer decision, the BBC has reported.

Nev Cartwright, 45, received DLA because of breathing difficulties caused by a lung tumour which led to his left lung being removed.

Last year he was told to attend a ‘medical’ to assess him for PIP instead of DLA. Because he had seen a programme the night before questioning the fairness of PIP assessments, Nev decided to secretly record the interview on his mobile phone.

As a result of the assessment Nev lost his higher rate mobility and had to return his Motability car.

When he read the PIP assessors report he realised that there was information missing and other details such as his peak flow reading, had been altered. The effect was to make Nev seem much more mobile than he actually was.

Nev had a professional company write a transcript of his assessment recording and asked to be allowed to submit it as evidence for his appeal.

The DWP tried to prevent the transcript being admitted by the tribunal, but they failed and the transcript was taken into account. As a result Nev won his case and now has his Motability vehicle again.

Given the very costly restrictions attempt to place on openly recording your PIP assessment, it is not surprising that some claimants turn to doing so covertly. Although we have had members who have used relatively inexpensive cassette recorders at their assessment.

It is not illegal to secretly record your assessment.

But if you are caught doing so and refuse to stop, the interview is likely to be ended and you will be held by the DWP to have failed to take part in the assessment with the result that you will not be awarded PIP.

This imbalance of power is most certainly subverting justice for disabled people. We often hear about the outright unfair methods the DWP uses to cut disabled people’s income when they have been held to account. But for every case we hear about where justice prevails in the end, there are many more that slip under the radar, because perhaps some of us are simply too ill, exhausted and disheartened to appeal alone, without any legal support, while the government spends hundreds of thousands of pounds of public funds to prevent us from having a fair and balanced assessment and hearing, and accessing the social security support that most of us have paid towards.

Meanwhile, Atos and Capita have come under fire for the reported mishandling of as many as a third of the PIP assessments they carried out. The firms received a raise for their efforts last year, raking in more than £250 million each for the controversial disability welfare checks, despite Parliament’s Work and Pensions Committee recently suggesting vulnerable people had been “pushed to the brink of destitution” by the contractors’ handling of the scheme.

That’s because the private companies are contracted to do precisely that by the government.

pip-esa inhumane

 


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Misleading DWP letter to GPs is depriving disabled people of lifeline support

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Credit: PA Images

Last month I reported about the issues raised by the Department for Work and Pensions’ ESA65B GP’s letter template, which was only recently placed on the government site, following a series of Parliamentary Written Questions.

Campaigners and MPs have called for the Department for Work and Pensions (DWP) standard letter to GPs to be scrapped after it emerged that ill and disabled appealing against unfair work capability assessment (WCA) decisions were left in near destitution after their GPs refused to provide further ‘fit notes’, because they were advised they did not need to by DWP officials.

It emerged that ministers ordered changes to the standard-issue letter to remove references that made it clear to GPs they may have to issue a medical statement if their patient wished to appeal against a WCA decision. The DWP claims this was not intended to dissuade GPs from issuing fit notes. 

Those people who challenge WCA decisions are entitled to continue to receive employment and support allowance (ESA) at basic rate, worth £73.10 a week while they await their appeal hearing, but to do so they must obtain fit notes from their GPs to prove they are too ill to work.

They must also await the outcome of a mandatory review.  Before a claimant may lodge an appeal, the must first ask the DWP to ‘reconsider’ their original decision. However, the DWP has a stated target of upholding 80% of their original decisions, so the majority of people then have to appeal following the review outcome. The law says that the claimant may claim basic rate ESA following mandatory review if they wish to proceed with an appeal.

So the misleading change to the template letter routinely sent from the DWP to GPs has led to people who have lodged an appeal against an unfair decision being blocked from claiming ESA while awaiting the appeal hearing. This prevents many low-income disabled people from accessing financial support while they wait for months on end to go to tribunal. Furthermore, we know that catastrophically inaccurate assessments within the DWP are pretty much the norm. Nationally, 72% of people who appeal against their work capability assessment decision are successful.

Entitlement to ESA pending appeal is enshrined in the ESA Regulations to cover the whole of the period leading up the hearing. It is also possible to have the payment backdated to cover the Mandatory Review waiting period too – it can take over six weeks for the DWP to review their original decision, over which time people are left without welfare support.

ESA pending appeal is not paid automatically – people usually have to ask for it, and must provide fit notes from their GP, presenting these along with their appeal acknowledgment letter from the Tribunal Courts to their local Job Centre. The Job Centre should report back to the DWP who will arrange for ESA pending appeal to be paid.

From last year, then minister for disabled people, Sarah Newton, responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an Employment and Support Allowance (ESA) claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008. 

“Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

The decision to change the letter template was made without any scrutiny from or consultation with parliament or the public.

The standard letter, titled “Help us support your patient to return to or start work.” says: “We assessed [Title] [First name] [Surname] on and decided that [select] is capable of doing some work, but this might not be the same type of work [select] may have done before.

“We know most people are better off in work, so we are encouraging [Title] [First name] [Surname] to find out what type of work [select] may be able to do with [select] health condition or disability through focused support at [select] local Jobcentre Plus.

“In the course of any further consultations with [Title] [First name] [Surname] we hope you will also encourage [select] in [select] efforts to return to, or start, work

“Please do not give [Title] [First name] [Surname] any more fit notes relating to [select] disability/health condition for ESA purposes.

Minister for disabled people, Sarah Newton, responded to one of several Written Questions from Emma Dent Coad, saying: “The ESA65B letter is issued to GPs in every case where an ESA claimant has been found ‘fit for work’. This process was built into the IT system as part of the introduction of ESA in October 2008. 

“Following a Ministerial requirement by the Cabinet Secretary, which was endorsed by the Secretary of State for Work and Pensions, the content of the ESA65B letter has been improved in order to explain to GPs the type of support customers can expect to receive from their local Jobcentre, and to ask GPs to encourage customers in their efforts to return to work.” [My emphasis]. 

Professor Helen Stokes-Lampard, the chair of the Royal College of GPs (RCGP), said the lack of clarity over when GPs should issue fit notes could put patients’ finances and health at risk. “No GP wants that, and it only serves to threaten the long-standing trust that patients have in their family doctor.”

Until 2017 the standard letter advised GPs that if their patient appealed against the WCA decision they must continue to provide fit notes.

However, on (undisclosed) ministerial orders, the letter now states that GPs “do not need to provide any more fit notes for ESA purposes”. It does not mention the possibility that the patient may appeal, or that a fit note is needed for the patient to obtain ESA payments until the appeal is heard.

Frank Field, the chair of the work and pensions select committee, has also raised the issue with the then disability minister Sarah Newton back in January. Newton replied that the wording was amended “to make the letter simpler and clearer”, adding that DWP communications were intended to be “clear, understandable and fit for purpose”.

Field replied that the wording was “not having the desired effect”, and urged her to revise it to make clear ESA claimants on appeal were entitled to fit notes. “This simple step could greatly ease the stress and worry that people who are awaiting an appeal experience.”

A DWP spokesperson said: “These letters simply inform GPs when a claimant has been found fit for work and are not intended to dissuade them from issuing fit notes for ESA appeal purposes, to claim otherwise is inaccurate.”

However, there is a hint the letter may be changed. Newton told Field: “We are committed to ensuring our communication is clear, which is why the wording of this letter was cleared by both the British Medical Association and the Royal College of General Practitioners (RCGP). However, we will of course consider feedback when revising the letter.”  Newton tends to stick to a script in her responses, though. She told Emma Coad Dent exactly the same thing, almost word for word last year, in her response to a Written Question.

It remains very unclear on what basis the RCGP agreed to the new wording as the change was agreed at a DWP stakeholder meeting for which, according to Newton, there are no formal minutes. Newton confirmed this in the correspondence between herself and Field, as well as in her responses to Emma Coad Dent’s long series of Written Questions on this issue.

Firstly, on 16 May, last year, Newton says: “The Cabinet Secretary first issued the requirement to revise the ESA65B letter in November 2014.

“The wording of the ESA65B was changed to emphasise the benefits of work and to ask GPs to encourage their patients in their efforts to return to some form of work.”

Then, according to Newton: “The British Medical Association and the Royal College of General Practitioners agreed to the revised wording of the ESA65B on 4 August 2016.” 

However, in June last year, she also said, in response to a Written Question from Emma Dent Coad: “DWP’s Legal Service cleared the revised wording on 29 July 2016 and the then Secretary of State for Work and Pensions subsequently authorised the changes.”

Yet when asked in November last year what written evidence her Department holds on the British Medical Association and Royal College of General Practitioners agreement to the revised wording of the ESA65B letters sent to claimants’ GPs when they fail the work capability assessment, she replied: “There is no written evidence relating to the agreement obtained from the British Medical Association and the Royal College of General Practitioners on the revised wording of the ESA65B letter.

“In accordance with the Answer of 30 May 2018 to Question 146987, agreement on the final wording of the ESA65B was obtained via the regular meetings DWP holds with both organisations.” 

Newton had previously also said: “In accordance with the Answer of 3 July 2018 to Question 155402, the information is not available as there is no written minute of the meeting between officials from this Department and representatives from the British Medical Association and the Royal College of General Practitioners on the revised wording of the ESA65B letter.” 

In June last year, Dent Coad asked Newton who attended the meetings between officials in her Department and the (a) British Medical Association and (b) Royal College of General Practitioners on the revised wording of the ESA65B; and if she would place in the Library a copy of the minutes of those meetings. Newton responded on 03 July 2018:  

“The names of the participants representing the British Medical Association and the Royal College of General Practitioners who attended the meetings referred to constitute their personal data and in accordance with data protection principles, they will not be disclosed without informed consent. DWP officials did not take minutes of these meetings.”

And: “No other external stakeholders were consulted on the development of the revised ESA65B letter.”

Newton has also said in response to Written Questions: “The Department is committed to ensuring all of its communications are clear, accurate and understandable and we continuously improve our letters. We engage regularly with the welfare benefits advice sector and disability charities and take into account all of the feedback we receive.”

“We have received comments from a number of sources including MPs, stakeholder organisations and GPs on the current version of the ESA65B letter and will take all of their feedback into account when revising it.”

I should hope so. The idea of the state persuading doctors and other professionals to “sing from the same [political] hymn sheet”, by promoting work outcomes in social and health care settings is more than a little Orwellian. Co-opting professionals to police the welfare system is very dangerous. 

In linking receipt of welfare with health services and “state therapy,” with the single intended outcome explicitly expressed as employment, the government is purposefully conflating citizen’s widely varied needs with economic outcomes and diktats, isolating people from traditionally non-partisan networks of relatively unconditional support, such as the health service, social services, community services and mental health services.

Public services “speaking with one voice” as the government are urging, will invariably make accessing support conditional, and further isolate already marginalised social groups. Citizens’ safe spaces for genuine and objective support is shrinking as the state encroaches with strategies to micromanage those using public services. This encroachment will damage trust between people needing support and professionals who are meant to deliver essential public services, rather than simply extending government dogma, prejudices and discrimination.

 

Related

Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died.

GPs told to consider making fit notes conditional on patients having appointment with work coach

Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

 


 

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Court victory for disabled EU benefit claimants at appeal

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Two disabled people who moved to the UK from other EU countries have won an important Appeal Court case which entitles them to disability-related benefits in the UK from shortly after they arrived rather than having to wait two years.

The case, brought by Child Poverty Action Group and Harrow Law Centre, will ensure that disabled EU citizens and their carers who have a “genuine and sufficient” connection to the UK will receive social security support at an earlier point if they relocate to the UK.

The ruling overturns an Upper Tribunal finding that had denied both households benefits. And it confirms that the “genuine and sufficient” link which must be demonstrated by claimants in these circumstances is to the UK as a whole, rather than to its social security system.

One of the claimants, Ms Mohamed, is a Somalian-born woman who after 14 years’ residence in Germany as a German citizen came to the UK to settle here, aged 65.

When her health deteriorated to the point where she could no longer live alone and required the care of her daughter, a British citizen living in the UK, she claimed Attendance Allowance (AA). Her claim was refused.

The other claimant is 18-year-old Brandon Kavanagh, an Irish citizen who was diagnosed with Asperger’s Syndrome as a child.

His mother, a British citizen, moved to Ireland when she was a teenager but returned to the UK in 2013 with her children to escape domestic violence and to be closer to her family, from whom she receives support. Her son was then aged 12.

She claimed Disability Allowance (DLA) for her son when she arrived in the UK, but her claim was refused.

Between 2011 and 2013 she had received care allowances for her son and for herself from the Irish social security system.

Both were refused disability-related benefits on the grounds that they hadn’t been in the UK long enough to pass the so-called ‘past presence test’.

The test requires people claiming disability benefits to have been in Britain for 104 weeks of the 156 weeks before they claim. EU citizens may be able to meet this test by combining, in certain circumstances, the time they have lived in another EU state with the time they lived in the UK.

Alternatively, the test doesn’t apply to EU citizens if they can establish a genuine and sufficient link to the UK.

Both claimants appealed the refusal of their benefit claims. In Brandon Kavanagh’s case he lost the appeal while Ms Mohamed was successful in hers. Brandon appealed to the Upper Tribunal in his case and the Secretary of State for Work and Pensions appealed in Ms Mohamed’s case.

The cases then went jointly to an Upper Tribunal which found that although the “genuine and sufficient link” needed to be to the UK as a whole rather than limited to its social security system and that such a link may be established on the basis of presence alone, neither of the claimants could demonstrate a sufficiently strong link to the UK.

In a judgement handed down yesterday, the Court of Appeal ruled that both claimants had a genuine and sufficient connection to the UK when they claimed disability benefits shortly after their arrival and that the approach taken by the Upper Tribunal was flawed and unduly inflexible because it failed to take account of all the particular, personal circumstances and motives of the claimants which, in the round, proved the required sufficient link.

The Judges say: “… objective evidence of the [genuine and sufficient] link is plainly critical but evidence of the motives, intentions and expectations of the applicant are not to be ignored if they are relevant to proof of the link and are convincing.”

In Kavanagh’s case, the judges found the fact that his mother was fleeing domestic violence explained and confirmed her settled intention to remain in the UK, her country of nationality.

She needed the support of her wider family in England, enrolled her children in English schools, closed her only bank account in Ireland, severed all ties with the Republic and had no intention of returning.

In the case of Ms Mohamed, she suffered a number of physical ailments including osteoporosis, rheumatoid arthritis and high blood pressure.

She used a wheelchair, required support with mobility and daily activities such as washing, cooking meals, dressing and administering medication and had moved to the UK to join her daughter, a British citizen who provides daily care for her.

Commenting on the judgement, Child Poverty Action Group’s Head of Litigation Carla Clarke said: “This is a strong judgement which recognises that justice requires decision makers to take a wide view of all the relevant facts and motives where a genuine and sufficient link to the UK must be proved for benefit purposes.

“Both of our clients already had strong family ties to the UK and a clear intention to settle here when they first claimed disability benefits yet they were denied help with the extra costs of disability because, as today’s judgement finds, the criteria for proving a sufficient link to the UK has been too narrowly applied.

“Today’s ruling means that disabled EU citizens, including UK citizens, who relocate or return to the UK from another EU country because their carer is fundamentally connected to the UK will receive the financial help they need because of their disability at a much earlier point.”

 


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The state is policing social security claimants in hospital and via their medical records to find reasons to cut their support

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The Department for Work and Pensions (DWP) officers have been visiting patients in hospital to check if they are actually unwell, a damning new review into the roll-out of universal credit has revealed. This news comes after it emerged that the DWP are in the process of designing an automated system to trawl claimants NHS health records. 

Doctors have already raised serious concerns that social security claimants could be deterred from accessing healthcare after it emerged that the government is to start accessing medical records as an intrusive part of the welfare assessment process. A job advert posted by the DWP shows that a team in Leeds is building a system to “capture information from citizens and present this to DWP agents”. The work is proceeding on the controversial assumption that the consent of patients would make the system lawful. 

However the DWP have told doctors that when people make a claim for disability benefits, they have already consented for medical information to be shared.

GPs and charities said the plans resemble the controversial data-sharing scheme  between the Home Office and the NHS, which prompted outrage after it emerged some immigrants were subsequently afraid to access healthcare, ultimately forcing the government to end the policy.

In response, Professor Helen Stokes-Lampard, chair of the Royal College of GPs, expressed concern that the process would damage the doctor-patient relationship, and “deter vulnerable people from seeking medical assistance when they need it”.

“If the reports are true, the DWP, like the Home Office before them, must not consider GP patient data as an open resource to support them to carry out their duties. We are doctors, whose first interest is the care of our patient: we are not border guards, and we are not benefits assessors.

“We do not hold our patients’ confidential data to help other organisations check their eligibility for welfare, their immigration status, or any other function not related to their health and wellbeing,” she said.

Head of policy and profile at Law Centres Network, Nimrod Ben-Cnaan, said the sharing of people’s medical records would breach patient confidentiality and put GPs and other medical staff in the “invidious” position of benefits assessors.

However it seems the DWP are determined to co-opt doctors into policing people who are ill and claiming social security. I raised my own concerns about this back in 2015-16 and have continued to campaign on this issue, raising awareness of the implications and consequences of state intrusion in the health care of vulnerable citizens.

The DWP continually look for reasons to end people’s disability awards, even following assessments that have deemed them eligible. Trawling through people’s medical records presents another opportunity to look for tenuous reasons to cut people’s support claim. 

As does intruding on people who are ill in hospital.

The all-pervasiveness of welfare conditionality and the state panopticon

In 1965, American historian Gertrude Himmelfarb published an essay, The Haunted House of Jeremy Bentham, in which she portrayed Bentham’s mechanism of surveillance as a tool of oppression and social control. Bentham’s famous mechanistic and inhumane approach to human lives – the Panopticon – is a type of institutional building and a system of control designed by the English philosopher  in the late 18th century. The scheme of the design is to allow all (pan-) inmates of an institution to be observed (-opticon) by a single watchman without the inmates being able to tell whether or not they are being watched.

Bentham conceived the basic plan as being equally applicable to hospitals, schools, sanatoriums, and asylums. The idea is that people are in constant fear of being scrutinised, and so are coerced or compelled to regulate or change their own behaviour to comply. Bentham described the Panopticon as “a new mode of obtaining power of mind over mind, in a quantity hitherto without example”. Elsewhere, in a letter, he described the Panopticon prison as “a mill for grinding rogues honest.”

The Panopticon is the tool of a deeply suspicious state with a very pessimistic view of human nature. 

Last year, Dr Jay Watts wrote:  “The level of scrutiny all benefits claimants feel under is so brutal that it is no surprise that supermarket giant Sainsbury’s has a policy to share CCTV “where we are asked to do so by a public or regulatory authority such as the police or the Department for Work and Pensions”. Gym memberships, airport footage and surveillance video from public buildings are now used to build cases against claimants, with posts from social media used to suggest people are lying about their disabilities. More and more private companies are being asked to send in footage. The atmosphere is one of pervasive suspicion, fuelled by TV programmes such as Benefits Street and successive governments’ mentality of “strivers v skivers”. 

People claiming disability benefits have often raised concerns that the right to privacy is no longer their own – and this is a deliberate function of an extremely punitive regime.

Mass surveillance has become a norm in developed countries, through both the proliferation of overt measures like security cameras, the use of facial recognition software, but also more subtle and invasive means like data trawling, analysis, segmentation, psychograpic profiling and targeted , tailored ‘interventions’.

Governments, corporations and other powerful entities are able to comb through large volumes of data on specific people or larger demographics in order to gather information on them and exert control over their decision-making and behaviours. Nudge reflects the further development of covert state strategies to scrutinise and  manage citizens’ perceptions and behaviours.

Foucault, in Discipline and Punish, developed the Panopticon as a metaphor for the modern disciplinary society, in which the state constantly oversees the behaviour of the citizens, and he saw it as a mechanistic tool and oppressive system of permanent visibility as a tool of power. Foucault’s idea of panoptic architecture turned it into an omnipresent and insidious institution. It’s true to say that now, the disciplinary “eye of the state Inspector” is upon all of us. But some are scrutinised more than others.

More recently, DWP employees have also found to be interviewing people awaiting NHS treatment to ensure they were on the “right money” and not “abusing the system.” This is a particularly intrusive, oppressive practice, designed to police claims and scrutinise the ever-shrinking criteria of validity for someone’s need or social security support.

The visits were condemned as ‘grotesque’ by a council scrutiny panel in London, where it has emerged that hospitalised universal credit claimants have received shock visits from the welfare officials policing patient’s claims.

Islington’s Policy and Performance Scrutiny Committee, which has been tracking the full roll out of universal credit in Islington since last June, published a review earlier this month, where the information emerged that DWP officers have been pursuing ill claimants while in hospital.

In the meeting on 14 February, concern was expressed that DWP staff visiting claimants in hospital and this added to the stress that patients were already under while in hospital.

The DWP responded that “the visiting team may occasionally visit claimants in hospital but this would be done in a supportive manner and it happened on only a very small number of cases”.

On one occasion, DWP officers visited a person in hospital awaiting an operation because they had missed an appointment,
 reports the Islington Gazette.

The committee’s vice chair, Councillor Troy Gallagher, told the Gazette: “The fact that the DWP send people out to the hospital to interview and pursue people sends the wrong message.

“When people are in hospital they are not there to be chased and it’s not for the DWP to guess or validate if they are well or unwell. I think it’s callous.

“It’s an issue they need to amend quickly because it’s highly stressful and deeply upsetting.”

Cllr Gallagher added: “It’s grotesque and unbelievable.

“If someone says they’re unwell, whatever the reason is, you should always accept that.”

A DWP spokesperson said: “Jobcentre staff occasionally conduct hospital visits to confirm people’s bank account or rent details. This ensures we can pay their full benefits on time.”

They added that visits to claimants homes will be made “if necessary”.

The DWP told me “Claimants must inform the relevant benefit office when they go into hospital and when they come out. If they don’t report changes and they’re overpaid as a result, they have to pay back any money they owe. They may also have to pay a civil penalty.

“State Pension will not be affected.

“A stay in hospital affects people’s disability benefit support in the following ways:

“If someone has been in hospital for 28 days, they should stop receiving these benefits:

  • Attendance Allowance
  • Disability Living Allowance (DLA)
  • Personal Independence Payment (PIP)

“If someone is discharged but goes back into hospital within 28 days, the days spent in hospital on both occasions will be added together and if the total is more than 28 days they will lose eligibility until they go back home. They will still be paid for the days they spend at home between hospital stays.”

I was also informed: “Employment and support allowance is paid for an indefinite period as long as the other qualifying conditions are met. If someone is getting income-related employment and support allowance (ESA), certain premiums and housing costs are affected:

  • Severe disability premium will stop after four weeks if someone is in hospital and they lose their attendance allowance, disability living allowance care component or personal independence payment daily living component. If the person has a partner who is not in hospital and who also qualifies for the severe disability premium, they will continue to receive it.
  • Carer premium will stop 8 weeks after the person’s carer’s allowance stops.
  • After 52 weeks, they will lose the enhanced disability premium unless they have a partner who meets the conditions for the premium themselves. They will also lose their work-related activity or support component.”

It seems that documented evidence from doctors isn’t considered sufficient for the DWP to verify that someone is ill and in need of support. People who are ill in hospital are being treated as though they have done something wrong because of the effect their ill health has on their ability to work.

The government claims that disability support such as PIP is “targeted at those most in need”. Yet we see that those who are clearly most in need are being policed constantly and in an inexcusably intrusive, disrespectful way that strips disabled people of security and dignity.

What use is a social security system that is being designed to constantly work against those very people it was initially set up to help? 


 

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