Tag: Hostile environment

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

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

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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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Authoritarians don’t do democracy

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“A great democracy does not make it harder to vote than to buy an assault weapon.” former President Bill Clinton.

In the US, civil rights groups opposed voter ID laws because, they say, they discriminate against low-income and minority voters — groups that tend to vote Democratic. About 25 percent of eligible black voters and 16 percent of Hispanic voters did not have photo ID, compared with 9 percent of whites, according to the Brennan Center for Justice at New York University.

The center says many poor voters can’t afford cars or vacations abroad, and thus don’t have driver’s licenses or passports, and will be unfairly burdened by the cost of obtaining birth certificates and travelling to a government agency to secure a photo ID. In a recent opinion condemning Wisconsin’s voter ID law, US Circuit Judge Richard Posner — a President Reagan appointee — compared the laws to the poll tax implemented to stop blacks from voting in the Jim Crow–era South.

“The only reason to impose voter ID laws”, said Posner, “is to discourage voting by persons likely to vote against the party responsible for imposing the burdens.” The available evidence indicates that voting fraud in the US was not a problem. In states such as Texas, citizens could apply for a “free election ID card”, but then have to pay for the official documents that are needed to apply for the cards. 

Voter suppression is an attempt to reduce the number of voters who might vote against a government. The tactics of voter suppression range from seemingly minor changes to make voting difficult or less convenient for some demographic groups, to psychologically and physically intimidating and attacking prospective voters, which is illegal.

Voter suppression works if a significant number of voters are intimidated or disenfranchised.  According to the Brennan Center for Justice, the US states most likely to enact voting restrictions were states with the highest African-American turnout in the 2008 election.

Gerrymandering isn’t confined to recognisably despotic regimes. The US – “the land of the free” has shown a proclivity towards making democracy conditional. So has the UK.

Any law that presents reduced choice and bureaucratic barriers to voting in elections for the poorest citizens – in this case, it may mean going without food or fuel in order to fulfil the conditions to vote – is not indicative of a functioning democracy.

Yet the wealthiest citizens tend to vote more frequently. Nonvoters are more likely to be poor, young, or from an ethnic background. Some research also indicates they’re more likely to align with the Democratic Party in the states, and the Labour party in the UK.

Currently in the UK, in order to vote, it is compulsory for members of a household to register before every election. The ‘head of the household’ (a Tory anachronism) is obliged to provide their National Insurance number, name other family members of voting age in the household and provide dates of birth for family members. Individual family members then also have to register to vote individually.

Voters must be on the electoral roll in order to vote in national, local or European elections. A fixed address is also required in order for an individual to vote in an election. To provide for persons who are considered ‘transient’, if an individual lacking a fixed address wants to vote, they may register by filling in a ‘Declaration of local connection’ form. This establishes a connection to the area based on the last fixed address someone had, or the place where they spend a substantial amount of their time (e.g. a homeless shelter).

Those eligible to vote are sent a confirmatory polling card with a voter ID number on it. When that is presented at the polling station, citizens’ details are already on a list there, and each person is ticked off once they turn up to vote, after providing their identifying details.

That is effectively a voter ID system, which is already in place. The card is an ID card, which the council issues when they know that you are authentic and eligible to vote.

The UK government has recently announced controversial plans to prevent people from voting unless they can provide photographic identification, prompting accusations it is attempting to “rig the next election”. These are reasonable allegations, on the premise that any barrier placed in front of the democratic right to vote of some groups in a population is discriminatory.

Current proposals by the Conservative Party to require one of several forms of expensive photo ID in order to vote are likely to reduce the turnout of young and poor voters, who are more likely to vote for the Labour party.

The government was previously told to ditch its controversial voter ID policy after new analysis found that it had stopped “thousands” of people voting in local elections in the limited trials in 2017 and 2018. Bearing in mind that this was a limited trial, that number proportionally replicated at a national level would fundamentally damage our democracy.

Charities including Age UK and Liberty have joined forces with groups such as the Electoral Reform Society to demand that the government stop the “dangerous and undemocratic” policy. The LGC analysis suggests that the number of people turned away could have influenced the election result in some areas. In Mid Sussex, 78 people were denied a vote and there were three cases in which a candidate won by less than 25 votes. 

Demanding a rethink of the policy in March last year, a group of 40 charities and academics said Electoral Commission figures showed there were only 28 allegations of impersonation out of almost 45 million votes in 2017, and one conviction.

“Decades of international studies show that restrictive identification requirements are particularly disadvantageous to certain voter groups who are less likely to possess approved ID for a variety of socio-economic and accessibility reasons,” said their letter, sent to the government.

“Voter ID reforms could therefore affect young people, older people, disabled people, transgender and gender non-conforming people, BAME communities and the homeless.”

Darren Hughes, chief executive of the Electoral Reform Society (ERS), said last year: “There is anecdotal evidence emerging from the pilot areas that people have been denied their democratic right to vote because of the voter ID requirements.

“Thousands of people were told they could not vote because of “draconian” ID requirements in five local election areas on 3 May 2018, according to analysis by the Electoral Reform Society (ERS). 

Based on figures released by electoral observers at ID trial area polling stations, the ERS estimate 3,981 people were denied a ballot paper across the five pilot areas (1.67 per cent of those who tried to vote).

Voter ID trials took place in Bromley, Woking, Gosport, Watford and Swindon in what the campaigners have branded a “dark day for politics.”

Hughes, Chief Executive of the Electoral Reform Society, said: “Britain prides itself on being a leading democracy – but it is a dark day for politics when thousands of blameless people turn out to vote only to be refused.

“Our estimates, based on evidence gathered by electoral observers, reveal the shocking scale of the problem. These trials have been shown up to be the chaotic, undemocratic mess many predicted.

“This is exactly what we feared: that this draconian measure would result in blameless individuals being disenfranchised.”

The Labour party said the figures proved that the voter ID trial should be “abandoned immediately” and accused the government of frank voter suppression.

In a country without universal, free or cheap access to ID, such a move is dangerous, misguided and profoundly undemocratic. The policy will make it harder for millions of ordinary citizens to vote. A 2015 Electoral Commission report, for example, pointed out that 3.5 million citizens in the UK do not have access to photo ID, while 11 million citizens do not have a passport or driving licence.

The government claims that the introduction of voter ID will tackle fraud and corruption, in particular “personation”. But this is a completely disproportionate response to the extremely rare incidence of personation at the polling station.

Official figures show that of the 266 cases of electoral fraud investigated by police in 2018, personation fraud at the polling station accounted for just eight of the allegations made. No further action was taken for seven of these allegations, and one was locally resolved.

At the last election, several Tory MPs claimed that many young people had voted more than once. However, following over a thousand formal complaints to the Electoral Commission, upon investigation there was no evidence found to substantiate these claims.

Some Conservatives claim very loudly that the Labour party have “double standards” since ID is required to attend Labour party meetings. However, this is a typical Tory diversion strategy. The proof of ID requirement is true of all parties, and a party membership card is issued free of charge to party members.

The request to present membership cards at Labour party meetings is reasonable, in any case, since the Conservatives have a track record of attempting to deceitfully infiltrate Labour party meetings to use illegal entrapment methods to fuel their own smear tactics and propaganda campaigns. 

The Tories have created a hostile environment for disadvantaged voters

We may debate whether election results would be different if the entire population voted, but voting determines more than which candidate or party wins or loses. It ultimately influences which policies elected officials enact and whose interests candidates ignore and acknowledge.

Research in the US  found that nonvoters are more likely, for example, to support a redistribution of wealth, affordable housing and expanded social safety net programmes, according to a Pew Research Center analysis of Census Bureau data. Many would-be voters face a range of barriers, including: voter ID laws, registration difficulty, being disabled or having criminal records. Hundreds of thousands of nonvoters want to vote, but can’t.

If you think the government’s new emphasis on further ID documentation for voting is a good idea, well, universal credit and the welfare ‘reforms’ were presented as good ideas. But the Tories are never honest about their real aims, and those aims are invariably much less than as honourable as they try to claim. 

After all, the last group of people who were asked to provide documentation of their ID – which had been placed in the care of the Home Office, under Theresa May – were the Windrush generation citizens. That didn’t end well.

This move for further costly ID evidence is simply another hostile environment designed to ensure that as few people as possible who would most likely vote for the  Labour party will be permitted to do so. Many people with low income can’t afford to drive or pay for/renew their passport.

There will be other as yet unforeseen problems too. The limited trial run at the last election saw thousands of people being turned away without being allowed to vote. At a national level, this would have massive implications for our democracy.

The authoritarianism of the Conservative has become increasingly apparent over the last nine years. From “dark ads”,  the development of hostile environments, grubby organisations that spend all their time smearing the opposition to the misuse of psychological behaviourism to alter and micromanage the perceptions of citizens concerning the government’s draconian austerity policies, to the increased use of secondary legislation, in the form of statutory instruments to sidestep democracy and hammer through very controversial legislation without adequate parliamentary scrutiny.

And of course, authoritarians don’t do rights or democracy. 


 

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Former DWP boss tells how Tory policies pushed her to quit her job

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Mhairi Doyle with her grandson Isaac supporting junior doctors at Southport Hospital. Picture courtesy of the Liverpool Echo.

A Merseyside councillor has spoken out about why she retired from the Department for Work and Pensions (DWP) after 25 years. She says it’s because she “refused to be complicit in how the Tories treat vulnerable people.”

Mhairi Doyle, Labour councillor for Norwood ward in Southport, was also the social inclusion manager for Merseyside in the Department of Work and Pensions until 2012. She moved to Southport in 1988, having been born and raised in Edinburgh.

Doyle received an MBE for her work with disadvantaged people, especially her work with Street Sex Workers in Liverpool, and has worked at local, regional and national levels developing policy to help change lives.

She said: “I was working with heroin users, sufferers of domestic violence, people who were in and out of prison, homeless people… with some funding we managed to create networks to support people and help them out of horrendous situations.

“We were getting about 80% of people back into work.

“It took time and energy but we had a really good thing going. And then the coalition government came in and everything was cut, gone in an instant.

“Everyone was shocked when I said I was retiring; they used to joke that I’d have to be carried out, I loved my job so much. But I could not be complicit in the way the Tories think it’s acceptable to treat vulnerable people.”

Doyle said that there have been abrupt changes in the ethos of job centres since 2012. She said: “We used to be there to help and advise, but it’s gone from being a service about people to a service about numbers.

“The benefit regime is so harsh. They say people don’t have targets on benefit sanctions but it’s all semantics – there is an expectation on staff to cut benefits.

“I’m not having a go at anybody who works at job centres. It’s a difficult job and it’s not well-paid, it’s the system. Workers are expected to get people out the door quickly and get them to do it online, but not everyone is computer literate or has internet access.”

She added: “The bulk of my caseload is people struggling to get the benefits they need to live on, and a lot of these people work.”

She continued: “When I moved here I was told, as many of us were, that a vote for Labour was a wasted vote. So, to keep the Tories out I voted Lib Dem until 2010, when I voted Lib Dem and still got the Tories.

“Even worse, they took part in and enabled all the devastating cuts still affecting us today.

“I don’t think it is fair that our NHS is being sold off piece by piece or that my grandson when he gets out of university, will leave with over £50,000 of debt.

“And I don’t think it is fair that the Tories and Lib Dems have starved our local council of money, forcing them into such difficult decisions over services and amenities and then stand back and blithely criticise when they are the very reason it is happening.”

In a completely meaningless response, a DWP spokesman reading from the DWP crib sheet, said: “Finding work is the best route towards prosperity and Universal Credit is a force for good, providing tailored support for over 1.6 million people as they find jobs faster and stay working longer.

“Extra digital help and budgeting support are also available.”

The comment doesn’t address the issues raised by Doyle at all, nor do the political platitudes mitigate the hostile environment that has been engineered by successive Conservative-led governments, which is having dire consequences for many people, both in and out of work.

Doyle 2

Mhairi Doyle, pictured here alongside Bootle MP Peter Dowd and Southport Labour members, won her seat in 2018.  Picture courtesy of the Liverpool Echo.

 


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Tory racism is embedded in policy and clearly evident in Tory social media groups

racism

A Conservative councillor has been suspended by the Conservative Party after a Facebook group he moderates was found to contain several Islamophobic and racist comments.

Martyn York, a Conservative councillor in Wellingborough, was a moderator for “Boris Johnson: Supporters’ Group”, which included  members whose comments called for the bombing of mosques around the UK. Dorinda Bailey, a former Conservative council candidate, has also been accused of supporting Islamophobia with her comments following a post in the group calling for mosques to be bombed.

Furthermore, the group, which has 4,800 members, can only be joined after receiving approval from moderators, and its guidelines explicitly call on members not to post hate speech. 

Comments in the group, however, seriously violate these rules, with several referring to Muslims as “ragheads” and calling immigrants “cockroaches”.

In one comment, the mayor of London, Sadiq Khan, is called a “conniving little muzrat”, and Muslim Labour MP Naz Shah is also targeted with abuse and told to “p*** off to [her] own country”.

Someone posted in the group that any mosques “found to preach hate” should be shut down, another group member responded: “Bomb the f****** lot.” 

Bailey responded, without a trace of irony: “I agree, but any chance you could edit your comment please. No swearing policy.”

There were also comments in the group telling an African solider to “p*** off back to Africa” and for Labour MP Fiona Onasanya to be “put on a banana boat back home”.

After the offensive posts were brought to his attention, Conservative Party chairman Brandon Lewis confirmed York’s suspension and said Bailey was no longer a member of the party.

The Muslim Council of Britain (MCB), which has repeatedly called for an inquiry into Islamophobia in the Conservative Party, said this was further evidence of a “significant problem”.

“A Facebook group led by Conservative politicians containing unashamed bigotry has made it completely apparent that there is a significant problem with racism and Islamophobia within the party of government,” a spokesperson for the MCB said.

“Polls revealing that half of all Conservative voters in 2017 believe Islam to be a threat to the British way of life have shown how widespread this sentiment is. We reiterate our call for the government to launch an inquiry into Islamophobia and lead by example by committing to tackle bigotry everywhere, not just where it’s politically convenient.”

There government were happy enough to ensure an inquiry into the allegations of antisemitism in the Labour party, and ‘inappropriate’ posts on social media took place. However, the conclusions of the Home Office Committee contradicted the claims being made on the right and among the neoliberal centrists, about the Labour party.

Nonetheless, the claims have continued, indicating a degree of underpinning political expedience and media misdirection.commons-select-committee-antisemitism

That is not to say there is no antisemitism at all among Labour party members, and where allegations arise, those MUST be addressed. However, it does indicate that political and media claims that the party is ‘institutionally antisemitic’ are completely unfounded. 

It is also absolutely reasonable to point this out. 

Unlawful and discriminatory Conservative policy

Meanwhile the Conservatives have continued to embed their prejudices and racism in  discriminatory policies. For example, in 2014 Theresa May was the Home Secretary who introduced the disgraceful Hostile Environment legislation that ultimately led to the Windrush scandal.  On March 1st 2019 a central mechanism of that legislation was ruled unlawful by the High Court because of the way it has unleashed a wave of racism, and because it was found to violate the European Convention on Human Rights. 

Judge Martin Spencer found the policy caused landlords to discriminate against both black and ethnic minority British people and foreign UK residents.

He also ruled that rolling out the scheme in Scotland, Wales or Northern Ireland without further evaluation would be “irrational” and breach equality laws.

“The evidence, when taken together, strongly showed not only that landlords are discriminating against potential tenants on grounds of nationality and ethnicity but also that they are doing so because of the scheme,” Mr Justice Spencer told the court on Friday.

He added “It is my view that the scheme introduced by the government does not merely provide the occasion or opportunity for private landlords to discriminate, but causes them to do so where otherwise they would not.”

The changes that came into force in 2016 required private landlords to check the immigration status of potential tenants, or face unlimited fines or even prison for renting to undocumented migrants, coercing landlords into becoming agents of the state, effectively.

Judge Martin Spencer said: “The government cannot wash its hands of responsibility for the discrimination which is taking place by asserting that such discrimination is carried out by landlords acting contrary to the intention of the scheme.”

He also said he had found that Right to Rent had “little or no effect” on controlling immigration and that the Home Office had “not come close” to justifying it.

The legal challenge was launched by the Residential Landlords Association (RLA) and Joint Council for the Welfare of Immigrants (JCWI), which called Right to Rent a “key plank of Theresa May’s hostile environment” policy.

Chai Patel, JCWI legal policy director, said: “Now that the High Court has confirmed that Ms May’s policy actively causes discrimination, parliament must act immediately to scrap it.

“But we all know that this sort of discrimination, caused by making private individuals into border guards, affects almost every aspect of public life – it has crept into our banks, hospitals, and schools. Today’s judgment only reveals the tip of the iceberg and demonstrates why the Hostile Environment must be dismantled.” 

John Stewart, policy manager for the RLA, called the ruling a “damning critique of a flagship government policy”. 

He added : “We have warned all along that turning landlords into untrained and unwilling border police would lead to the exact form of discrimination the court has found.” 

Rather than accept the High Court’s findings, a Home Office spokesperson has said that an independent mystery shopping exercise found “no evidence of systemic discrimination”.

“We are disappointed with the judgement and we have been granted permission to appeal, which reflects the important points of law that were considered in the case. In the meantime, we are giving careful consideration to the judge’s comments,” he added.

I have written at length about the prejudiced, discriminatory and unlawful policies that the Conservatives have directed at ill and disabled people over the last few years. I also submitted evidence to the United Nations on this matter. However, the UN’s findings of “grave and systematic violations” of disabled peoples’ human rights, and the examples of structural violence inflicted on our politically marginalised community currently fails to get the media attention that mere allegations of antisemitism within the Labour party attracts.

People are suffering harm and psychological distress, and increasingly, some are dying, as a direct consequence of oppressive, cruel, illegal and dangerously authoritarian Conservative policies, while shamefully, much of the media prefers to look the other way.

That is, where the state directs them to ‘look’. 

If you’ve ever wondered how some societies have permitted conscious cruelty to flourish, to the point where entire groups are targeted with oppressive and discriminatory policies resulting in distress, harm and death, I have to tell you that it’s pretty much like this.

Allport's ladder

 


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Disabled people face a hostile environment of calculated, strategic ordeals to deny support

PIP court

Disabled people face a hostile environment comprised of strategically placed and thoroughly demoralising ordeals, which are being passed off as arising because of bad administrative practices and simple errors. However, such ordeals are happening far too frequently to have arisen through random error. Furthermore, there is an identifiable pattern of government sponsored behaviours that has emerged within privately contracted companies hired to deliver disability assessments, and within the Department for Work and Pensions, which is aimed at simply denying people support.

Many people who have challenged a Department for Work and Pensions’ (DWP) decision not to award them Personal Independent Payment (PIP) in court successfully are finding that soon after they have won their appeal, they face a reassessment, and their award is taken from them again.

Even when people appeal, the system is rigged against them applying for legal support, and cuts to charities mean any support at all is shrinking away. Official figures last year showed that legal aid cuts mean ill and disabled people appealing their lifeline support through what have been consistently shown to be fatally flawed assessments and irrational, poorly evidenced DWP decision-making, are denied legal support in a staggering 99% of cases.

This means that someone with severe depression, or battling serious illnesses such as multiple sclerosis, cystic fibrosis or connective tissue illnesses for example, are left to take on a long, exhausting and complex legal case against the government, alone. 

The assessment process is set up to remove people’s disability benefits entirely because the evidence provided in medical notes by GPs and consultants, and the account of ill and disabled people, are not deemed by the state to be as credible as a snapshot report by a private company assessor, based on a half hour interview.

Private companies are motivated purely by making profit. This perverse incentive leaves no room for improving the dire situation that people, often at their most vulnerable, are facing. Improving performance as a service provider, or of prioritising human needs in a system that was originally designed to do so offers no reward for companies such as Maximus and Atos, because the government has been willing to pay them – from public funds – for atrocious failings that have harmed people and caused much distress. 

Since PIP was launched in 2013 to reduce the costs of disability support, the increasingly reduced access to financial assistance to help with the additional costs of being disabled has forced more than 75,000 people to give up their specially-adapted Motability vehicles. 

The UN have found that government policies have brought about “grave and systematic violations of disabled people’s rights” in the UK.

As someone who has gone through both PIP and Employment and Support Allowance (ESA) assessments and subsequent appeal, and as someone who co-runs a support group online for others going through this system, I know that both the assessment processes are beset by profound administrative failures and ordeals which seem to be wholly designed to work to the disadvantage of  ill and disabled people.

A report last year called Access Denied: Barriers to Justice in the Disability Benefits System, shows some of the immense suffering that the adversarial social security system causes disabled people and the long, exhausting and difficult process people who are ill have to go through to finally get the support they deserve and have paid into.

After being wrongly turned down at assessment, people must first go through mandatory review which can take anything from a few weeks to several months. The DWP argues that claims are fully reviewed at this stage, but the fact that 69 per cent of claimants win their appeal after having gone through MR proves that the MR itself is failing to correct the assessment’s flaws.

Case study: ‘Rose’

I spoke to someone this week who has faced two tribunals regarding her PIP award.  After successfully appealing the first, Rose (not her real name) had a face to face assessment when her review was due in July 2017.  The DWP decided to end her award, so she requested a mandatory review.  The DWP ‘lost’ Rose’s request twice after she had sent it, and then failed to log it and upload it onto their system.

Many other people have reported that they are not being notified of mandatory review outcomes, too, finding out after months of phone calls that the original decision was upheld. People cannot appeal until they have gone through a mandatory review, and several people told me they think the delaying tactics are deliberate, to discourage them from appealing DWP decisions. 

The mandatory review request in Rose’s case was sent in September 2017. The DWP acknowledged it had been received but had not been ‘logged’. As she was kept in the dark, Rose rang to find out what was happening over a month later in November, and was told once again hat the DWP had  ‘forgot’ to put it on the system.

She told me “They just said that there were always delays and to be patient and didn’t tell me why it had been delayed in the first place, then didn’t log it yet again”.

She added: “The DWP finally did the MR in a rush (and did not change anything from the original decision obviously) when I phoned again a month after that in Dec 2017 (as I still hadn’t heard anything) and they finally admitted what had happened both times. They sort of apologised on the phone but that was it. The MR document didn’t even change one letter of their original decision.”

Rose then waited almost a year for a tribunal date, which was arranged for 19 December 2018.

She told me: “The tribunal was very hard. It was not my first or even my second, as I fought and won before a couple of years ago after having two hearings adjourned because I was too upset to continue. But I won.

“It was an interrogation in a proper court room, with very quick fire questions and a very bizarre one, to presumably try to catch me out right at the end as I was standing up.

“The judge asked where I went to get my nails done!? I have never had my nails done in my life. I actually laughed and showed them my very short, bitten, discoloured nails. When I told my parents about that bit, they were furious and quite rightly said ‘would he have asked a man something like that?'”

The court didn’t reach a decision that day.

Rose said: “They did not decide on the day as it was 3.45pm (the hearing started at 3) and they were finished for the day – it was almost Christmas. The staff there definitely seemed to be winding down to say the least.

“Whilst I was crying in the waiting area, the receptionists were all screeching and laughing about their party plans, which I felt was pretty jarring and unprofessional. 

“I finally got my letter on Christmas eve telling me that they had awarded me standard rates on both daily living and mobility components, which I was relatively happy with.

“Although relieved, I do think it should have been enhanced rate on daily living but they never consider finances / therapy in most cases I’ve heard. I wasn’t so happy with the amount of time awarded (see below) but I was relieved to have an award.”

Rose waited for around five weeks to hear from the DWP, anxious that they may be considering appealing the tribunal’s decision. After being prompted to ring them by  someone online offering her advice, she was told it was usual for the DWP to contact people to check details before they can sort out an award and backpay.

Rose told me: “I don’t have my own phone so used my parents’. The DWP said that their self imposed deadline to ‘sort it out’ was within six weeks and it would be paid then.

“I  phoned up again to check something and they said the same… then phoned yet again when the six weeks was up, a few days later, and I still hadn’t heard anything.

“The guy on the phone said he didn’t know why I hadn’t heard anything (he was lying as they did know by then) but said that there was nothing he could do and to just to be patient.

“I was distressed, pretty hysterical and in tears at this point on the phone to him and felt a bit sorry for him, as I don’t think he could understand much of what I was saying.”

Rose became more and more anxious and worried, so emailed her MP  in the hope that she could find out what was going on. She told me she was petrified that the tribunal outcome was being appealed.

Her MP phoned a special DWP ‘hotline’ and immediately found out that there was a problem, as the tribunal decision letter that Rose and the DWP had received on Christmas eve had one tiny date error on it: the court had written that Rose’s  PIP award should be backdated from the 07/07/2017 rather than 02/07/2017 .

Rose said: “The error apparently meant that they couldn’t pay me until it had gone back to the courts service to be changed (and then back to the DWP and right back to the back of the queue) which could take months, depending on how busy they were. 

“I would NOT have known this if the MP’s office had not have got involved ….the DWP outright lied to me on the phone more than once when they knew what was happening and further to that should really have picked up on this earlier i.e. when it was received by them before Christmas, according to the MP’s assistant.

“The MP’s assistant emailed the courts email address (apparently the only way he could contact them as they don’t have a hotline to HMCTS like they do to other government departments) and told me that they had two weeks to respond to him with further details.

“The day before that deadline this week (now 9 weeks since the tribunal) they contacted him and said that apparently the courts are STILL waiting for my file to be sent from an ‘offsite storage facility’ and it has not even got to the judge yet to sign. They have known about this since the 25th January (which is when the DWP finally contacted them, they took over a month to realise the mistake)! You’d think sending a simple file would not take that long…..

“They refuse to give timescales (the MP’s assistant has emailed them back to ask for some but obviously they then have 2 weeks to respond to that request again!) ….and obviously after the judge deigns to have time to change it, it then has to go back to the DWP to sort out (and go to the back of their queue again).

Rose told me “I can’t believe this, I need this money to live on. I SHOULD have had it every month since July 2017 (20 months back dated almost)! I’m at the end of my tether and don’t think I can cope with much more.

“It has almost been 20 months that I have been living on the breadline, just on my ESA as I don’t claim anything else. This whole process has made me so very ill. I mean I’m ill anyway, very ill but the added of all of this and the constant mistakes and errors and not knowing what’s going on and waiting has out me on the verge of sending me into crisis again. I have started self harming more regularly, my psychiatrist has put my medication up yet again and I don’t think I can cope with this anymore.”

Rose added “There will be no respite either, even when /if this gets sorted out, as I have just had my ESA renewal forms (ESA50) through last week …which is what sent me into a [mental health] crisis a couple of years ago.

“I will also have to apply for PIP again at the end of this year presumably as most of the backdated PIP will then be gone, as they only gave me 3 years. They felt I ‘could get better’, which is utterly laughable.”

Rose has Ehlers Danlos Syndrome (EDS), which is a degenerative genetic connective tissue disorder which causes constant chronic pain, chronic fatigue and frequent joint dislocations, with it’s concurrent POTS [postural orthostatic tachycardia syndrome], MCAS [a mast cell autoimmune disorder]and IBS. Rose also has spinal scoliosis, kyphosis, three ruptured spinal discs and trigeminal neuralgia. She is undergoing investigations for dyspraxia as well. 

She also has bipolar with severe depression and chronic anxiety.

She told me: “I’m a relatively intelligent person who used to have a very good job before I became too ill to cope (something the DWP have repeatedly used against me, that and my degrees). 

“Obviously mental health can improve in some cases, which is probably what they were getting at (very unlikely though with this strain constantly happening. I can’t see anyone going through this terrible system having time to gather their thoughts and improve in any way, shape or form when they constantly make you fight and justify why you are ill).

“But EDS is a degenerative genetic illness and the symptoms severely impact on my mental health as it is. Trigeminal neuralgia also only gets worse with age. The latter is also known as the ‘suicide disease’ because of the amount of people who have killed themselves rather than live with the pain. It’s said to be one of the most painful things you can get.

“It’s ridiculous, these are things that aren’t just going to go away. I have already been ‘not well’ for 20 years now, but was forced to finally give up work in 2009 after years of struggling and disciplinary meetings for being off sick so much. Yet the judge only gave me an award for three years, as it is, because they thought I could ‘improve’, which is impossible. 

“I’m so scared, this can’t be right, living in constant fear like this. Why do they hate us so much? I still can’t get hold of my welfare advisor at the local council to help me with my ESA50 either. I emailed him on the 12th and have left phone messages on his mobile and with his colleagues.

“I’m just so petrified that they will find some excuse not to give this [PIP award] to me now altogether. At the same time I am terrified that my ESA will be taken away and I’ll be left with nothing. The timing of the ESA reassessment is atrocious (but not surprising). I’ve been on ESA, in the support group since 2013 and have never had an assessment for that. Not until now, anyway.”

The tribunal granted Rose’s appeal. Because of the date error on the court letter, it may be justifiable that the error needs to be rectified by the court before the DWP issue the money she is owed in PIP backpay – from the date of her claim. However, Rose is entitled to ongoing PIP payments too. The DWP know this, yet haven’t given her a single payment. There is no credible reason for not paying her ongoing award in the meantime.

Recently, I have seen a large number of cases where people are being re-assessed earlier than the DWP had stated and they are losing their awards. For those on PIP and ESA, it’s become commonplace for people to be going through appeals for both awards at the same time, or successively, which means there is no respite from the extreme strain that they are being put through. The thing that strikes me is that in every case, the decision to end someone’s award is irrational and cruel, most often with absolutely no reasonable justification provided in the assessment reports, which are invariably completely inaccurate.   

The endless ordeal of re-assessments and withdrawals of support for disabled people; the introduction of heavily bureaucratic mandatory reviews, designed to deter appeals; the withdrawal of support and the long periods people are being left without any means of meeting even basic needs; the fact that mandatory review very rarely changes the decision to end an award and then the awful experience of having to appeal again is certainly convincing evidence of an intentionally created hostile environment for ill and disabled people – those very people the government claims it protects. 

There are also the unofficial, undeclared and non-legislative means that the Department for Work and Pensions frequently use to try at every opportunity to end claims. For example, it’s fairly common for the DWP to try to end ESA claims because a disabled person has been awarded PIP – a non means-tested income to support day-to-day independence and meet the costs of the additional needs arising because of disabilities. The DWP often try to claim that this is “standard” process when someone has “another award.” But PIP does not affect people’s  eligibility for ESA at all.

The endless tactics deployed by the DWP are designed to force disabled people to go through the thoroughly demoralisng, anxiety-provoking and punitive claim process all over again – which means a huge reduction in income because during the mandatory review, people cannot claim any ESA, and following MR, they will then only be eligible for the basic rate ESA. This also means there will be another long wait for another harrowing assessment, which presents a further opportunity for the withdrawal of lifeline disability support, and so on.

This kind of ruthless tactic was probably also designed to ensure that people never feel secure while needing lifeline support – a kind of informal Poor Law-styled “deterrence”.

Earlier this year, through a parliamentary question from Labour MP Madeleine Moon, it was revealed that more than 17,000 people died waiting for a DWP decision on their PIP claim between April 2013 and April 2018.

Disclosed official DWP data also reveals that 7,990 people died within six months of having a claim for PIP rejected by callous DWP ‘decision makers’. This indicates that contrary to Conservative minister’s claims, those most in need of support are being catastrophically failed by the assessment and decision making regime. 

Of these, 3,680 died within just three months of having their PIP applications rejected by the DWP.

I’m wondering what it will take for the government to admit that the system is unacceptably cruel and to acknowledge the mounting empirical evidence that, rather than supporting those most in need, the system is intentionally set up to deny support to as many people as possible, regardless of their needs and regardless of the ethical red line that has been shamefully crossed by the Conservatives under the guise of ‘welfare reform’.

 


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The NHS business services authority is creating a hostile environment for vulnerable patients

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Patients claiming universal credit who are exempted from prescription charges are receiving penalty notices because prescription forms have not been amended to include the benefit – six years after it was introduced. Some people have reported receiving multiple charge notices. Many people are being penalised for a pharmacy error or because of a misunderstanding. A third of the 2017 penalties imposed were overturned on appeal so far.

Patients who are suspected of wrongly claiming free prescriptions face a penalty of five times the prescription charge plus the charge itself. The maximum is £100; £50 is added if the bill is not settled within 28 days. 

The NHS Business Services Authority (NHSBSA), an arm’s length body of the Department of Health and Social Care (DHSC), says a universal credit tick box should be added “later this year”. Until then, claimants entitled to free prescriptions must tick the “income-based jobseeker’s allowance” box. However, some who did so report they have still been penalised. Furthermore, no one is informing people which box to tick.

Many of the patients who receive penalty notices simply failed to realise that they no longer qualified for free prescriptions and dental treatment. Exemption certificates are automatically issued to those who earn less than £15,276 a year and receive working tax credit, child tax credit, or income support, as well as income related Employment and Support Allowance.

However, apparently, the certificates are only valid for up to seven months and recipients are not notified if they do not qualify for a renewal. The new fraud prevention system seems to be set up to penalise people because of the fact they are not kept informed of changes to their entitlement to free prescriptions, which is categorically unfair.

Moreover, it is creating severe distress and harm.

The devastating impact on vulnerable patients

Last year, Labour called for an overhaul of the system when a woman killed herself after receiving nearly £200 in penalty charges. Penny Oliver, a part-time chef, had not realised her exemption had lapsed after an ESA assessment deemed her fit for full-time work. Because her benefits had been cut she could not afford the penalties. In June 2018, she took an overdose of antidepressants – the medication that had created the debt.

Oliver owed sums of just £8.60 and £20.60. But with penalty fees and surcharges these rocketed – the second one alone soaring to £120.60. That’s ten times the amount for that prescription. After having lost hundreds of pounds a month when her benefits were cut, she simply couldn’t pay. Her housing benefit and council tax reduction were also cut, leaving her facing recovery action for an overpayment. 

She had just a few pounds in her account and was surrounded by payment demands when her family tragically found her dead last in June. Letters from the council, the NHS and Department for Work and Pensions included threats to take her to court and inform her employer if she did not pay.

At the time, shadow Health and Social Care Secretary Jonathan Ashworth said: “This is shocking. Questions have to be asked about the humanity of a system that does this to vulnerable people.

Penalty charges should be scrapped – it’s a disgrace to exploit vulnerable, ill people in this way. Ministers urgently need to step in and review this system.

“Our NHS is there to help patients get better not make their condition worse by putting ­unacceptable burdens on people like this.”

Single mother Sue Carpenter was ordered to pay £100 after mistakenly claiming a free dental check-up. “I have had an NHS exemption since my daughter was three, but I received no reminder that it would run out when she was 18,” she explains.

“I knew my child tax credit would change, but I’m still eligible for working tax credit and I assumed the exemption was linked to the entire tax credit award, not just to the child component. The dentist didn’t ask to see my certificate, which I now realise expired two weeks before.”

Carpenter says that the expiry date should be made clear. “The NHS exemption seems a unique instance of a status that runs out with no clear warning, allows you to continue using it when it has expired and then incurs a steep penalty without prior notice of the consequences.”

The NHSBSA says it is a patient’s responsibility to check the expiry date on their exemption certificate.

However, recovering costs someone incurred in error is one thing, but fining people because they didn’t read the very small print, especially given that the citizens affected are likely to be ill and also on a low income, is a step too far. While it raises revenue for a cash-starved NHS, it is at the expense of those with the least, as usual. Fining people for a genuine mistake because they are not provided with sufficient information in the first place is outrageously mercenary.

The high cost of countering pre-estimated fraud

It is unsurprising to learn that the NHS counter fraud authority was created by legislation, launched in 2017-18, and is subject to direction by the Secretary of State. It’s also worth noting that the majority of health funding goes to the Department’s
arm’s-length bodies. 

In 2016-17 the Health Department had an overall revenue and capital budget of £122.2 billion. Less than 4% (£4.7 billion) of its funding was allocated to the core Department, according to the National Audit Office (NAO). The remainder  (£117.5 billion) was allocated to its arm’s-length bodies. That’s a huge sum of public money that is spent on managing the NHS and not on delivering frontline services. 

Furthermore, amendment was made via statutory instrument to the Regulation of Investigatory Powers (Directed Surveillance and Covert Human Intelligence Sources) to ensure that the senior officers of the NHSCFA will have the power to authorise the conduct of covert directed surveillance. The health authority is directed to carry out the Secretary of State’s functions in relation to counter fraud against or affecting the health service in England.

Usually when Conservatives claim to “counter fraud”, it entails the creation of a hostile environment. Social security, for example, has been transformed from a redistributive system for the public protection from the ravages of poverty to one that administers the discipline, coercion and sanctions, using absolute poverty as a punishment for “non compliance”.

Professional and patients’ bodies have also expressed their concern that the system designed to detect fraud is undermining the whole ethos of the NHS.

Rachel Power, chief executive of the Patients Association said: “Serving penalty notices on patients cannot be a caring way to manage this system.” 

“Some of the people who received these notices will be in vulnerable situations, and the impact of letters threatening court action, particularly for those who are receiving treatment for mental illnesses, should not be underestimated.

“While it’s important that fraudulent and incorrect claims are identified, nearly one in three penalty notices had to be withdrawn because they were issued in error. This shows a system that is highly dysfunctional.”

It also indicates the introduction of an increasingly hostile environment within health services, especially for those ill people on low incomes. 

The health secretary, Matt Hancock, has previously said: “The message is clear. The NHS is no longer an easy target, and if you try to steal from it you will face the consequences.”  

I’m wondering how it is possible to steal healthcare, bearing in mind that the same minister insists that the healthcare in the UK is still “free at the point of access”. I think this systematic restriction of access to public services more generally is precisely what David Cameron meant when he said that he wanted to tackle the “culture of entitlement”.

The public pay taxes and national insurance – “social insurance” – for increasingly little return while millionaires get tax cuts and carrots while everyone else gets the austerity stick, and told to live within our increasingly diminishing means. We are being dispossessed, so the very wealthy can accumulate even more wealth.

This year the NHS is piloting a digitised system that it claims will enable pharmacists to check eligibility instantly. However, surely the same system could be used to inform patients of their eligibility status also. That would reduce error considerably, too. 

The NHSBSA say they are digital by default, and: “We use complex algorithms and data mining tools as a means to identify both normal behaviour and outliers in NHS data, within which fraudulent behaviour may be found.

The resulting “analyses” are used to support ongoing investigations as well as inform the intelligence picture and guide fraud prevention steps.”

The “complex algorithms” are very clearly being used as a blunt instrument, resulting in least one death, to date. Yet one of the highest costs of “highly probable” fraud, according to the NHS BSA is from procurement and commissioning fraud, at an estimated cost of £266m £266m between 2016-17. (See page 8 here). 

The key stakeholders of the counter fraud authority include NHS England, NHS Improvement and the Cabinet Office.

The Royal Pharmaceutical Society and the British Medical Association fear the new system will withhold vital treatment from people on low incomes who remain eligible for free prescriptions but have failed to renew their paperwork.

“Pharmacists don’t want to be the prescription police, spending their time checking exemptions rather than advising on patient care,” says Sandra Gidley, chair of the Royal Pharmaceutical Society’s English pharmacy board.

“It’s very easy for mistakes to happen. Sometimes it’s that the computer says ‘no’, on other occasions people have simply forgotten to renew. Some don’t know if they’re exempt or not, or wrongly assume they are.”

She says that the prescription system should be overhauled to prevent confusion and reflect medical advances. “Medical exemption criteria have not changed since 1968. This means they are completely unjust. For example, those with long-term asthma have to pay for prescriptions, whereas people with diabetes don’t. Many new long-term conditions have been discovered in the past 50 years and they aren’t covered at all.

“It would be much simpler to have free prescriptions for everyone, as is the case in Scotland and Wales, because then no one would have to worry about remembering to fill out the right form.”

Data released under the Freedom of Information Act last year shows that 1,052,430 penalty notices were issued to patients in England in 2017 – about double the level in the previous year. But the data confirms that 342,882 penalty notices were subsequently withdrawn because the patient was entitled to free prescriptions after all, upon further investigation. 

The NHSBSA, the agency in charge of issuing the fines, said it was “continually reviewing its data-matching process and making improvements to ensure eligible patients were not wrongly pursued.”

The agency said it was also trying to educate patients on the importance of keeping the details on both their GP records and their exemption or prescription prepayment certificates up to date. 

It’s yet another public service system that’s been designed to assume people are guilty of fraud, with the onus on patients to provide proof that they are innocent.

“The NHS loses millions each year through fraudulent and incorrect claims for free prescriptions,” said Alison O’Brien, head of loss recovery services at the authority. “On behalf of NHS England, and in discussion with the Department of Health and Social Care, the NHS Business Services Authority checks claims randomly and retrospectively to appropriately recover funds and return them to NHS services.”

However, as the data strongly suggests, in far too many cases, it isn’t appropriate to recover funds and impose fines. Errors are happening all too frequently, creating anxiety, distress and hardship. When accusations of fraud are made which are not true, it causes humiliation and creates scapegoats.

Given that the neoliberal state treats citizens as if they have done something wrong as a starting point – which is the key message embedded in hostile environments; creating stigma and criminalising already marginalised groups –  it’s become a standardised form of political abuse which is entrenched within our public services. It’s designed as a punitive form of resource gatekeeping, resulting in withholding service and support from the very people who those services were designed to support.

Unfortunately, there is a pathological political narrative that tends justify cost cutting measures and punitive policies which portray the state and the mythically discrete class, “the taxpayer”,  as victims, when the state is actually perpetrator, and we all pay taxes for the services that are being dismantled by stealth.

Many of us have raised concerns related to the impact of the government’s various “hostile environment” policies in the health, housing, welfare, finances and banking, education, social services and other sectors, on vulnerable groups and those who share protected characteristics. The Equality Act was originally designed to address this kind of discrimination. But as we have learned over the last eight years, the government regards human rights and equality frameworks as a mere inconvenience. 

Peter Burt, a patient who was wrongly issued with one of the NHS penalty notices, said he worried about how certain patients would react to receiving one. “Some of the people who received these notices will certainly be in vulnerable situations and some will be receiving prescription medication for anxiety and mental health issues,” Burt said.

“They should not be receiving letters threatening court action just because the NHS can’t be bothered to check the records to see whether they have a prepayment card – especially if there is no intention of carrying out the threat. It’s hugely disappointing that, at a time when clinical services are clearly facing financial strains, the NHS bureaucracy is wasting money by sending out hundreds of thousands of inaccurate demands every year.”

Watson said more problems lay ahead if further planned changes to the way medicines were prescribed were introduced.

“The bureaucracy around prescriptions is unfit for purpose, and will only get worse if NHS England introduces its planned restrictions on prescribing over the counter medicines,” she said. “Serving notice of penalties for free prescriptions on patients who may be vulnerable and unwell and are then required to demonstrate their right to a free prescription cannot be a compassionate and caring way to manage this system.”

It certainly seems to be the government’s modus operandi to withdraw compassion and care when it comes to public policy design, which have been templated to implement austerity rather than ensure delivery of public services that are fit for purpose.

You can check your eligibility for free prescriptions and other health services here: National campaign launches urging patients to ‘Check Before You Tick’ for free prescriptions.

 


 

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