Tag: Sarah Newton

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

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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

 


 

I don’t make any money from my work. I’m disabled through illness and on a very low income. But you can make a donation to help me continue to research and write free, informative, insightful and independent articles, and to provide support to others going through Universal Credit, PIP and ESA assessment, mandatory review and appeal. The smallest amount is much appreciated – thank you.

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DWP is trying to co-opt GPs in forcing ill people into work

facade welfare

Yesterday on Twitter, I posted one of my previous posts – Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died in which I discuss a letter addressed to a GP regarding a seriously ill patient. It said:

We have decided your patient is capable of work from and including January 10, 2016.

“This means you do not have to give your patient more medical certificates for employment and support allowance purposes unless they appeal against this decision.”

The patient, James Harrison, had been declared “fit for work” and the letter stated that he should not get further medical certificates. 

However, 10 months after the Department for Work and Pensions (DWP) contacted his doctor without telling him, he died, aged 55. James clearly wasn’t fit for work. 

The GP had stopped issuing medical certificates when the DWP told him to. It is completely unacceptable that James Harrison was left struggling without support, when he was clearly very ill. It is also unacceptable that James’ GP was given instructions from the state – that caused harm – without James’ knowledge. 

The certificates – so-called fit notes – demonstrate that the government seems to have some difficulty in recognising that sometimes people get ‘sick’ and require support via the provision they have paid into.

Austerity: When the state takes money from the public and hands it out to millionaires

David Cameron, however, had other plans for the UK. He said: “We simply have to get to grips with the sicknote culture that means a short spell of sickness absence can far too easily become a gradual slide to a life of long-term benefit dependency.

“The new welfare bill – described as the biggest shake-up of the system since it was set up 60 years ago – is designed to say end the culture of the fit and healthy being able to refuse work being rewarded for staying at home.”

However, the statement isn’t coherent. He infers that people are recovering from a brief period of illness and then refusing to return to work. As we have learned at great human cost over the last few years, this legislation has destroyed the lives of thousands of people who are ill. It was always intended to take away support from those who need it most. That is evident in the Conservatives’ incoherent attempt at a justification narrative, propped up by the right wing media. 

It never seemed to have crossed Cameron’s mind that 1) people’s medical conditions may worsen, they may have a chronic or degenerative illness. Being chronically ill does not make a person ‘benefit dependent’, it simply makes them ill. 2) The public contributes to the treasury, which is in part a funding mechanism towards social security and other state provisions, via tax and national insurance. This is done on the understanding that the state ensures that citizens can meet their basic survival needs. The Conservatives have clearly stated they have ‘other’ ideas on how our public funds should be spent, which does not include meeting the needs of the public.

The state is responsible for handling public funds. It is unacceptable that such contentious neoliberal ideology is being used by the Conservatives to dismantle state provision for those who need it most, while deliberately targeting the poorest citizens with austerity cuts. Meanwhile, millionaires are rewarded with generous tax cuts from the public purse. At the time when the welfare reform act was passed, millonaires were handed a tax cut of £107,000 each per year. This callous and unjustified approach to social administration is destroying people’s lives and has profoundly damaged our democracy and society, while seriously and systematically violating the human rights of the UK’s most marginalised groups.

It is very worrying that the clearly dangerous ESA65B form is a standardised response to GPs from the DWP following an assessment where someone has been found fit for work.  I discussed some of the raised issues further in another article from last year that I posted on Twitter yesterday – GPs told to consider making fit notes conditional on patients having appointment with work coach 

It’s even more worrying that the part clarifying ‘fit notes’ should continue if a person is appealing a ‘fit for work’ has been removed from the standard letter, and a line added that says: “In the course of any further consultations with […] we hope you will also encourage [the patient]in [their]efforts to return to, or start, work.” 

I always worry when the government uses the words “encourage”, “help” and “support” in the context of policies and political practices that affect disabled people. They are usually techniques of neutralisation – euphemisms for the actions embedded in punitive and harmful policies.

This growing practice of the state intruding in the confidential relationship between a GP and patient undermines trust, it damages the professionalism and clinical expertise of doctors and threatens the safety and wellbeing of patients. It shrinks the safe spaces for citizens to escape the increasingly oppressive practices of the government. It turns GPs into non-neutral agents of the state.

We know from the high rate of success at appeal for Employment and Support Allowance claims that the DWP’s decision making regarding ill and disabled people’s ‘work capability’ is truly atrocious and negligent, and there is absolutely no convincing empirical evidence that “work is a health outcome”. (See: Work as a health outcome, making work pay and other Conservative myths and magical thinking.)

Last year, jobcentre staff were forced to withdraw guidance that urged GPs in Leeds to use deceitful tactics to attempt to get people who are ill off social security support and into work. The shocking guidance asked doctors to send patients for a 45-minute session with a “Patient Coach” – without mentioning that the coach actually worked for the the DWP.

It was even suggested that GPs withhold sick notes unless patients agreed to attend an appointment with the work coach. 

This is a tactic many of us have previously warned of – the government attempting to co-opt doctors to police ill and disabled people, pushing them into work, regardless of whether or not it is appropriate or safe to do so. But it also indicates the direction of travel for healthcare in the UK. The government intend to make that provision conditional also. (See Tories propose nudge, big business AI initiative and ‘personal responsibility’ in place of adequate health care funding.)

The government is forcing people who are ill into either work or into poverty, and both  outcomes are absolutely ethically unacceptable, a violation of rights, authoritarian and very dangerous. Increasingly, poverty is being used as a weapon to coerce people into work. However, many jobs are not paying enough for people to meet their living costs, so it is no guarantee that work will alleviate poverty.

The government seems to think that citizenship rights ought to be entirely conditional on people being economically useful to the government.

If we fail to be so, we are being treated as disposable political commodities. But citizens are not a means to state imposed ends and ideological aims in wealthy so-called first world democracies. And democratic governments don’t generally impose ‘behavioural change’ techniques on citizens, or professionals, for that matter, in order to make them complicit in the abuse and oppression of marginalised groups. The state is increasingly policing and punishing the poorest citizens, leaving them completely isolated and without any reliable support whatsoever.

The ESA65B is misleading GPs and deterring people from appealing wrongful  DWP decisions

On the DWP’s ESA65B GP’s letter template most recently placed on the government site, titled “Help us support your patient to return to or start work” it 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.

The problem is that people appealing wrongful DWP work capability decisions need to provide sickness certification in order to proceed.

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]. 

GPs are trained and tasked to objectively address health and wellbeing, they should not be co-opted as government ideologues.

The decision to change the letter template was made without any scrutiny from or consultation with parliament and the public. It’s worth reading the series of questions by Emma Dent Coad. Prompting accountable and transparent answers from Sarah Newton appears similar to an exercise in pulling teeth. The responses given display the arrogance, contempt and delusions of an authoritarian government.

When people become ill, they make an appointment with my GP, and not the secretary of state for work and pensions, and for very good reasons. People need support and treatment, not someone spouting ideologically orchestrated dangerous claptrap about how work is ‘good’ for them. It seems the notion of convalescence and recovery are incompatible with the government’s aim of “getting Britain working”.

Catastrophically inaccurate assessments within the DWP are the norm. The government are intentionally reducing access to essential support and services for ill and disabled people, and this ideological attack is causing material hardship, suffering, distress and sometimes, it is killing people. 

The contentious “fit for work” assessment is forcing severely ill people to look for work and sanctioning them if they’re exhausted, in too much pain to get out of bed, while delays in social security are forcing cancer patients to food banks, and the bedroom tax results in bed-bound ill and disabled people facing horrifying threats of eviction. 

These are the direct consequence of intentionally punitive government policies, which aim at enforcing ‘personal responsibility’ and ‘behavioural change’ on those citizens with the fewest choices.

Dan Carden’s letter to Amber Rudd

I was pleased to see Liverpool Walton MP Dan Carden’s letter to Amber Rudd (below) which addresses some of the concerns many of us have raised. He also notes that without a GP’s ‘fit note’, (the Conservative’s Orwellian rebrand of the sick note) it isn’t possible for people challenging Department for Work and Pensions (DWP) decisions to claim Employment and Support Allowance (ESA) in the interim period, until their appeal is heard at Tribunal. 

Indeed, people who have lodged an appeal against a wrongful decision have been blocked from claiming ESA while awaiting the hearing, due to the misleading letter routinely sent from the DWP to doctors. This prevents untold numbers of low-income claimants from accessing financial support while they wait for months on end to go to tribunal. 

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.

However, 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.

It simply isn’t appropriate for the DWP to interfere in a GP’s professional and qualified judgement, especially given the high rate of successful ESA appeals, indicating just how poor the decisions issued by the DWP actually are concerning people’s capacity to work. 

Dan’s letter:

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Related

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

Rogue company Unum’s profiteering hand in the government’s work, health and disability green paper

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

Tories propose nudge, big business AI initiative and ‘personal responsibility’ in place of adequate health care funding

 


I don’t make any money from my work. But you can contribute by making a donation and help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

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Government data reveals scandal: 1,000s dying just months after being denied PIP support

Tory newton

Sarah Newton, minister for disabled people.

Government ministers have said that the controversial Personal Independence Payment (PIP) assessments ensure that those people “most in need” receive support. Last month I wrote about a disclosure from the Department for Work and Pensions (DWP) concerning the mortality rates of people awaiting PIP assessments.

Official DWP data reveals that 7,990 people died within six months of having a claim for PIP rejected by cruel 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 regime. 

Of these, 3,680 died within just three months of having their PIP applications rejected by the DWP.  The figures also show that 17,070 people have died waiting for their PIP claims to be assessed by DWP decision makers.

It has also been revealed that 5,290 of those who had applied under the Special Rules for terminally ill people (SRTI), (those with a terminal disease with less than 6 months to live), died before the DWP made a decision on their claim. 

Further disclosure indicated that 11,790 of these undecided claims were dealt with under ‘normal rules’ and so had not been fast-tracked because they were terminally-ill.

A separate set of DWP figures show that 72% of PIP claimants who take their cases to a social security tribunal go on to win their appeals.

Labour MP Madeleine Moon said: “These shameful figures reveal how potentially gravely ill people who should be eligible for benefits, have tragically fallen through the cracks of a system that should be there to support them as they approach the end of life.”

They haven’t fallen through the cracks. These people were forced through them.

Marsha de Cordova, Labour’s shadow minister for disabled people, said: “These shocking figures show that the cruel and callous PIP assessment is unfit for purpose.

“That thousands of people die three months after being denied vital social security payments is disgraceful.

“Ill and disabled people are being failed [with]the most tragic consequences.

“Labour will end the hostile environment in the DWP and replace the PIP assessment framework with a system that treats disabled people with dignity and respect.”

A DWP spokesperson shamefully insisted there was “no evidence” to suggest people died for the same reason they were trying to claim PIP. And those affected were “only a small fraction of the millions of PIP claims since 2013.”

But there is also no evidence that people did not die for the same reasons they were turned down for support, either.

The government are not monitoring the impacts of the policy, and so have persistently failed to collect evidence either way. Furthermore, dismissing thousands of people so atrociously left in hardship – by a system designed specifically to cut support – indicates the hardened and callous attitude of the state and fundamental lack of compassion towards ill and disabled people, most of whom have paid social insurance contributions for social security provision, only to find in their time of need that welfare support and public services are increasingly inaccessible.

In 2017, two tribunals had ruled the DWP should expand the reach of PIP – which helps disabled people fund their additional living costs. Yet the DWP warned that this would cost £3.7bn extra by 2022 – so unveiled emergency legislation to stop the change happening. At the time, then Disabilities Minister Penny Mordaunt said her move would “make sure we are giving support to those who need it most” – and insisted no one who had already been claiming PIP would see payments drop. 

However, there is clear evidence that PIP is not being awarded to many thousands of people “who need it most”. 

Sarah Newton, now the Minister of State for Disabled People, published one lot of  figures on 11 January following a question raised in parliament by 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.”

Newton is actually implying that payments are being delayed because people aren’t informing the DWP of their terminal condition. That’s highly unlikely.

She said: “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. There is clearly a gap between what we are being told and what is actually happening. 

Newton also warns on her data release: “This is unpublished data… It should be used with caution and it may be subject to future revision.”

There is, however, an Excel spreadsheet that indicates some of the primary conditions of those people who have died. But we cannot assume that those mortalities have arisen as a consequence of the recorded condition. That’s because the DWP isn’t carrying out any detailed monitoring. 

The DWP are experts at reluctantly providing data that lacks both context and details, which, they often say, they simply don’t collate. And 9,020 people’s main condition was not recorded at all by the DWP.  There is no means of useful comparison between mortality rates year by year, or a reference point to start from. A similar statistical analysis of Disability Living Allowance (DLA) claimant mortalities, for example, would help establish an average or baseline. 

Moon followed up on her questions. On January 17, she asked “the Secretary of State for Work and Pensions, pursuant to the Answer on 11 January 2019 to Question 203813, how many claimants of personal independence payments who died within six months of their claim being registered had their application rejected.” (See: Personal Independence Payment: Written question – 209778).  

Sarah Newton answered on the 01 February as follows:  

“Over 3.6 million applications to Personal Independence Payment (PIP) were made between April 2013 and 30th April 2018. Of these, 73,800 claimants died within 6 months of their claim being registered.  

“Prior to any Mandatory Reconsideration or Appeal action, 56,770 and 7,990 of these claimants had their claims awarded and disallowed respectively. 

If a claimant dies before a decision is made on an outstanding claim, the Department establishes whether the claimant’s representative or next of kin wishes to proceed with the claim. If not, the claim is withdrawn so around 7,700 of the 73,800 claims were withdrawn rather than awarded or disallowed.

“56,920 of the 73,800 claims have been credited with a payment.

“Claims made under the special rules for people who are terminally ill are fast tracked and are currently being cleared at a median average of 6 working days for new claimants. This has reduced from a median average of 11 working days between April 2013 and March 2014. 

“Notes: 

  • These figures include claims made under both Normal Rules and Special Rules for Terminal Illness (SRTI) and include new claims and Disability Living Allowance (DLA) to PIP reassessment claims. 
  • The point of application is taken as the day the claimant registered a claim to PIP as recorded on the PIP computer system. 
  • The outcome is the first DWP decision recorded on the PIP Computer system. This does not take into account any mandatory reconsideration or Appeal action so some of these claimants may have subsequently been awarded PIP. Some cases do not have a decision recorded. 
  • This is unpublished data from the PIP computer system’s (PIP CS) management information. It should be used with caution and it may be subject to future revision. 
  • Figures are rounded to the nearest 10. 
  • Figures cover claims made up to and including 30th April 2018 and clearances up to and including 31st October 2018. 
  • GB only. 

“Under the Social Security (Notification of Deaths) Regulations 2012 and s125 of Social Security Administration Act 1992 date of death is provided to the Department for all registered deaths. Additionally next of kin also provide information on the date of death of an individual and this information is used appropriately in the administration of Departmental benefits.” 

Grouped Questions: 209776. 

In December last year, Amber Rudd admitted she has ‘concerns’ that disability benefit tests could be failing the most vulnerable citizens. 

The Work and Pensions Secretary made the comment days after we told how 72% of tribunal appeals overturn the original test

Previously the DWP has said the number of successful appeals is low overall. But Rudd told MPs: “I do have concerns about the number of appeals that get through, i.e. a lot. 

“Which does indicate that maybe those earlier decisions could be better made.”

rudd
Amber Rudd

20,133 people appealed a decision to change or deny their PIP in the three months before Christmas, of which 14,581 won their case. All those people had already gone through an internal appeal known as a Mandatory Reconsideration – which several  MPs have described as a “rubber stamp”.  

The figures released by Sarah Newton reveal that more than 130 working-age disabled people a month on average have been found ineligible for PIP following an initial assessment by government contractors Atos and Capita but were nonetheless so unwell that they died soon afterwards. 3,680 disabled people – or more than 60 a month – died within three months of their initial PIP applications being rejected by DWP. 

PIP is very clearly unfit for purpose. The government urgently need to change this, instead of continuing with their neoliberal project of disassembling public services, including social security. Imposing conscious cruelty on marginalised social groups in the UK has become a standardised policy practice of the Conservatives.

 


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DWP disclose controversial mortality rates of those awaiting PIP assessments

Image result for PIP assessments kittysjones

The Department for Work and Pensions (DWP) has disclosed that over 21,000 ill and disabled people died waiting for their Personal Independence Payment (PIP) assessment to be completed, between April 2013 and 30 April 2018. PIP is claimed by people with a range of health conditions and disabilities, many of which are chronic, degenerative or life limiting.

newton

Sarah Newton, the 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 claimants1 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.

Newton also warns on her data release: “This is unpublished data… It should be used with caution and it may be subject to future revision.”

There is, however, an Excel spreadsheet that indicates some of the primary conditions of those people who have died. But we cannot assume that those mortalities have arisen as a consequence of the recorded condition.

The DWP are experts at reluctantly providing data that lacks both context and details, which, they often say, they simply don’t collate. And 9,020 people’s main condition was not recorded at all by the DWP.  There is no means of useful comparison between mortality rates year by year, or a reference point to start from. A similar statistical analysis of Disability Living Allowance (DLA) claimant mortalities would help us establish a useful baseline. 

I rang the DWP press office on Friday for a response and to ask for details of DLA claimant pre-assessment mortality rates, and was promised an email that has not arrived. 

Personal experience

As someone who has undergone both Employment and Support Allowance (ESA) and PIP assessments, I know from personal experience they are dehumanising, and  the stress they create exacerbates the symptoms of chronic illness. I have lupus. 

Back in 2013, I wrote about the terrible impact of  stressful, continuous work capability assessments on disabled people, particularly those with chronic illness. It’s long been understood that distress exacerbates the symptoms of both physical and mental illness. In my case, the ESA assessments and subsequent Tribunal were so stressful that the process itself created a deterioration in my mental health at the time.

My physical symptoms worsened to the point where I became severely underweight at less than seven and a half stones. I was often left without enough money to buy food and keep warm. I also have Raynaud’s, which means I have to keep warm. My rheumatologist prescribed a chemotherapy – methotrexate – and other immune suppressants to halt the rapid acceleration in disease activity and to try and stop the subsequent wake of permanent widespread damage being done to my body. 

Those exacerbations were stress-related, and have left a wake of damage to my joints, nerves, tendons, organs and blood cells, and, together with the treatments, the severe illness flares have irrepairably damaged my immune system, leaving me even more susceptible to serious infections like pneumonia, abcesses, kidney infection and an abnormal immune response to those – sepsis.

I was very poorly when I claimed ESA, but was critically ill by the time I was forced to appeal the DWP’s decision that I was ‘fit for work’.  

A government that cared about monitoring the impact of its’ policies on vulnerable citizens would do a much better job of collating and recording information about mortalities, and would also present a context that permits us to make meaningful comparisons. Instead, we see the Conservatives micromanaging information with expedience, while claiming that there is “no causal link established” between policy and any increase in harm or mortality.

However, the government have no grounds for making that claim, since there has been a persistent refusal to carry out a cumulative impact assessment of the welfare reforms, or to open an inquiry regarding the many concerns raised and cases presented where people have suffered harm, distress and premature mortality, indicating a correlation with the government’s policy changes.

Although correlation isn’t the same thing as causality, it often implies causality. Without further investigation, we cannot say that there is or isn’t a causal relationship between punitive policies and distress, harm, premature mortality. But we can say there is an association evident. It’s worth bearing in mind that much social science research establishes correlations, not causality.

Government guidelines for PIP assessment: a political redefinition of the word ‘objective’

The Department for Work and Pensions have issued a guidance document for providers carrying out assessments for PIP. It can be found here: PIP Assessment Guide. From the document: “The HP should check the consistency of what is being said by using different approaches, asking questions in different ways or coming back to a previous point. When considering inconsistencies, HPs should bear in mind that some claimants may have no insight into their condition, for example claimants with cognitive or developmental impairments.”

This approach – “checking for inconsistencies” by using indirect questioning and assumption is NOT “objective”. It is a calculated strategy to justify a starting point of disbelief and skepticism regarding the accounts provided by ill and disabled people about the impact of their conditions and disabilities on their day-to-day living. As such, it frames the entire assessment process, weighting it towards evidence gathering to justify refusing awards, rather than being “objective”, as claimed.

It’s simply a method based on side-stepping and discounting people’s own accounts of their experiences of their disability, and any medical evidence submitted to verify that.

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.

It becomes easier to disassociate from someone you view “objectively” and to distance yourself from the impact of your calculated and target-led decision-making, constrained within a highly political framework. Such an objectification of a person or group of people serves to de-empathise us, which is a key characteristic requirement of neoliberal ideology, embedded in inhumane “small state” policy and extended via administrative (and outsourced, privatised) practices. It leaves us much less likely to relate to the circumstances, emotions or accept the needs and choices of others.

Surely a considerable part of our experience of being objectively diagnosed as ill and/or disabled, in any case, is initiated by a person’s subjective experience of it, rather than categories and counts; quantifiable, reductive and speculative statements about how we may perform highly specific tasks.

Quantitative medical evidence is important, because it does often give a general indication of conditions that would entail loss of function. But considering medical evidence isn’t a central part of the assessment process. Whether or not we can perform certain tasks, and inferences drawn from that are the central considerations for PIP eligibility.

The tasks I was asked to perform at assessment were not related to those I carry out from day to day. Consequently, as they were unfamiliar, I had no idea what I could and couldn’t actually do. It was a shocking experience for me to learn how much mobility I have lost in my hands, wrists, shoulders and neck. It was also very painful attempting what looked like simple movements, which the assessor demonstrated as she conducted the examination. Because she moved quickly from one movement to another, I had no time to assess if I could do the activities. I was trembling because of the pain and effort, and couldn’t understand why I was struggling with what looked like basic movements. I left in a lot more pain than when I arrived. My shoulder and calf swelled inexplicably during the assessment and I couldn’t walk for over a week afterwards.

Many conditions “fluctuate” – they vary so much that it’s difficult to assess performance of specific tasks consistently. Many conditions become progressively worse at a varied pace, often leaving little scope for a person developing coping strategies and adapting their everyday lives to the changes as they happen, such as a progressive loss of mobility, cognitive impairment, mood changes, anxiety, depression, sleep disruption and other psychological impacts, and the increasing pain and fatigue that they may experience.   

If the process were genuinely “fair, accurate and objective” then there would be no need for mandatory reviews and scrutiny through the appeals process. The introduction of the mandatory review – another layer of bureaucracy and a barrier to justice, where the DWP decide whether their first decision should be changed – has deterred many from appealing wrong decisions.

Those making the decisions about PIP awards are: “trained DWP staff who are familiar with the legislation governing PIP, but who do not have a healthcare background. The HP enables CMs to make fair and accurate decisions by providing impartial, objective and justified advice.”

The PIP assessment is geared towards looking for “inconsistencies” in “functional limitations”. For example, if you say you can’t sit unaided for half an hour, but then say that you watch soaps on TV, it will be assumed you sit unaided for at least half an hour to watch TV, and that will be classed as a “discrepancy between the reported need and the actual needs of the claimant.”

The whole assessment process is set up and designed to look for “inconsistencies.” In other words, the assessor is looking for any excuse to justify a decision that you are not among those in “greatest need” for a PIP award. The entire process happens within a framework of reducing welfare costs, after all. This makes a mockery of the government’s fondness for using the words “objective” and “fair.”

What has become clear is this so-called support for those who are “in the greatest need” is not working for disabled and ill citizens. It most certainly does not help disabled people maintain their dignity and support them in independent living.

It is not such a big inferential leap to conclude that continually cutting essential lifeline support for ill and disabled people will ultimately lead to harm, distress, hardship and other negative consequences, and will, ultimately, have wider political, social, cultural and economic “adverse” consequences, too.

dpac


For people who can’t translate the coded statement at the foot of the Excel Spreadsheet, it says:

These figures include claims made under both Normal Rules and Special Rules for the Terminally Ill and include new claims and Disability Living Allowance (DLA) to PIP reassessment claims. · This is unpublished data from the PIP computer system (PICS) management information. It should be used with caution and it may be subject to future revision. · Claimants may often have multiple disabling conditions upon which the decision is based but only the primary condition as recorded on the PIPCS. · Figures are rounded to the nearest 10 and ‘#’ is used for totals of greater than 0 but less than 5. · Components may not sum to totals due to rounding.


 

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Tens of thousands of people claiming ESA owed thousands each due to government blunder

Tens of thousands of disabled people are set to receive backdated benefit payments averaging £5,000 following a government error. The Department for Work and Pensions (DWP) has revealed it will pay out more than £1.5bn after “shoddy administration” meant about 180,000 people did not receive benefits they were legally entitled to after being ‘migrated’ from Incapacity Benefit to Employment and Support Allowance (ESA).

The average underpayment for each person is estimated to be about £5,000, but some people will be owed significantly more, with approximately 20,000 having been underpaid around £11,500 and a small number owed as much as £20,000.

The error was first thought to have resulted in underpayment for 70,000 disabled people over seven years, but a government document published on Wednesday shows it is expected to have affected far more people, with the estimated back payments bill having risen from £340m to £970m. 

The average underpayment for each person affected is estimated to be about £5,000, but some people will be owed significantly more, with approximately 20,000 people having been underpaid around £11,500 and a small number owed as much as £20,000.

Initially, the government said there would be up to £150m that may never be paid back because arrears would only be accounted for as far back as 21 October 2014, the date of a legal tribunal ruling – meaning some would never have been reimbursed. However, following legal action, ministers made a U-turn in July and subsequently announced it would pay back the thousands of disabled people in full. 

In July, Esther McVey, the minster for work and pensions, made a ministerial statement: “The Department has analysed the relationship between ‘official error’ and section 27 of the Social Security Act 1998 in regulating how and to what extent arrears can be paid. As a result of the conclusions of this analysis, we will now be paying arrears to those affected back to their date of conversion to ESA.

“My department will be contacting all those identified as potentially affected as planned. Once an individual is contacted, and the relevant information gathered, they can expect to receive appropriate payment within 12 weeks.” 

Marsha de Cordova, Labour’s shadow minister for disabled people, accused the Conservatives of creating a “hostile environment for sick and disabled people”.

She added: “Disabled people have been short-changed and denied the social security they were entitled to. The government must ensure that disabled people who have been so unfairly treated are properly compensated.”

McVey also confirmed that once contacted, claimants would be provided with a dedicated free phone number on which they can make contact with the department.

The government said it was in the process of reviewing about 570,000 ESA cases that could be affected, and that it expects to complete the process by the end of 2019.

A DWP spokesperson said: “Anyone affected by this historic error will receive all of the money they are entitled to. That is why we have created a dedicated team of over 400 staff to examine cases, and have paid back around £120m so far. 

“We have worked with charities and other disability organisations to make sure that we are providing the right support to all affected claimants and are hiring and allocating more staff to do that.”

Responding at the time of the ruling, Carla Clarke, solicitor for Child Poverty Action Group, which launched the legal action, said: “Poor and inadequate DWP processes left up to 70,000 [now estimated at 180,000] disabled individuals without the support they should have received to help them with their additional costs.  

Justice required that the DWP error was corrected in its entirety for the people affected, many of whom are owed arrears from 2011. We are pleased that the DWP agreed that this was correct following our legal action. 

However, it shouldn’t be necessary to take a government department to court to achieve justice for people who have been failed by officials making avoidable errors.”

The government’s hostile environment and Personal Independence Payments

Image result for universal credit disabled people criticism

The government announced in January this year that every person receiving Personal Independence Payments (PIP) will have their claim reviewed. A total of 1.6 million of the main disability benefit claims will be reviewed, with around 220,000 people expected to receive more money.

The decision came after the DWP decided not to challenge a court ruling that said changes to PIP were unfair to people with mental health conditions. The review could cost £3.7bn by 2023.

The minister for disabled people, Sarah Newton, said the DWP was embarking on a “complex exercise and of considerable scale”.

She added: “Whilst we will be working at pace to complete this exercise, it is important that we get it right.”

The government should have got it right in the first place. It shouldn’t be necessary to take a government department to court to achieve justice for people who have been failed by officials.

Ministers made changes to PIP in 2017 which limited the amount of support people with mental health conditions could receive. As a result, people who were unable to travel independently on the grounds of psychological distress – as opposed to other conditions – were not entitled to the enhanced mobility rate of the benefit. 

The government pressed ahead with these changes, despite criticism from an independent tribunal in 2016.

In 2017, an independent review of PIP was highly critical of the assessment system, after revealing 65% of those who appealed against rejected claims saw the decision overturned by judges.

Last December, a High Court judge ruled the alterations “blatantly discriminate” against people with psychiatric problems and were a breach of their human rights.

Work and Pensions Secretary Esther McVey subsequently announced that the government would not appeal against the judgement, despite not agreeing with ‘certain aspects of it.’ 

 Disability income guarantee cut under Universal Credit

The first legal challenge against Universal Credit in June this year found that the government discriminated against two men with severe disabilities who were required to claim the new benefit after moving into new local authority area.

Prior to moving, both men were in receipt of the Severe Disability Premium (SDP) and Enhanced Disability Premium (EDP), which were specifically aimed at meeting the additional care needs of severely disabled people living alone with no carer, as part of their Employment and Support Allowance entitlement.

Recently released figures from the DWP suggest that 500,000 individuals are in receipt of the SDP. Both the SDP and EDP have been axed and are not available under Universal Credit. According to both the men, they were advised by DWP staff that their benefit entitlement would not change.

Despite repeated assurances from the government that “no one will experience a reduction in the benefit they are receiving at the point of migration to Universal Credit where circumstances remain the same” both claimants saw an immediate drop in their income of around £178 a month when they were moved onto Universal Credit.

When they asked for top up payments they were told that government policy was that no such payments would be paid until July 2019, when managed migration would begin.

The court ruled that the implementation of Universal Credit and the absence of any ‘top up’ payments for disabled people as compared to others constitutes discrimination contrary to the European Convention on Human Rights. Following months of litigation, McVey, Secretary of State for Work and Pensions, carried out a policy U-turn and committed the government to ensuring that no severely disabled person in receipt of the SDP will be made to move onto Universal Credit until transitional protection is in place and also committed to compensating those like the two disabled men who have lost out.

Despite this, following hand down of the judgment the Secretary of State for Work and Pensions has sought permission to appeal, maintaining that there was “nothing unlawful” with the way the disabled claimants were treated.

However, a subsequent court case resulted in agreement on compensation for the two men. TP will now receive £3,277 for past financial losses and £3,240 for the pain and distress he has been caused, as well as £173.50 a month to cover the shortfall in his benefits pending transitional protection coming into force.

AR will receive £2,108 for past financial losses and £2,680 for the anxiety and distress he was caused, as well as a monthly payment of £176 to make up the shortfall in his benefits.

The DWP had initially attempted to keep the terms of the agreement secret. However, the High Court ordered the department to disclose the details of the compensation settlement. 

Marsha de Cordova, Labour’s shadow minister for disabled people, said: “This again demonstrates the government’s mistreatment of disabled people.

“These men were assured by the government that they wouldn’t lose out on universal credit but they were left thousands of pounds out of pocket, which severely impacted on their wellbeing.

“Esther McVey should now compensate all those who lost out, reverse cuts to transitional protection, and withdraw her appeal against the original finding of discrimination.

“The government must also stop the roll out of universal credit and fix its fundamental flaws.

“The next Labour government will transform our social security system, ensuring it is there to support disabled people to live independently and with dignity.”

Tessa Gregory, from the law firm Leigh Day, who represented the two men, known only as AR and TP, welcomed the financial settlements.

But she called on McVey to compensate all other claimants in similar positions, and to reconsider her decision to appeal the finding of discrimination.

She said AR and TP had called on McVey to “urgently” reconsider draft regulations which currently only compensate disabled people in their position with a flat rate payment of £80 a month.

Gregory said: “This plainly does not reflect the actual loss suffered by our clients and thousands like them and compounds the unlawful treatment to which they have been subjected.”

The DWP have refused to answer questions about the case, including how many disabled people it believed had so far lost out on EDP and SDP in the move to universal credit, and whether McVey would reconsider her decision to compensate others in the same position as AR and TP by only £80 a month.

A DWP spokesman confirmed: “The government is appealing the decision of the judicial review, but in the interim we have agreed to make payments to the lead claimants.”

Figures published by the DWP suggest that, in February this year, there were 4,000 SDP claimants and 14,000 EDP claimants (including 3,000 who received both EDP and SDP) who have been moved onto universal credit.

The DWP has previously said it will stop moving claimants of SDP onto universal credit until the introduction of transitional protection next year, while all those who have already lost out through such a move will receive some backdated payments.

But it has not offered them the full compensation agreed with AR and TP and there has been no mention so far of claimants who previously received EDP but not SDP before their move onto universal credit.

And the DWP has still not been able to explain how it justifies not providing equivalent levels of support to new disabled claimants of universal credit, who will receive lower payments than those transferred onto universal credit from legacy benefits such as income-related ESA.

DNS has been forced to complain to the Information Commissioner’s Office about DWP’s refusal to offer a detailed description of how the introduction of universal credit – and the loss of the premiums – will impact disabled people financially.

I did some joint work with Alex, who writes at Universal Credit Sufferer, after a third sector welfare advisor informed us that people claiming PIP were being told to claim legacy benefits – ESA or JSA if they are fit for work – by the DWP and that they were not allowed to sign onto Universal Credit. 

Following several calls between us to the DWP press office, it was clear that staff were not at all clear about this situation. The response we eventually got was “We need to check with officials and come back to you tomorrow.” However, I didn’t get a follow-up call. 

It seems that all new claims for Universal Credit will not be accepted if the person claiming is in receipt of the Personal Independence Payment (PIP) Daily Living Component. However, this move has not been widely publicised. Both Alex and I found that when we used Universal Credit’s online application portal, it will not accept a claim if you declare you are in receipt of Personal Independence Payment (PIP).

While it may be a reluctantly positive move on the part of the government to ensure that disabled people won’t be forced into claiming universal credit and therefore losing their disability premiums, this isn’t a long term solution. It nothing to address the loss of the premiums for new disabled claimants. Nor does it address the controversial and fatally flawed assessment and appeal processes that are unfit for purpose under any welfare circumstance.

But the road to tyranny is mostly paved by government that create hostile environments for some groups and ignore citizens’ accounts of the impacts of their actions on citizens.


Related

Conservative MPs accuse citizens of ‘scaremongering stories’ about experiences of Universal Credit.

Work and Pensions Committee publishes “damning” evidence of the impact of Universal Credit

Disabled people ‘worse off’ under universal credit

 


I don’t make any money from my work.  But if you like, you can help by making a donation and enable me to continue to research and write informative, insightful and independent articles, and to provide support to others going through disability benefit assessment processes and appeals. The smallest amount is much appreciated – thank you.

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