Tag: Work and Pension Committee inquiry into ESA

Thousands of disability assessments deemed ‘unacceptable’ under the government’s own quality control scheme

351-burden-cuts-by-populationInfographic from The Centre for Welfare Reform

New figures released by the Government indicate that neither Atos nor Capita – the private companies contracted by the government – paid more than £500m to assess people for Personal Independence Payments (PIP) – are actually meeting the target of 97% of assessments conforming to standards. 

The government have released the data to the Commons Work and Pensions Committee, which was due to take evidence from Atos and Capita regarding the assessments yesterday.

While private companies carry out the assessments, it is the Department for Work and Pensions (DWP) that makes the final decision on whether to award people financial support. However, those decisions are informed by the contents of reports that privately contracted ‘health professionals’ write during the assessment process.

Latest audits show that 6.4% of PIP assessments were deemed “unacceptable” in the three months leading up to October 2017.

Furthermore, the two companies have never met the target once, by the standard set using the government’s current method of quality control and measuring performance for PIP assessments.

Audits of the 4,200 PIP assessments take place every three months and are split between three ‘lots’ that are managed by different companies.

Lot 1 is assigned to Atos trading as ‘Independent Assessment Services’ (IAS). The Department for Work and Pensions (DWP) said 6.2% of its assessments were “unacceptable” in the three months to October 2017.

Lot 3 is also assigned to IAS. The DWP said 5.7% of the assessments were “unacceptable” in the three months to October 2017.

Lot 2 is assigned to Capita. The DWP said 7.3% of its assessments were “unacceptable” in the three months to October 2017.

        The government’s own figures on the rate of ‘unacceptable’ PIP tests.                                   (Image: Department for Work and Pensions)

The current performance measure – which sees an independent team pick cases at random – was launched in March 2016. Under the previous method, the private providers audited assessments themselves. 

The National Audit Office (NAO) found last year that the number of completed ESA assessments were below target, despite an expected doubling of the cost to the taxpayer of the contracts for disability benefit assessments, to £579m a year in 2016/17compared with 2014/15.

The NAO said that nearly 1 in 10 of the reports on disabled people claiming support were rejected as below standard by the government. This compares with around one in 25 before Atos left its contract. 

The provider was not on track to complete the number of assessments expected last year and has also missed assessment report quality targets. 

Atos abandoned its contract early following mounting evidence that hundreds of thousands of ill and disabled people have been wrongly judged to be fit for work and ineligible for government support. 

The proportion of Capita PIP tests deemed unacceptable reached a peak of 56% in the three months to April 2015.

For Atos, the peak was 29.1% for one lot in June 2014. 

More than 2.7million people have had a DWP decision regarding PIP since the benefit launched in 2013 – this suggests that tens of thousands went through an ‘unacceptable’ assessment.

The PCS union, which represents lower paid workers at the Department for Work and Pensions (DWP), told MPs during the Work and Pensions Committee inquiry: “We do not believe that there is any real quality control.

“Our belief is that delivering the assessments in-house is the only effective way for DWP to guarantee the level of quality that is required.” 

In evidence submitted to the Work and Pensions Committee, Capita said 95% of assessments are now deemed acceptable – giving the figure for the past year. The company said:

“This represents a significant improvement from previous years and producing quality reports for the DWP remains a top priority within Capita.”

“Additionally, we use a range of intelligence as indicators, to identify disability assessors who may not be operating at the high quality output levels we expect.

“This includes data from audit activity, coaching and monitoring.

“This enables us to continually monitor performance, and take appropriate internal actions… where necessary to ensure we continue to deliver a quality service.”

Atos said 95.4% of tests are now acceptable and more work was needed to ensure the auditing process itself is “consistent”, adding: “We strive to deliver fair and accurate assessment reports 100% of the time.”

However, many disabled people would beg to differ. See for example: Essential Information for ESA claims, assessments and appeals. The comments section alone highlights just how unfair and inaccurate Atos assessments commonly are.

It also emerged that Atos and Capita employ just FOUR doctors between them. Most employees within the companies are nurses, paramedics, physiotherapists or occupational therapists. Capita’s chief medical officer Dr Ian Gargan confessed he was just one of two doctors at the firm’s PIP division, which has 1,500 staff.

He told the Commons Work and Pensions Committee: “Two thirds of our professionals have a nursing background and the remainder are from occupational therapy, physiotherapy and paramedicine.”

Dr Barrie McKillop, clinical director of Atos’ PIP division, admitted they too only had two doctors among their staff. 

Frank Field said: “You’ve got two doctors each, mega workload – maybe there’s a lot of doctors out there who would long for some part-time work.” 

“You haven’t sought them out to raise your game, have you?”

However Dr McKillop insisted Atos’ current model “is a strong one” and people “bring clinical experience in different areas”.

You can listen to yesterday’s Work and Pensions Committee’s PIP and ESA evidence session here. 

The witnesses are: Simon Freeman, Managing Director, Capita Personal Independence Payments, Dr Ian Gargan, Chief Medical Officer, Capita Personal Independence Payments, David Haley, Chief Executive, Atos Independent Assessment Services and Dr Barrie McKillop, Clinical Director, Atos Independent Assessment Services.

You can access the written evidence here.

You can access the written evidence and watch the session online from the previous session here from 22 November.

The inquiry is ongoing. The Committee is interested in receiving recommendations for change both on the assessment process for each benefit individually, and on common lessons that can be learned from the two processes. 

 

Related 

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

 


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

DonatenowButton

Government turns a blind eye to work capability assessment related deaths and expect the public to do the same

11046274_80388630968089cam c

Tory ministers are facing further pressure to reveal information about how many people have died after being assessed as “fit for work.” Labour MP for central Newcastle-upon-Tyne, Chi Onwurah, has joined over 120,000 people that have signed a petition to demand that the Government release the figures.

Many campaigners have been calling on the Department for Work and Pensions (DWP) to publish the figures since November 2012.

Mrs Onwurah, who led a Commons debate on welfare earlier this year, said: “One of the most powerful and distressing examples in my debate was of a man who had committed suicide.

“If someone dies after being found fit to work it doesn’t necessarily mean that being found fit to work had an impact in their death, so I can understand that the Government might fear the figures would be misinterpreted.

“But if the Government has figures then they should share those, and allow people to interpret them fairly.

“This isn’t just a matter of dry statistics. It is about about the health-affecting impact that having been found fit to work can have on claimants.

“And I know that because I see them in my surgery on a regular basis.

“When bad decisions are made I know they can have a life-destroying impact on vulnerable people. So it makes sense for the Government to share that data.”

It was in January of this year that Mrs Onwurah told MPs about a vulnerable constituent who had tragically committed suicide after being found fit for work. He was claiming Employment Support Allowance and incapacity allowance. He was being supported by Newcastle Welfare Rights, who told the DWP that after suddenly being found fit to work:

“.. he was acutely distressed; he struggled to talk, he was having thoughts of suicide, he had also started drinking alcohol to cope and had struggled to leave the house”

Despite supporting psychological assessments, other evidence, and an attempted suicide, the decision was not reversed and in January 2014 he was found hanged by his neighbour.

Mrs Onwurah said: “My constituent was found hanged in his home by a neighbour. He was well known to Newcastle Welfare Rights, from which he had received considerable support in his dealings with the Department for Work and Pensions.

“He had been in receipt of employment and support allowance, and previously incapacity benefit, and he was engaging well with Newcastle Welfare Rights until November 2013, when he underwent a work capability assessment.”

The Department for Work and Pensions (DWP) insists it is irresponsible to suggest deaths which follow an assessment that claimants are fit to work were caused by the assessment.

The DWP originally published statistics in July 2012  after several of us submitted Freedom of Information requests (FOIs). The released statistics indicated that 10,600 people had died between January and November 2011 who had been claiming Employment Support Allowance (ESA), and where the date of death was within six weeks of the claim ending.

The DWP publication caused huge controversy, although many people disagreed over what the figures actually showed. Ministers subsequently blocked publication of any updated figures.

At the time, I made a statistical cross comparison of deaths, and the information released showed that people having their claim for Employment Support Allowance (ESA) stopped, between October 2010 and November 2011, with a recorded date of death within six weeks of that claim ceasing, who were until recently claiming Incapacity Benefit (IB) – and who were migrated onto ESA – totalled 310. Between January and November 2011, those having their ESA claim ended, with a recorded date of death within six weeks of that claim ending totalled 10,600. The DWP did not provide information regarding whether or not people had died before or after their benefit claim was ended, which complicated matters.

However, there is a very substantial and significant statistical variation over a comparatively similar time scale (although the 10,600 deaths actually happened over a shorter time scale – by 3 months) that appears to be correlated with the type of benefit and, therefore, the differing eligibility criteria – the assessment process – as both population samples of claimants on ESA and IB contain little variation regarding the distribution in the cohorts in terms of severity of illness or disability. 

Bearing in mind that those who were successfully migrated to ESA from IB were assessed and deemed unfit for work, (under a different assessment process, originally) one would expect that the death rates would be similar to those who have only ever claimed ESA.

This is very clearly not the case. And we know that the ESA assessment process has actually excluded many seriously ill people from entitlement because of the media coverage of individual tragic cases, when a person deemed fit for work by Atos has died soon after the withdrawal of their lifeline benefit, and of course, such accounts of constituents’ experiences and case studies, as evidence, informs Parliamentary debate, as well as the ongoing Work and Pension Committee inquiry into ESA, details of which may be found on the Hansard parliamentary record.

An official watchdog has also ordered the Government to release further information about how many people have died after going through the work capability assessment (WCA) which had resulted in a decision that they were fit for work, since the last publication in 2012.

The ruling was made after an appeal by Mike Sivier, a fellow campaigner, freelance journalist and a carer that runs the Vox Political blog who has himself been pushing for the figures to be published since the summer of 2013.

Being assessed as fit for work would mean that someone is expected to start looking for a job, take part in training designed to “prepare them for employment”, including workfare programmes – and would face the prospect of sanctions as part of the strict welfare conditionality regime – losing their lifeline benefits – unless they comply.

Mike also used the Freedom of Information Act to ask how many people who died between November 2011 and May 2014 had been found “fit for work”, or told they should move towards finding work.

But the Department for Work and Pensions refused his request, saying it was already preparing to publish the information.

Mr Sivier appealed to Information Commissioner, Christopher Graham, who ordered the DWP to publish the data within 35 days of his ruling on April 30, 2015.

But the Department of Work and Pensions has instead decided to appeal this ruling.

Campaigners now want to know what the government is trying to hide and the online petition demanding that Work and Pensions Secretary Iain Duncan Smith stop attempting to block publication of the statistics has been signed by more than 120,000 people on the website: www.change.org.

A spokeswoman for the DWP said: “We have been clear that we intended to publish these statistics – but we need to make sure they meet the high standards expected by the UK Statistics Authority before we do so.”

Many sick and disabled people have said that the constant strain, anxiety and stress of what they have described as a “revolving door process” of assessment, review, appeal and re-assessment, has contributed significantly to a decline in their health.

The previous figures from the DWP, and the marked contrast between the ESA and IB death statistics certainly substantiate these claims that the assessment process places a great deal of stress on people who are often seriously ill. Anyone with a chronic illness will tell you that stress invariably exacerbates their condition.

At a meeting in June 2012, British Medical Association doctors voted that the Work Capability Assessment (WCA) should be ended “with immediate effect and be replaced with a rigorous and safe system that does not cause unavoidable harm to some of the weakest and vulnerable in society”.

The vote has not been acknowledged by Atos or by the Government, although it was reported widely in the media at the time. On 22 May 2013, a landmark decision by the courts in a judicial review brought by two individuals with mental health problems ruled that the WCA is not fit for purpose, and that Atos assessments substantially disadvantage people with mental health conditions. Despite the ruling’s authoritative importance, the decision had a similar lack of real-world effect as it did not halt or slow down the WCA process: Atos and the DWP have ignored the judgement and its implications.

In mid-January 2012, there was a significant scandal as media were alerted to the fact that the WCA had found a man in a coma to be “fit for work”. Work Capability Assessments have found patients with brain damage, terminal cancer, severe multiple sclerosis, and Parkinson’s Disease to be fit for work. On 24 April 2013, a woman who was a double heart and lung transplant patient died in her hospital bed only days after she was told after a WCA that her allowance was being stopped and that she was fit for work.

In August 2011, twelve doctors working for Atos as disability assessors were placed under investigation by the General Medical Council because of allegations of misconduct in relation to their duty of care to patients. One doctor was forced to resign from Atos after being told to change a report about an individual, pointing out “the General Medical Council makes it clear that doctors must not change a report and risk being disciplined for unprofessional conduct if they do”.

There are many more well-documented problems with the Work Capability Assessment. It’s mired in controversy. Yet since 2010 the current government has continued to expand its role to reassess millions of  people that the DWP had already judged to be entitled to Incapacity Benefit. The government also made changes to the framework of the test to make ESA more difficult to claim.

Despite the controversy, the government continues to show a somewhat baffling and extremely troubling disinterest in the serious problems related to the increased means-testing and conditionality of sickness and disability benefits that they have introduced.

Another major area of concern is that there is a clear absence of impact monitoring, regarding the changes they have made to policy. I find it curious that whilst the DWP couldn’t state either way which side of a claim ending that the deaths happened, journalists and the government shrug the figures off, rather than actually INVESTIGATING the matter.

I have lost 3 friends during the past three years, who each died tragically just after being told they were fit for work, their lifeline benefit support was ended. Families who have suffered bereavement related to ESA claims consistently report that it is the stress of the assessment, the strain of being told they are fit to work when they are not, and the fact that chronically sick people then have to fight for their lifeline benefits that causes a further decline in their health, and the exceptional stress, caused by government welfare policy that is very punitive in nature, that is leading to some people dying.

It’s inconceivable that the government have failed to understand that placing very ill people in a position where their lifeline benefit is stopped so they have to fight for the means to meet their most basic needs – those of food, fuel and shelter – will potentially be very harmful, having a detrimental impact on their health, which may be fatal.

Further related reading:  Cross-party concerns raised in Parliament about Atos assessments, with evidence – presented cases studies of people who died AFTER their lifeline benefit was withdrawn – Atos comes under attack in emotional Commons debate

How many persons has Atos killed today? – Michael Meacher MP

Black Propaganda

What you need to know about Atos assessments

Clause 99, Catch 22 – State sadism and silencing the vulnerable

Labour would end this Government’s demonisation of benefits claimants – Chi Onwurah MP

Essential information for ESA claims, assessments and appeals

Remembering the victims of the Government’s welfare “reforms”

385294_195107567306966_1850351962_n

Thanks to Robert Livingstone for his excellent pictures.