Better Benefit ‘Work’ Tests
posted: 24/11/2010
The government has said it will overhaul its controversial medical tests to decide whether the seriously ill and disabled can claim long-term sickness benefits. An independent review found they were "impersonal, mechanistic and lacked empathy", leaving many claimants feeling unjustly treated and distressed.
The review, conducted by the academic Malcolm Harrington, an occupational health specialist, looked at whether the 'working capability assessment' was a fair system. There is mounting evidence that people with serious illnesses, like HIV, are being judged fit for work, when they are not. 40% of people who appeal, win their appeals.
Testing 94,000 people a month
The tests, first introduced in October 2008, mean 53,000 people are assessed a month for 'employment and support allowance'. The numbers being tested will balloon from next April as another 41,000 incapacity benefit recipients are re-assessed under the ‘work capability assessment’ every month.
Long-term ill and disabled somehow pass ‘work’ tests
Harrington found that the assessments, run by a French multinational, Atos Origin, which received £54m from the coalition government for the contract, failed people with mental illnesses and long-term disabilities.
‘Impossible’ 28 page form
One form which claimants needed to complete is 28 pages long and almost half the people "found the questionnaire difficult or impossible to complete".
Another problem is that people’s ability to work is measured by a computer questionnaire that uses "descriptors" - questions that are apparently unrelated to work. One example is that people are asked whether they had "loaded a dishwasher or washing machine" that day. "It does not bother to ask whether the claimant has a dishwasher or washing machine. That is the danger with computer systems and drop-down menus," said Harrington.
Another question asks if you sit and watch TV. Say yes and they assume you can sit for long periods in a chair.
"We want to rely much more on healthcare professionals and assessments., said Harrison..
He pointed out that 40% of those found fit for work by the system appealed and won – and added that most people who appealed provided "additional medical information".
Radical change needed
Harrington called for a radical overhaul, with jobcentre staff having to take into account health records, the Atos assessments and an individual's own testimony before making a decision about whether someone on sickness benefits should be forced back into work.
At present benefits staff rarely dissented from Atos's verdict, he said, and "a lack of procedural justice can lead people to feel embittered and for some this can lead to psychological distress with affects on physical and mental health".
Champions to help
The report also recommends the appointment of lay "champions" to guide claimants through the process, and detailed explanations of why a benefit has been refused.
Welcome for review
Many working with the poor and vulnerable welcomed the report, saying it was a long overdue recognition of the system's problems. Citizens Advice said its surveys showed a 41% increase in complaints from claimants in the past year alone.
NAT, National AIDS Trust welcomed the findings and recommendations. They say ‘we fully support the call for change to ‘improve the fairness and effectiveness of the WCA’ by improving transparency, empathy and communication within the assessment process for Employment Support Allowance (ESA)’. NAT were among the 400 organisations and individuals to contribute to the independent review, based on their research report Unseen disability, Unmet needs – A review of the impact of Work Capability Assessment on people living with HIV. Deborah Jack, Chief Executive of NAT (National AIDS Trust), said: ‘NAT supports the recommendations of the independent review and we were extremely pleased to see some of our concerns included in the final report.
Government to make all the changes
The government said it accepted Harrington's conclusions and would implement them in full. The work and pensions minister Chris Grayling said: "There were no targets or goals to get people off benefits. This is meant to be a fair process … we are dealing with claimants who we have had very little contact with."
Reform delay criticised
However, Harrington did criticise the government for failing to implement a key recommendation quickly enough: that of a "personalised summary of assessments in plain English" to be produced by Atos. The government could only promise that ministers "explored the feasibility of providing a summary" by the end of 2011. Given the planned expansion in the scheme next year, Harrington said, this "was just not good enough".
Charities said the "review pinpoints what is wrong with the system". Matthew Lester of the Papworth Trust, a disability charity, said the main concern now was how quickly the government would implement the report's main findings. "Even if they get the main points implemented by April that will mean another 250,000 people being assessed by a system that we already know is unfair."
NAT report
Source (adapted)
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