ESA SOS - The Starting Gun #ESAendgame

Though I'm posting it here, this post was actually written by Sue and originally appeared on her own blog. Please post any comments there.

In a few weeks, I'm going to arrange for some very significant stories to break in the very mainstream press about ESA.

I've been collecting them for about 6 months and if there's any justice left at all, they will kill ESA once and for all.

They will totally change your perception of ESA and WCAs

We need a Spartacus 2 and as you all know, I've been sick as a dog.

Today is stage one. If you're in, please leave your Name and user name on twitter or Facebook (Feel free to only provide the latter if you like to keep your anonymity a little) and Constituency

There will be a task most days, so please keep watching my blog.

Today, I would like something very specific. What is the worst thing, for you about ESA/WCAs? I need you to simply leave a one line answer if possible, ie "1 Year Time Limit - It totally undermines any contributory principle"

The most popular of these "subjects" will make up every short section of the new report.

Share this post everywhere you can. This will be the start of our biggest fightback. EVERYONE will have to give this everything if it is to work. We need hundreds of responses to every request to make this a truly representative report from disabled people, by disabled people. The more join, the more powerful our voice and the more impact any final work will have.

What's more, by crowdsourcing our information and skills, believe me, we have 100 times the resources and ability of the DWP.

I have an awesome team in place - they produced #esaSOS in just 4 days. Hard though it will be, PLEASE, I'm still very weak and CAN'T read endless comments or pages and pages of Hansard or reports. Make this easy for me by keeping as close to the brief each day as you possibly can. I WILL cover everything, nothing will get missed. I'll ask the question you're itching to comment on, honest, but if we do it this way, I can delegate very much and empower you all to know exactly what we need.

Even a shadow of division will see us fail. This will need every group, every campaigner, every supporter, no matter how radical or moderate, how powerful or unknown, every journalist that has supported us, every politician who is fully signed up to our arguments.

If you have a prominent welfare/disability/political voice, website or other outlet, please cross post this from me.

So today, in the comment thread below please leave :

Name and social media name/s (or just the latter if more comfortable)
Constituency
The WORST thing for you about ESA/WCAs in one line.


****ESA is the most terrible failure of any developed nation for a very long time. The reasons are numerous and utterly undeniable. The government has failed to implement Harrington with any commitment and is actively increasing the rate at which vulnerable people face a failing and unfair test. We have engaged with a democratic process that has failed us at every stage. We have no choice left but to stop this ourselves. Over 100,000 people now face some kind of ESA assessment every MONTH. We can't afford to wait. ****

Enough is Enough.

From today, please use the hashtag #ESAendgame in all your tweets. We must build awareness and create an army or support and dissemination.

"Alone we Whisper, Together we Shout"


http://wowpetition.com/

A Testing Journey

I have my Work Capability Assessment (WCA) on Sunday.

Yes, you read that right: A Sunday. And, yes, 2 days before Christmas. I presume Atos are working weekends in order to claim overtime expenses from the DWP.

I've read news reports about people getting all precious and going to the press saying "why would they want to assess me? Look at me... I'm clearly not fit for work." Erm... that's the point of the assessment: To look at you.

But there was something in the envelope that made my jaw drop in disbelief: A suggested journey plan.

"What's wrong with that? Surely that's Atos being helpful in giving you directions to their centre..."

They told me to take a route that's not wheelchair accessible.

First of all they tell me to walk 16 minutes to Kings Cross tube station. I'm not going to get pedantic about that; I talk of going for "a walk" despite being a wheelchair user. They tell me to take the Circle Line to Edgware Road and then walk another 9 minutes to the testing centre.

Edgware Road has no wheelchair access. In fact the closest wheelchair accessible tube station is Kings Cross.

You have to remember this isn't just a random travel leaflet shoved in with the letter; this is a tailor made journey plan for someone coming from my address to the testing centre at that specific date and time.

Atos haven't seen me in 4.5 years. It's possible that some of my health problems may have changed. But one thing that has not, and will never get any better is my lifelong mobility impairment.

Atos and the DWP know I'm a wheelchair user because of an incurable impairment. My impairment's incurableness is the reason I have an indefinite DLA award.

Further proof that Atos believe in miracles.

The People's Review of the Work Capability Assessment #realWCA

New report highlights failures of Work Capability Assessment as Spartacus campaign awaits Harrington’s final review

A new report from the Spartacus campaign today (Monday 12 November) analyses the failures of the Government’s Work Capability Assessment and the Employment & Support Allowance system, which is supposed to support people who are too sick or disabled to work.

It also warns that disabled people are at risk because of the government’s refusal to consider a ‘real world’ test – where part of the test would take into account the real barriers to employment.

The report, ‘The People’s Review of the Work Capability Assessment’, includes examples of people who have been told they are fit for work, including:

• Someone with no short term memory mechanism
• A man with a terminal brain tumour
• An incontinent disabled man who is both blind and deaf

Other examples of claimants’ experiences include a man whose benefits were stopped for failing to return the necessary forms, despite his wife informing the Department for Work and Pensions (DWP) that he was in a coma; and a man who died 48 hours after filling in his questionnaire - after informing everyone of his death his wife received a call 3 months later asking him to come in for his assessment.

Overall the report highlights stories of more than 70 people who have been inappropriately assessed, forced to go to tribunal, felt humiliated or treated inappropriately. It comes prior to the publication of the final review of the Work Capability Assessment by Professor Harrington, who steps down as advisor to the DWP this month, and whose resignation was announced in July, just days after the broadcast of two TV documentaries exposing the reality of claimants’ experience of the assessment process.

The report also highlights serious concerns about the number of people who have died after being told by the DWP they were ‘fit for work’ or have taken their own lives in circumstances where applying for ESA and going through the WCA appear to be factors in their deaths.

Professor Peter Beresford OBE, professor of social policy at Brunel University and chair of Shaping Our Lives, said:

“The work capability assessment is unreliable and unhelpful, as well as being arbitrary and cruel... No-one – not the doctors who make the assessment decisions, nor Atos which has responsibility for providing assessments, nor the Department of Work and Pensions which commissioned them – takes responsibility for the problems and failures in the system. It’s a perfect storm of irresponsibility and unaccountability.”

The report includes an analysis of the position of a number of professional and regulatory organisations on the WCA, including the British Medical Association, the Royal College of Nursing, the General Medical Council, the National Audit Office and the Citizens Advice Bureau, as well as Government statements and background information on Atos, the company employed to carry out the assessments.

The report’s author added:

These issues are a matter of survival for people living with illness and disability. It is unacceptable that in 21st century Britain vulnerable people are being treated so appallingly. We hope The People’s Review will spur the Government into prompt and concrete action on the failures of the WCA. Radical change is needed - and it is needed now. Whilst there has been some acknowledgement of the problems following Professor Harrington‘s previous Reviews, our evidence from those at the sharp end of the process, including of the high rate of successful appeals and the huge backlog of unheard appeals, shows the whole system is still failing badly. The cost to the taxpayer is enormous and the cost to those going through it goes way beyond money. In the meantime, sick and disabled people continue to be severely affected by what they’ve experienced, and terrified of what the future holds.

The new report is available from: http://wearespartacus.org.uk/wca-peoples-review.

Guest post: Spoon overdrafts and the #WCA

This is a post by @MargoJMilne and originally appeared here on Tuesday 12th June.

It's difficult. I'd love to blog more. I'd love to do so many other things more too! Go out with friends, go shopping, go on holiday, keep on with my voluntary work, hold down a job...



But I'm a spoonie. I'm dreadfully, cripplingly fatigued because of long-term illness - in my case multiple sclerosis. And not only am I short on energy in the first place, but it takes me ages to recover after doing anything.

This weekend is an example. My beautiful, much loved cat Bing died on Friday. It was very, very stressful. Then on Sunday I drove to Oxford for lunch. Before I took ill, I wouldn't have thought twice about driving 60 miles each way for lunch. Now, it's an expedition of Amazonian proportions.

Today is Tuesday. I've not been out of my PJs since Sunday night. I really need to go into town to the bank, but my body's having none of it. It is, in fact, my spoon overdraft that's stopping me dealing with my financial one until I've got that blasted spoon level back up again.



And that's just one of the many problems with the Work Capability Assessment, which decides whether - and at what rate - people should get Employment and Support Allowance (ESA). It asks nothing at all about fatigue. It asks whether you can do a task once, but not whether you can do it repeatedly. It doesn't ask how your ability to work is affected by stress. ("Sorry, Mr. Employer, I can't come in this week. I'm tired cos my cat died.")

It's no wonder that so many people and organisations, including GPs, have denounced the WCA as inadequate. Staff members of ATOS, the company which carries out the assessments, have expressed concerns that not enough time is allowed for each appointment, for what are often complex cases with multiple comorbidities.

Karen Sherlock had multiple comorbidities - basically a lot of bad shit going on - but in her WCA she was put into the "work-related activity" group. That means they thought she'd be able to do some work, eventually.

Well, she couldn't. After a year's frantic, terrified gathering of evidence, Karen's appeal was successful, and she was placed in the support group.

And this week, two weeks after that decision, she died.

Wouldn't it be a wonderful memorial to Karen if this bluntest of blunt instruments were to be consigned to the history books forever? Let's continue to do all we can, for Karen and its other victims.

32 deaths a week.

I haven't been able to write here for a while. After the Welfare Reform Bill came into law it has all felt a bit pointless. I felt helpless, that all was lost.

Whether or not that is the case remains to be seen, but I've been prompted back into action after seeing this story: 32 die a week after failing test for new incapacity benefit.

32 people every week.

We've used the Freedom of Information Act to discover that, between January and August last year, 1,100 claimants died after they were put in the "work-related activity group".

This group - which accounted for 21% of all claimants at the last count - get a lower rate of benefit for one year and are expected to go out and find work. [...]

We don't know how many people died after being found "fit to work", the third group, as that information was "not available".

But we have also found that 1,600 people died before their assessment had been completed.

Go and read the whole thing, and kick up a fuss, put this to the top of everybody's agenda. It can't go on.

It's never that simple

As readers of this blog are no doubt aware, yesterday Labour leader Ed Miliband made a speech attacking those disabled people who he believes can and should be doing some sort of (unspecified) work.

So far as anyone can ascertain, Mr Miliband doesn't have any basis for this belief - no background in Occupational Therapy, no medical qualifications - it goes right back to the old refrain of "if you can press a button, you can work," that we heard many times while Labour were in power and introducing ESA and their harsh Work Capability Assessment.

As I responded to Bendygirl's blogpost yesterday: it's never that simple.

If there is a button-pushing factory in my town (despite offshoring), or in a town I could move to (despite lack of accessible housing and the housing benefit caps), and if they're hiring (despite record UK unemployment), and if I can get up and washed and dressed in the morning (despite cutbacks to Social Services), and if I can actually get to work (despite inaccessibility of public transport), and if the button-pushing workstation and the route to it is or can be made accessible (despite Access to Work cuts)...

...and if the bosses and co-workers are happy to accommodate my need for frequent breaks at unpredictable moments (despite the hundreds of other applicants for the button-pushing job who are equally qualified for button-pushing and don't need breaks or adjustments), and if I will earn a living wage (despite the messing about with Tax Credits)...

...and if we can account for the fact that I only have the energy to function for about 10 non-contiguous hours out of every 24 and I must keep three or four hours of that aside for necessary things like eating, medicating, grocery shopping, banking, cleaning and managing my household, and the bureaucratic maze of disability...

...then I, along with many others, will be right there.

More Sloppy BBC 'Journalism'

In a new article on BBC Politics, Auntie takes a look at the situation with WCA and the charities protesting against it (no mention of disabled peoples groups -- I guess we don't count). Just for once they actually give enough detail to demonstrate that there clearly are failures in the design and implementation of WCA, though they do tend to take the Harrington Report on trust.

But then they cite last month's ESA figures and sum them up as "Only 6% of claims - 73,500 people - were considered to be entitled to full ESA support."

Hang on a minute, 6%? Where did that come from? 94% of applicants aren't entitled to ESA?

Look closer and the problem becomes clear, Auntie can't add up.

1,175,700 people applied for ESA in the period covered by the stats.

According to Auntie, 887,300 people (75.5%) had their claims rejected or were forced into withdrawing their claims --which doesn't mean they aren't disabled, flaws in the WCA are, after all, the supposed point of the article. Going to the original DWP source data shows that these split roughly 50:50 (39% 'fit for work': 36% 'withdrew claim').

Which leaves 288,400 people (24.5%) who passed the WCA, four times as many as Auntie's '6%'.

73,500 people (6.25%) passed the WCA and were placed in the Support Group.

Leaving 214,900 people (18.25%) left over. Auntie only missed 200,000+ people from the stats....

Those 214,900 people break down into:

188,300 people (16%) who passed the WCA and were placed in WRAG.

26,700 people (2.25%) who have assessments still in progress and have neither passed nor failed the WCA.

But it's even worse. Those aren't the final figure, they are the statistics before appeal. And the statistics for appeal are that 36% of people found fit for work appeal, and 39% of those succeed.

When you allow for appeals, 235,800 people (20%) have been placed in the WRAG and 77,100 people (7%) have been placed in Support Group, with only 407,300 people (35%) assessed as fit for work.

Disregard the withdrawn claims - Auntie talks about claims being 'considered' and withdrawn ones clearly aren't - and those still in progress to allow us to look only at the assessments that are complete, and we find that the percentages rise to 'Fit For Work': 56.5%, Support Group : 10.5%, WRAG: 32.5%.

So rather than Auntie's 6%, 43% of people who take the WCA actually pass it, 7 times as many as Auntie would have us believe.

You might think that I am being picky, that a careful reading gives most of the figures, that I'm interpreting the data in a different fashion to Auntie, but that isn't the point. Most people don't read articles like this carefully, they don't have the background to know when the figures given by a trusted, supposedly neutral, source are just plain wrong. The impression this article is going to give to most people reading it is that only 6% of ESA applicants are genuinely disabled, and that 94% are faking it or trying it on. I can flag up the flaws in the article, but the damage it does to us is impossible to undo.

Press request

I received this Email from journalist Amandine Alexandre:

I work as a journalist in London for French media.

I am looking for testimonies on the Work Capacity Assessment for a piece which will be broadcasted on the French radio-station Europe 1 (www.europe1.fr) on Wednesday morning.

The idea is to talk to someone who has been put through this test and was found fit for work when, in reality, he/she is not capable of working.

I am looking for people based in London or not far from London.

If you are in or near London, have been through the WCA and deemed "fit for work" and would be willing to talk to Amandine her Email address is amandine.london@gmail.com.

The GMC, ATOS and Duty of Care

It's a little late, but I've just come across something to give ATOS's hired guns a moment to pause while counting their thirty pieces of silver.

When Doctor Margaret McCartney questioned in the BMJ whether doctors could work for ATOS and remain true to their professional ethics and responsibilities, another doctor (worryingly a tribunal member) suggested in comments that ATOS quacks were not subject to their normal duty of care as the nature of their work is not a doctor-patient interaction. This is particularly alarming as it is an interpretation of professionalism that isn't true of other professions (or English law), as an engineer I have a legal duty of care greater than that of the man in the street any time I work as an an engineer in any way, shape or form. The GMC Standards and Fitness to Practise Directorate have now issued guidance that the argument made in the comment is not correct, that ATOS assessments are a doctor-patient interaction and that doctors have to make the interests of their patients their first concern at all times. Interestingly they also find it necessary to remind doctors that "Being open and honest and acting with integrity is also an essential part of medical professionalism."

Now this ruling doesn't extend to physios or nurses as the GMC is not their professional body, however they are subject to the same legal duty of care requirements as any other professional and it would clearly be untenable for their professional bodies to try and argue that their members are not subject to a duty of care in circumstances where the GMC has ruled that its members are and where all three professions are theoretically considered fit to practise. Equally Dr McCartney has pointed out in her blog that the professional standards for both nurses and physios contain identical requirements to place the care of the patient first at all times.

Abandoned Claims

Originally posted at This Is My Blog in response to a Daily Mail article. Unfortunately, today, the Telegraph and the BBC got in on the act...

Woke up this morning to see that a certain right-wing rag has surpassed itself in the propaganda it chooses to spout about ESA.

I'm not going to link to it because it will only upset me and every reader.

The headline asserted that 75% of those who claim ESA are found "fit to work".

This was then broken down that 75% of those who claim ESA were either found "fit to work" or abandoned their claims before testing was complete. It proposed that the abandonment of a claim meant that the claimant was clearly "trying it on".

Legitimate reasons why an ESA claim may be started and then abandoned:

• The claimant dies.


• The claimant gets better, be it a miracle or a new treatment or being bumped up the waiting list for surgery or getting private treatment.


• The claimant, having lost their job, is offered support and a place to stay by their parents or their children. They decide to abandon their claim and re-start it once their move is complete.


• The claimant looks at the highly personal questions on the form and says "you know what, I'll never be this desperate for money, prostitution is less demeaning."


• The claimant wins an insurance or compensation payout that enables them to survive without benefits.


• Due to their condition, the claimant is unable to understand the importance of filling in the form or unable to remember that the form needs doing.


• Due to their condition, the claimant is unable to fill out the forms - perhaps they have a brain injury or learning disability and cannot read and/or write, perhaps they have issues with their hands and cannot physically hold a pen, perhaps they have a mental health condition that causes panic attacks every time they approach the form.


• Due to their condition, the claimant is unable to access support to fill in the forms - for instance they are unable to go out, they do not yet have formal Social Services support, and their CAB is overstretched with permanently engaged phone lines (I have personal experience of urgently needing to get to the CAB but having to wait until support is available).


• The claimant completed the form, but due to their condition, they are unable to travel to and from the medical examination centre alone, and they are unable to secure help and/or funding to allow them to attend. Because their level of impairment does not exist until ATOS say it does, this is not a valid excuse for non-attendance. (I had this issue with my DLA a few years ago).


• The claimant is sitting at home with the heating off, desperately waiting to hear back from the DWP about their claim, which the DWP has lost.

If it was any other publication (I hesitate to use the term "newspaper") I would be shocked and appalled by the deliberate lies and misinformation being used to attack disabled people. Unfortunately, I'm getting used to it, and so is everyone else, and all these little drops of poison are being allowed to drip on into the public consciousness unchallenged.

A useful comment was also added to the original post, by a commenter called Nemonie:

There is also the fact that if you are on JSA and become ill or need surgery, break your leg etc. So that you are considered not able to look for work they will tell you to open a claim for ESA until you are better, which may only be a few weeks. You can also apply for ESA if you work and get ill but don't get statutory sick pay or have run out of statutory sick pay. Again in this case you may only need to claim for a short time.

The WCA: Sick Joke, or National Disgrace?

The migration from Incapacity Benefit to ESA is now underway, a migration the Con-Dems and the rabid press trumpet as a step towards getting all those indolent fraudsters on disability benefits into work. If only anything of that was true. The truth is a system that has been deliberately designed to fail a significant proportion of clearly disabled people and assessment criteria that have already been identified as unacceptable by the independent assessor. Then that system, with its built-in failures, is handed over to the contractor ATOS Origin to operate, and they set out to deliberately overstress it in order to process as many people as possible, in as little time as possible, and at as low a cost as possible, all in the name of the Great God Profit; no matter the inadequacy of the process delivered, no matter the huge percentage of claims overturned at appeal, no matter a failure rate that would be unacceptable in any other industry. And then there are the medics who conduct their inadequate assessments, happily claiming they don’t need to meet their normal standards of care, because they aren’t acting as doctors or whatever – um, isn’t that the very reason ATOS crossed your palm with 30 pieces of silver?

I'm that rare bird, the ESA claimant who actually passed the WCA without needing to appeal, in theory I have no axe to grind from having an application refused. However the process fell so far short of an acceptable level of competence that I have to stand my ground alongside those unjustly failed by the system.

I became unemployed just after ESA and the WCA were introduced, but initially elected to claim JSA, in large part because of the stories already coming out about the way the WCA system was failing disabled people. With an Employment Tribunal claim to manage I just didn’t have the energy available to fight for ESA if necessary. But ESA wasn’t that easy to avoid and it rapidly became clear (contrary to Professor Harrington’s complacent assurances in his review of the WCA) that JCP were utterly incapable of dealing with someone who was either disabled or highly qualified, and god help you if you were both. In fact the only way they could deal with me was by ignoring both qualifications and disability. That sad tale I’ve already described, but the end result was a complaint to ministerial level, abject apologies from JCP, and a request that I transfer onto ESA.

As an ESA claimant I was first expected to fill in the 28 page ESA50 form. The unavailability of an electronic version of this form from 2008 until the new version rolled out a few days ago speaks to an utter institutional contempt within DWP for disabled people and their needs. The paper form is not simply inaccessible to people with visual impairments, but also to anyone, like me, who is unable to write comfortably or legibly as a result of their disability. Equally the space provided in the form is utterly inadequate for anyone, again like me, who needs to discuss several decades of experience of a complex disability. And while someone could potentially fill it in for me, there are details of how my disability affects me that I’m not even comfortable discussing with my specialists, never mind anyone else.

My first WCA assessment was scheduled for May 6^th, 2010 at the local ATOS Assessment Centre, and what an ill-omened day that turned out to be! The building is located in the centre of town and has no on-site disabled parking, so is utterly unfit for purpose before you even get to the door. There is a public disabled car park some 150m away, but that regularly requires a wait of over 30 minutes to find a space in it and like many disabled people I cannot walk even 50m without experiencing significant pain. The next nearest disabled parking is 350m away. If you can manage to get to the building, then access at the door is via intercom, so how someone deaf and/or without speech is supposed to manage is a mystery. The DDA and the Equality Act both require service providers to make provisions based on the likely needs of their clientele, so a building whose entire clientele is disabled should make a significantly greater degree of access provision than most, yet ATOS continue to operate centres, and even open new ones, that fail to meet even the most basic standards of accessibility.

I had informed ATOS in advance via the ESA50 form that I would require adjustable seating because of the difficulty in sitting that results from my disability, which is in fact the core of my problems regarding working, so pretty much fundamental to the whole assessment process. None had been provided. The tattily-dressed individual who checked my ID led me into a waiting room filled with cheap, non-adjustable seating completely inappropriate to the needs of a client population containing a high proportion of people with musculo-skeletal and pain and fatigue based disorders. Within seconds of trying the seating I had realised that I was completely unable to sit on it in any comfort, only by rolling sideways onto my hip was I able to tolerate it at all. By the time I was called through, something over 10 minutes later (despite apparently being the only client in the building), I was in considerable distress, which only deepened when I reached the examination room and found that the seating there was actually worse. It was at this point that I discovered the tattily-dressed individual was actually the doctor who was supposed to assess me, not the caretaker as I had first assumed. I pointed out that I had told ATOS I needed an adjustable seat and his reaction was ‘Oh, you’ll just have to book another appointment’. He then admitted that this was not the first time this problem had occurred, that they had asked for adjustable seating to be supplied and that they had been told by their regional management to ‘make do with what you have’. In my opinion this is a clear indication of an active contempt by ATOS management for both their client population and for the reasonable adjustment provisions of the Disability Discrimination Act and now the Equality Act.

I returned home having wasted my time and experienced major amounts of pain as a result. This pain then served to trigger a massive flare-up in my condition and I spent the following week on the floor of my bathroom as I was wracked by one muscle-spasm after another, not knowing even what day it was. I eventually managed to get to my GP, who doubled the strength of my opiate painkillers, which brought the flare-up under control, but at the cost of my wandering around in a daze for several months with no energy or volition. The loss of control in this kind of flare-up is extremely distressing both physically and mentally and I was completely unable to deal with mail during this period, simply the thought of a letter from ATOS or DWP being sufficient to send my pain levels sky-rocketing. Ultimately it took me six months to completely catch up with my mail, at which point I discovered a letter from ATOS dated a week after my initial WCA date and calling me for another WCA a few days later, which needless to say I had not attended, being barely conscious at the time.

So, knowing that I had a major problem with their centre environment, having failed to provide a requested reasonable adjustment, and having visibly caused me considerable distress, ATOS didn’t even think it was worth ringing me to ensure that my appointment was rearranged for a convenient time and to assure me that the needed reasonable adjustment would be there this time. Their response was actually worse than this, but it would be several months before I realised quite how bad.

In late-August I received a letter from DWP stating that my ESA payments had been stopped, from the week before my initial appointment, owing to my failure to attend the WCA. I called the office the letter had originated with and the person I spoke to was perhaps the only DWP employee ever to have impressed me with competence and common sense. She immediately accepted my inability to attend a WCA I was not aware of and noted that ATOS had made no mention of their failure to provide a required reasonable adjustment, but had simply stated that I had not completed the initial WCA. When ATOS set out to deliberately portray their own error as a failing by the victim of that error, and a failing with fiscal consequences, then there is no way to interpret their actions as anything less than actively and deliberately dishonest.

Thanks to an unusual outbreak of common sense at DWP, my claim was eventually reinstated and a further WCA was arranged for mid-October, again at the local assessment centre. This time I was met at the door with an adjustable chair. Unfortunately I could not even raise the seat of the chair to an appropriate level and at five feet eight I am not exactly tall, nor did the seat angle adjust, the only hope I have of a usable position if the seat isn’t high enough. Again I was reduced to rolling sideways onto my hip. This time the delay was not 10 minutes, it was something over 45 minutes. By the time I was called through (with the receptionist bringing the useless adjustable seat through after me) I was physically shaking. It was a different doctor to my first appointment, but again he was scruffily dressed in a tatty anorak. It is impossible to conclude that this reflects anything other than a profound lack of respect for their clientele on the part of ATOS medical staff.

My pain-management consultant has told me that is almost impossible to get doctors who are not specialists in pain-management to comprehend just how disabling pain is, and I was therefore concerned about how much of a background the assessor had in chronic-pain based disabilities, unfortunately his manner instantly convinced me that any question would be interpreted negatively and I did not feel able to make my point. As the session started I rapidly became aware that I was in so much pain that I was not answering effectively and was making a case for myself that was not as strong as it should have been. It also became rapidly apparent that the doctor was profoundly irritated by my refusal to give yes or no answers. He may have found it irritating, but any understanding of my condition required that he listen to the details and I would not be swayed on this, though undoubtedly many people who are less able to express themselves will have been browbeaten into less than complete answers by his manner. It was also extremely apparent that he was reading from a computer-based script, his eyes fixed on the screen, and less than pleased with answers that did not fit the format its questions mandated. As a result of this there was an almost complete refusal to make eye contact, destroying any sense that he was truly engaging with me.

More disturbingly, he chose to take umbrage at certain of my points. I do not expect automatic complete agreement, but I do not expect to be told that I am wrong to have tried to search out information on the assessment process, particularly when his subsequent conduct proved the correctness of that information, nor do I expect to be criticised for the way I have described the effects of my disability on my walking, particularly when later events demonstrated that I was being absolutely accurate.

Some 20-odd minutes into the assessment I reached my limits on my pain tolerance, either I had to stand, or vomit. I spent the rest of the assessment balanced on one leg and crutches and it was only at this point, a cynic would say at the point he started to fear being found negligent in my treatment, that the doctor finally broke script and started to treat me as an individual. He asked several times whether I was able to continue, but by that point I just wanted the WCA over with, I certainly wasn’t about to put myself through the process for a third time. He completed the physical part of the assessment, but even then he criticised me for being unable to bend my leg so he could tap my knee with his hammer. Locking my leg extended is something my disability does when my pain levels are extremely high, I have no conscious control of it and I don’t expect anyone, certainly not a doctor acting in a medical capacity, to criticise me for it.

WCA thankfully over, I made it back to my car on one leg, and, even though it is a bare 5 minutes from the assessment centre to my house, my pain levels were so high, never mind the opiate painkillers, never mind the TENS machine, that I had to give serious thought to pulling over on the way home. I spent the rest of the day in bed, the first hour physically shaking.

In late-November I finally received the notification that I had been placed into the Work Related Activities Group, which is where I believe I should be, together with back-payment of all the ESA payments I had been due since May, but the process had taken 10 months and caused me a considerable amount of pain and physical distress, actually worsening my disability. The treatment I received has convinced me that ATOS have a complete and utter contempt for the needs of their clients that adds up to institutional disability discrimination and that their medical assessors are happily compliant in this. Sadly DWP is little better, my experience has been that the system only works when you complain.

I have a skill set that should make me an asset, I am making every effort I can to maximise my potential for employment, but to date the organs of state that are supposed to support me in this actually seem to be working against me. And at the start of the 2012 financial year, no matter that my disability is worsening, no matter the efforts I am making to find work, the 12 month limitation of eligibility for contributions-based ESA will kick in and cut my benefits to nothing.

So that’s my experience of WCA and ATOS, contempt for disabled people that amounts to deliberate abuse. They damned near turned me into one of those statistics for withdrawn or failed claims that Nick Clegg loves to claim are evidence of fraudulent intent, rather than what they really are, evidence of a system that is failing those who need it most. I got through the system because I’m too bloody-minded to give in when people erect barriers in front of me and because I’m too articulate and persistent to easily dismiss; but many people aren’t as bloody-minded, aren’t as articulate, aren’t as persistent and the system will be far more of a nightmare for them than it was for me. The system should assess you fairly whoever you are, at the moment it isn’t even doing that for the people it passes. The phrase ‘a national disgrace’ is often over-used, but it was never more appropriate than when describing ATOS and the WCA.

And lest we forget, this isn’t simply Con-Dem policy, but a policy that began under Labour and which Ed Milliband continues to support.

ESA and the Work Capability Assessment

Today marks the day when the government's scheme to transfer all existing Incapacity Benefit claimants onto Employment and Support Allowance begins.
One and half million people will get their letters calling them into Atos offices for the Work Capability Assessment - the test designed to assess whether someone is genuinely in need of support or if they are fit for work.

Employment Minister Chris Grayling has said that genuine claimants have nothing to fear, that the only people who need to worry are the fakers who just prefer a life on benefits to one of work.

He's wrong. The fakers have nothing to fear; they have options. They are able to go out and work or comply with the regulations to claim Jobseekers Allowance. It's the genuine who are afraid because they have no options. If they could work they would do. No-one wants to be ill. No-one puts up with the 'scrounger' label or the suspicious looks if they don't have to.

Everyone who claims any of the disability benefits know about the WCA. Those on IB or in the work related activity group of ESA have been terrified of it for months. And rightly so - it's a terrible assessment that even the government's own advisory board as well as the man who designed it, have said is not fit for purpose.
They've heard the stories about those who've been denied benefit despite their illnesses. They've read the story of Paul Reekie, who committed suicide when his benefits were stopped.
Now they wait to see how their own claims will turn out.

I've been through two WCAs myself. The first was when I came down with my symptoms of MS, though I didn't have a formal diagnosis at that point. I was summoned to the Atos centre, waiting for what seemed an interminable amount of time, then was called in to see the doctor.
I was scared to start with and my fears were not allayed by he fact that I couldn't understand a word of what the doctor - from Eastern Europe - was saying. Nor could she understand me. She put me through a series of tests, none of which I could do, then sent me on way. The whole thing took maybe 15 minutes at most.

The following week I received the report she had sent to the DWP. I was shocked at what she had written - it was lies from top to bottom. Every test she had done she'd put me as passed even though I hadn't. She had omitted things I had told her and gone against everything that had happened in that room.
In short, she said there was nothing wrong with me.
This was despite being barely able to walk, being unable to feel my pelvic muscles which led to lots of bathroom visits and being so tired I could barely think straight. I couldn't bend down, I couldn't kneel down, I certainly couldn't touch my toes.

I sent the form, along with detailed rebuttals of everything that was wrong, off to the DWP. The following day I received a letter saying I wasn't entitled to benefits because I was fit for work. I then had to ring them up and tell them I'd appealed at which point they said my benefit would be continued until the appeal was heard. I was on tenterhooks, worrying over what would happen about it, if they would listen to me or uphold the Atos doctor's decision.

The next letter I received was one telling me the appeal had been successful and my benefit would continue. I can't tell you how relieved I was.

Last year I underwent the WCA again when I left hospital following my formal diagnosis with MS.
I received a letter from Atos telling me to call and make an appointment - if I didn't, one would be made for me. So I rang and spoke to a very bored and slightly dismissive man who gave me an appointment who gave me an appointment for a date that they decided.
When I arrived, I was shown into the waiting room by a security guard, and greeted by a receptionist who looked at me like I was something foul on the bottom of her shoe.
I waited for about half an hour, all the while getting more and more uncomfortable as I felt the judging stares coming from the staff. If anything is designed to put you off it's that. So far, it was worse than my previous experience.

When I was finally called in I met a very nice lady doctor who seemed to understand about MS. She didn't attempt to make me do anything she knew I couldn't and was very reassuring. Very different from the first assessment so I had hopes that it would be ok.
Well, she didn't lie. But that's about it. Despite having shown some knowledge of MS she placed me in the work related activity group, meaning that with the right support I could work.
Because of course the right support will mean that I no longer struggle to get dressed in the mornings. Or take a shower. Or cook meals. Or walk anywhere. Or need to rest after putting a load of washing on. Or want to cry when the pain in my head gets too bad. And it will get better because of course MS is curable.

I didn't have the strength or the energy to try and appeal though. Not to mention I was scared that they might stop it completely. So I left it as it was. I see an advisor every few weeks, meaning a taxi journey to the jobcentre where I wince with pain as I struggle with the sensory overload of neon lights and too many people.

And in the summer I get to go through it all over again.

Now then Mr Grayling, are you still going to tell me I have nothing to worry about?

Cross posted at Rage against the Coalition

The Inept Leading the Clueless: JCP, JSA and Disability

Professor Malcolm Harrington’s review of the ESA WCA claimed that disabled ESA claimants had nothing to fear if they were rejected and placed on JSA instead because 'Support is available on JSA that if explained to claimants could allay some of their fears about “failing” the WCA'. As a recent disabled JSA claimant (December 2008 to February 2010), I thought it might be interesting to take a look at the reality behind that blithe assurance. 

With an extensive outsourcing process behind me I was likely better informed than many JSA claimants and I made it clear in my initial contacts with JCP that I would need to talk to a Disability Employment Adviser. Getting the initial JSA paperwork back full of errors was worrying, the initial interview with the DEA was worse. Having explained to her that I was a highly qualified, highly experienced engineer and that the only thing stopping me being a strong candidate for any of dozens of available posts was my physical inability to commute or relocate, she promptly started advocating that I apply for minimum wage positions and it was fairly clear that that was her default setting for any disabled person sent to talk to her. As far as I am concerned there are two words that define that attitude: Institutional Discrimination. As I had suggested one possible way ahead for me would be to study for a doctorate she did pass me on to a careers adviser colleague of hers, who somewhat floored me by revealing that until the month before she hadn’t been allowed to talk to anyone with more than two GCSEs; how she was meant to help someone wanting to talk about a doctorate I’m not certain. To her credit she did manage to pass me on to an actual university careers advisor, but that was through a personal contact of her own rather than a regular JCP route.

I then moved into the fortnightly grind of signing on; initially with the DEA, but within two months she had thrown me back into the general pool, saying she couldn’t offer me any further help. This put me on a par with most JSA claimants, which may not seem like a problem, but my disability means that I am not most people. The Job Centre was pleasantly decorated and furnished, but it doesn’t seem to have occurred to anyone that they might need on-site disabled parking, or that couches and non-adjustable seats, no matter how smart, might not be adequate for someone who has problems sitting or standing for any length of time (and when you are running the better part of an hour behind scheduled appointment times with twenty people waiting and only eight seats in the waiting area…). It averaged out that every other trip to sign on was leaving me curled-up in pain for the rest of the day. That was just the physical access issues, I was also seeing a different JCP clerk pretty much every time, some of them obviously half-trained back-office staff dragged out to try and deal with the ever-increasing number of claimants, and almost every time I would be questioned about why there were agreed restrictions on commute distance in my Job Seeker’s Agreement. Surely the whole point of defining the Job Seeker’s Agreement with the DEA was to have it agreed by someone with some knowledge of disability? Not for it to then be questioned by everyone else who came into contact with it? Nor for me to need to explain the details of my disability to every JCP clerk I dealt with in order to justify myself. As soon as the DEA dumped me, and even though my crutches demonstrate to everyone who sees me that I am disabled, JCP lost sight of the fact that I was disabled and started trying to treat me as indistinguishable from anyone else, if not actively pressuring me into being precisely that.

JSA working practices for signing-on were enough to make any efficiency expert curl up in the corner in despair. Their computer system seems to be some Heath-Robinsonesque lash-up, part working in Windows, part needing them to spawn out into some proprietary tool. My part of the process as the claimant was to provide a list of job search activities made in the past fortnight and a little slip of a paper form was provided for this. As part of my disability means I can’t write legibly or comfortably, and the form was in any case too small to cover more than a fraction of my job-search activities, I simply ran-off a word-processed list each time, only to have several of the JSA clerks take umbrage that the list wasn’t on the ‘official’ form. What did they do with the form once I handed it over? They copied it, manually, into an on-screen form, taking anything up to five minutes of hunt-and-peck typing, then handed me back the original. Hello, this is the 21^st Century! Why drag me physically into the Job Centre, causing me considerable pain and distress, for a transaction that can be done more quickly and more efficiently using a telephone and/or email?

As I passed various JSA milestones I would occasionally have a more in-depth interview with someone at which I would have to justify everything yet again. Facing a highly-qualified disabled person clearly puzzled them, their systems could barely cope with a highly-qualified claimant, add disability to the mix and they simply had no reference point on how to deal with me. They did send me to talk to an ‘executive’ recruitment consultant at one point, but as soon as I explained what effect disability has on my ability to work, a look of absolute panic swept across her face and the only suggestion she could come up with was to pass my details to the Royal British Legion’s training agency – 18 months later I’ve still heard nothing back from them. The one real change was that after 6 months of claiming Contributions-Based JSA I stopped receiving any benefit at all.

When I reached the one year anniversary of my JSA claim, I became subject to ‘Flexible New Deal’ and received a letter telling me that if I didn’t attend an interview with a training contractor my benefit would be docked – that would be the benefit I wasn’t receiving anyway? No ‘Dear Sir’, no ‘please’ or ‘thank you’, just ‘Be Here or Else’. I know a lot of disabled people who would be seriously distressed by, if not completely unable to deal with, a threatening letter of that nature, yet the DWP propose to expand ‘conditionality’ of this sort to all ESA claimants, never mind just the ones rejected onto JSA.

So I turned up on time for the appointment with the training contractor, only to find that the address they had given me was wrong. Fortunately I was able to figure out which building on the out-of-town trading estate was likely theirs, even though its signage was for a completely different training contractor. If I had turned up using a wheelchair I would have been completely unable to access the building, as it was the step was so high that I fell over the threshold. The downstairs office was completely unmanned, with a handwritten sign on a piece of torn cardboard propped on a chair advising me that I needed to go back outside and up the stairs. How a visually impaired client was supposed to deal with that arrangement is anyone’s guess. The staircase I was supposed to climb was an exposed iron arrangement of the type commonly found in warehouses. On a wet day I would never have attempted it, and this was the middle of a notably wet December; even on the one dry day of the month I had to seriously consider whether I could safely make it to the top.

Having decided to risk the stairs, a corridor at the top led to a small office, into which were crammed a dozen desks with workstations surrounding a large central table. Inside the office were two staff members and another client. If I had somehow been able to get a wheelchair to the entrance to the room I would not have been able to get it inside, and even using crutches I had considerable problems navigating to a chair. Telling the staff who I was, and who I was due to see, produced consternation. I was apparently scheduled to see their ‘disability specialist’, but she was scheduled to be in a completely different office in an entirely different town. So one of the other staff decided that she would deal with me instead, and started working through a computerised form. Before I quite realised what was happening I was being asked intimate questions about my disability, despite the fact there was a complete stranger sitting immediately behind me. Apparently the entire concept of data protection, and their legal obligations under the Data Protection Act and the Disability Discrimination Act, had completely passed them by. To give them their due, once I had explained the limitations resulting from my disability the staff member immediately said that she felt that I was completely inappropriate for their programme, which apparently allowed them to compel me to apply for jobs, but did not allow them to first consider whether I was physically capable of doing the job, and that the only action she was giving me was to urgently contact JCP and tell them that she thought I needed to be on ESA, not JSA. The physical after-effects of that 45 minute interview put me in bed for the next week with massively increased pain levels.

After that clowning glory of incompetence I decided enough was enough and wrote a formal letter of complaint to JCP, copying it to the then-Minister for Disabled People (also my local MP as it happened). I also called JCP, spoke to a supervisor and left the switch from JSA to ESA in their hands while I went to visit family over Christmas. I returned home, a week later than expected due to the snow, to find a letter dated 5^th of January saying I had failed to sign on and my JSA claim had been stopped (hello, national crisis, massive snow disruption, not claiming JSA any more) and a letter dated the 6^th confirming that and sending me my P45. Despite my supposedly terminated JSA claim there was also a letter from the training contractor demanding I attend another interview. I rang JCP to complain, only to be told by the supervisor I had spoken to before Christmas that she had never heard me say anything about switching my claim to ESA, and had phoned me on my home number (despite me having told her I would be away) to confirm that I should be on the scheme with the training contractor

I arranged a face-to-face meeting with the supervisor, but by the time the meeting happened my complaint to the minister had obviously filtered through as I was greeted with a slightly awed ‘You’re the one that wrote the letter, aren’t you?’ and a general falling over themselves to get my JSA claim reinstated and then transferred over to ESA, which eventually happened a full two months after I had initially asked JCP to put it in hand. I also received a fairly abject written apology for the way I had been treated, which admitted JCP had completely lost sight of the nature of my disability, but still attempted to push the majority of blame onto the training agency – apparently the concept of being legally and morally responsible for the behaviour of your contractors hasn’t penetrated into JCP.

So there we have it, my experience of just how well JCP manages to deal with disabled JSA claimants: Professor Harrington, I am afraid that I will have to differ with your review; disabled ESA claimants whose claims are rejected and who are placed on JSA have everything to fear from JCP’s complete cluelessness about disability and their total lack of support for disabled claimants.

And my ESA claim? That’s a sad tale for another day.

The WCA Independent Review: Fit for Purpose?

The first annual review into the performance of the ESA Work Capability Assessment by the independent reviewer Professor Malcolm Harrington has been published, and calls the operation of the WCA by DWP and their contractor ATOS Origin into serious question; but did the review itself address everything it should have? As an ESA claimant and one of those who made submissions in response to Professor Harrington’s call for evidence I read the report with considerable interest and many of the conclusions and recommendations are an acknowledgement of the concerns expressed repeatedly by the disability community over the last two years or so, however detailed examination reveals some serious issues with the review. This article focuses on those issues, but that should not be taken to mean an outright condemnation of the report.

The issues with the report fall into three groups: concerns not addressed at all, concerns reported but not addressed or not adequately addressed in the recommendations and concerns with recommendations that appear to preserve or even exacerbate the problem rather than challenge it. Rather than deal with the concerns in thematic groups the ordering of the report has been retained for ease of cross-referencing.

Foreword

Professor Harrington lists a number of organisations which he met with to discuss the situation: disability charities, unions, DWP, JCP, ATOS Origin, but how much direct contact he had with individual disabled people trying to negotiate the system is not clearly indicated. It is unclear whether the review passes the litmus test of ‘Nothing About Us, Without Us’.

In his introduction Professor Harrington refers to Dame Carol Black’s report ‘Working for a Healthier Tomorrow’, describing it as part of the wider context within which the WCA has been introduced. Unfortunately Dame Carol’s report is fatally flawed by failing to acknowledge the widespread disablist bigotry experienced by disabled people in the workplace, the ultimate reason that forces many of us to access the benefits system and keeps us there, no matter our desire to work. There is no indication within the current review that Professor Harrington truly understands the sheer volume of discrimination experienced by disabled people both in finding work and in retaining it. Without that understanding, Professor Harrington lacks the perspective to view the WCA system and its outcomes from within the context experienced by disabled people.

Slightly later in his introduction Professor Harrington states ‘In addition, some conditions are more subjective and evidently more difficult to assess.’ Most disabled people would regard this statement as blatantly obvious, it is not unusual for disabled people to go through decades of medical treatment without a clear diagnosis, yet it appears that the impossibility of simply pigeon-holing disabled people according to some simple schema comes as a startling shock to DWP, ATOS Origin, and to Professor Harrington. Having identified the problem, Professor Harrington then fails to follow through to the logical conclusion that a computerised assessment system, as used by ATOS, is clearly not fit for purpose, because it cannot make an individual assessment of need and necessarily relies on a limited set of pre-programmed rules. It is worth noting with regard to this that both the Disability Discrimination Act and the new Equalities Act are built around, and define in law, the absolute necessity of dealing with each person’s disability on an individual rather than procedural basis.

Professor Harrington’s introduction closes with a paean to the benefit of work which can be summed up in its opening sentence: ‘Work is, by and large, good for people.’ This claim is repeated as the opening statement of the immediately following executive summary and at regular intervals throughout the review. Unfortunately the WCA is not dealing with a ‘by and large’ population of claimants, it is dealing with a population of people who universally experience difficulty in working because of their disabilities or illnesses and in many cases will find working adversely affecting their health. Professor Harrington’s repeated references to the benefits of work, which also raises serious concerns in other areas dealt with later, without similar acknowledgement of the universal difficulties faced by the disabled claimant population in accessing and accomplishing that work, raises serious concerns about the neutrality of his position.

Executive Summary

The Executive Summary states ‘The Work Capability Assessment (WCA) was designed to focus on a person’s capability rather than their incapacity’ and Professor Harrington clearly accepts this point as unreservedly a good thing. Yet capability and incapacity may often be diametrically opposed. To use my own situation as an example, I am capable of work that many people might label ‘rocket science’, yet doing that work results in rapidly rising pain levels, which in turn interferes severely with my ability to work at that level and ultimately prevents me from working at all. It is difficult to accomplish much while curled in a foetal position on the floor as a result of the levels of pain working has engendered. Any assessment which does not focus on both my capability and my incapacity will necessarily fail me.

Included in the review’s recommendations is a need to institute ‘champions’ in each assessment centre to mentor staff in dealing with mental, intellectual and cognitive health issues, an area where clear failings has been identified. However the review itself identifies that claimants from many other areas of disability, in essence all but people with SVIs, or who are wheelchair users or amputees and fall within the traditionally recognized definition of ‘disabled’ are experiencing similar difficulties in conducting an educated dialogue with the ATOS assessors, and the failures in education lie with the assessors, not the claimants. What goes for mental, intellectual and cognitive health issues, also goes for invisible disabilities, for fatigue and pain based disabilities, for anything which cannot be physically waved in the face of an assessor. Appointing mentors for mental, intellectual and cognitive health issues is essential, but must not stop there, and the need to educate ATOS staff around basic disability issues raises serious concerns with respect to the basic adequacy of the ATOS training regime.

Professor Harrington states that a focus for his second report will be the descriptors used in the assessment system, particularly with regard to the coverage of fluctuating conditions. However there is no indication that this is intended to do anything other than tweak the descriptors, no indication that the basic suitability of fixed descriptors against an infinitely variable range of disability will be seriously questioned. This represents a lost opportunity of significant proportions.

Chapter 1: The Review Outline

The first concern which needs to be addressed is the startlingly late appointment of Professor Harrington to perform the review. This did not occur until 29^th June, 2010, with the review due by November, a seriously problematical amount of time in which to produce a report of the quality and depth the subject required. A further, related, concern for many disabled people subject to the WCA will have been the appointment of an occupational health specialist to conduct the review. The only contact many of us will have had with occupational health physicians will have been with the hired guns who wrote the medical reports to back up companies which had decided our disabilities made us too much trouble to continue employing. No matter the independence and good intentions of Professor Harrington, our past experience with openly disablist behaviour by other members of his discipline will compromise the perceived independence of his report. Someone from within the disability movement, perhaps one of the past EHRC Disability Commissioners, would have been a far better choice by having the credentials to be taken seriously by both government and disabled people.

Similar concerns exists with the panel appointed by the Secretary of State to oversee, advise and challenge Professor Harrington, which includes one senior GP, two Occupational Health professionals who work for major employers, and only one representative from a Disabled Peoples Organisation. One of the Occupational Health professionals also represented the CBI, a particularly puzzling, if not troubling, appointment.

The report clearly identifies the concerns of disabled people that their answers are being frequently ignored, distorted or downright falsified by ATOS assessors, Professor Harrington himself states “It is clear that the process by which WCA decisions are reached is crucial to ensuring the fairness of the overall assessment. Individuals need to be treated with respect, need to be listened to and be able to get their case across,” yet methods to address these concerns are signally absent from his recommendations. The suggestion of a trial of recording interviews and consideration of providing an executive summary of the WCA to the claimant might be argued to address this, but the structure of the recommendation seems to suggest that Professor Harrington has concluded the concerns expressed are largely not factually correct, that disabled claimants do not understand the structure of the assessment and that they will be forced to acknowledge this if presented with clear evidence of what was said and how the process was conducted.

But what if the evidence from the trial shows instead that the problem does lie with the assessors, as the disability community believes? A whole year of additional distorted reports will have resulted, never mind the distorted reports that have gone before. How will the people subjected to those distorted reports find justice?

Equally Professor Harrington reports the concerns of disabled people that assessors are extremely reluctant to allow them to fully explain their situation and why it limits their ability to work, trying to force them into yes/no answers that have no place in any intelligent discussion of disability, and attempt to hurry the assessment to a conclusion in order to allow them to complete both it and their report in the allocated 46-49 minutes, something which apparently concerns even the assessors themselves, yet there are no related recommendations whatsoever. Are we to assume therefore that Professor Harrington does not believe it is important to the assessment process that we are entitled to fully explain our situation and likewise accepts unreservedly the use of the LiMA  computer programme whose limited functionality straitjackets the assessments in this fashion?

Chapter 2: The Evidence for a WCA

Chapter 2 opens with several pages extolling the virtues of work and demonising the health risks of being out of work, an attitude summed up in the statement “It must be made clear to all sections of society that being out of work is bad for an individual’s health.” This level of diktat is inappropriate in any independent review, particularly a review looking at a specific population of disabled people for whom being in work is entirely likely to have deleterious consequences. There may indeed be benefits from being in work in the general case, but we are not dealing with the general case and Professor Harrington appears to have forgotten this. Ill-considered generalisations about the ability or not of disabled people to work, further distorted into mindless bigotry by the yellow press, are leading to a significant rise in negative perceptions of disabled people from the non-disabled populace and disabled people are experiencing an all-too-necessary increase in their general fear of abuse as a result. To see ill-considered generalisations of this type repeated in this review, with an exhortation that everyone must believe them, is distressing in the extreme. At best this is a further example of Professor Harrington being unable to perceive the situation from the perspective of the individual disabled person.

Professor Harrington goes on to conclude Chapter 2 by arguing that the case for the benefit of work and the appropriate nature of ESA and the WCA is therefore proven. Yet nowhere in the chapter has he even discussed a dissenting opinion. A debate in which only one opinion is allowed is no debate at all, an argument to which no challenge is permitted is no kind of proof, scientific or otherwise. Work will benefit many disabled people claiming ESA, it will absolutely not benefit all and whether ESA and WCA are the most appropriate methods has not even been addressed, never mind pursued to a conclusion. And that is without even discussing whether WCA outcomes are matched by the availability of work and the willingness of employers to hire disabled people.

Chapter 3: Assessment: Process and Numbers

The report acknowledges that a large percentage of claimants fail to complete the WCA process, but fails to address several issues relating to this. Unaddressed, in fact not even acknowledged, is the deliberate and intentional use of ESA by the DWP as a holding pattern for benefit claimants who become temporarily too ill to actively look for work on JSA or who become unemployed for narrowly specific health reasons that do not limit their general employability. These claimants form a significant cohort of withdrawn claims and WCA attendees who can be largely guaranteed to fail the WCA, their existence serving to distort the wider statistics around ESA when combined with those claimants with significantly limiting long term disabilities. Failure to identify this cohort and classify them separately in the provided statistics compromises the value and function of those statistics.

Other issues leading to prematurely terminated claims include the intimidating nature of the ESA50 form, which is discussed later, and the widespread concern among disabled people that many claims are being abandoned because of the contempt with which disabled people perceive themselves to be treated by the process. The use of these statistics of abandoned and rejected claims by both the DWP and the yellow press to imply that ESA claimants are universally workshy  (an example of collective bigotry that amounts to a deliberate and sustained campaign aimed at inciting disability hatred amongst the general populace, and confirmed to be working by the BBC’s recent survey) makes this an area of clear concern for disabled people, whether claimants or not, and further contributes to abandoned claims, but Professor Harrington glosses over it as an area with conflicting data, ATOS claiming there is no problem, respondents to the review that there is. The conflicting data may prevent conclusions from being firmly drawn, but should not have prevented the recognition that this is an area of extreme concern to the disability community, requiring corrective action to be taken

Chapter 4: Experiences of the WCA

Professor Harrington dismisses concerns expressed about the fairness of the process by disabled claimants as ‘misconceptions’. I find his attitude here very troubling. At best it is dismissive, there seems no attempt to understand why the concerns are so persistent, nor whether they may in fact represent a genuine discontinuity in his understanding resulting from an inability to consider the situation from the viewpoint of a disabled claimant. Statements made by the assessor during my own assessment would seem to validate these supposed ‘misconceptions’ as fact, not fiction, nor failure to understand. Professor Harrington worries that these ‘misconceptions’ may become commonplace. They already are, and that information is readily available on any disability discussion board.

Professor Harrington makes the bald statement that there is no evidence that ATOS are being incentivized to rule a certain percentage of claimants as fit to be placed on JSA and dismisses opinions otherwise as misconceptions, yet there are many anecdotal reports of assessors being pressurized to declare more disabled claimants as fit for work. Even Danny Alexander, MP, before accepting a position in the government as Secretary of State for Scotland  and rapid promotion to number 2 at the Treasury, stated “There’s a suspicion that ministers may well be incentivising Atos to actually give results of the assessment which take people off benefit.” Convincing argument does not work in the way that Professor Harrington seems to believe it does, a statement that a widely held view is wrong needs to be supported by evidence. It is Professor Harrington’s remit to produce a report showing where the WCA is failing to meet its requirements, one of those requirements is that it is perceived to operate in a fair manner, and currently that perception is widely held not to be the case by members of the disability community and others.

Even if the ATOS contract does not include incentives, the possibility exists that ATOS assessors may be incentivized for internal, company reasons or even because of the perceptions of their immediate supervisors as to what the company really  wants; the review even acknowledges later that any assessor whose results differ from the local average will be audited, which clear incentivizes individual auditors to converge their results on an average, no matter the actual situation of the claimants they see. These concerns cannot be dismissed in a sentence, particularly when to dismiss them contradicts evidence elsewhere in the report, they must be addressed and explained away, any less suggests a contempt for our concerns and calls the reliability of the statement into question.  Rhydian Fôn James’ Guardian article on the review  also points out the existence of an implicit cost goal for DWP and ATOS, the need for the WCA to generate at least £250m in savings just to break even against its own costs.

Professor Harrington goes on to state that disabled benefit claimants should not fear being found fit for work and placed on JSA because DWP personnel are committed to helping disabled people and the procedures in place for disabled claimants of JSA should alleviate the concerns of those who find themselves transferred onto it. Having been a disabled claimant of JSA until February this year, before the DWP decided that JSA was completely unable to cope with my disability, I can assure Professor Harrington (as I did in my submission to the review) that the many frontline DWP personnel I dealt with, including DEAs, were near universally clueless about disability, the only exceptions being themselves disabled, and that their concept of appropriate support for a disabled claimant was to try and force me into minimum wage positions from the outset, no matter that I am a highly skilled engineer with extensive experience, an attitude that amounts to institutional disablism. It took a complaint to ministerial level to actually get them to look at my disability on an individual basis, not treat me as identical to all of their other non-disabled claimants. Other disabled people, from all across the country, report near-identical experiences. DWP and JSA are part of the problem, not part of the solution.

DWP’s sub-contractors are actually worse, even specialist disability charities such as the Shaw Trust and RBLI are widely reported to be operating from inaccessible premises, no matter the access requirements of their entire client base, while the non-disability specialist agencies lack even the most basic knowledge and understanding of disability issues, such as the legal requirements on them in relation to access and data protection. Meanwhile their overall tone in written communications can best be described as threatening (something which the report does acknowledge), not a manner likely to be productive with the many disabled people who have problems in dealing with authority or stressful situations. JSA is not fit for purpose with respect to disabled claimants.

Problems with the ESA50 form required to be completed by all ESA claimants are acknowledged in the report, but appear to have little understanding of the difficulties disabled people experience with it. The form is tens of pages of questions asking for the most intimate detail of how disability affects our lives as disabled people, yet appears to have been designed by someone completely unaware that many disabled people will find the form intimidating to the point of preferring to terminate their claim, that several decades of complex and occasionally contradictory symptoms cannot easily be fitted into a two inch high box, and that many disabled people will find a paper form difficult if not impossible to deal with due to the nature of their disabilities. Parts of the problem are easily dealt with by ensuring that an electronic version of the form is both available and publicised, but no such recommendations are made. Some of Professor Harrington’s statements in relation to the form are themselves problematical, he talks about people trying to put entries against as many questions as possible and of being coached to do so by advocacy organisations as though these are problems. Why does he consider it a problem for someone to identify every area in which their disability affects them? I was surprised by how widespread the effects of my disability were when I sat down to think about it in the systematic manner that the form enforces? Is there really something wrong in realising that your physical disability may affect you psychologically and acknowledging this? Is it really so wrong to complete the form from a position of knowledge rather than ignorance? (My WCA assessor certainly appeared to think so).

Equally Professor Harrington reports a statement by a tribunal president that “Many claimants give careful and detailed descriptions [in the ESA50] but this evidence is never referred to in the ATOS HCP report. Nor is it drawn upon by the decision-maker. It seems to be air-brushed out of the information gathering process”, yet in the immediately following recommendations section no recommendations are made to enforce the consideration by DWP and ATOS of the sole opportunity that claimants have to make a considered and systematic report on the nature of their disability.

Chapter 5: The ATOS Assessment

Chapter 5 relates that ATOS employ some 1250 assessors and that in the last year they have stopped using 25 of them for cause. Professor Harrington appears not to realise that an effective dismissal rate of 1 in 50 professional staff per annum is symptomatic of an organisation with a very serious problem.

Having discussed a wide range of misreporting by assessors, the review then dismisses them with the statement “In part these concerns reflect the difference between a medical examination, which focuses on diagnosis, and the ATOS assessment, which looks at a person’s functional capability.” Yet all of the misreporting detailed is directly or potentially relevant to functional capacity.

Professor Harrington acknowledges that the very limited training of ATOS assessors is an area of great concern for disabled people. Many disabled people have combinations of medical conditions that have taken specialists many years to reach a diagnosis over, others are without a specific diagnosis even after decades of investigation, but are recognised as genuinely disabled by the specialists who have spent years working with them. How is someone without a background in disability medicine, with barely 8 days of training, meant to be able to give a superior assessment of capability to work in comparison to a specialist with years of experience of both discipline and patient? To quote my own pain management specialist: ‘It is nearly impossible to get a doctor from another discipline to adequately acknowledge how disabling pain can be’. How can I trust the judgement of someone with 8 days training in the face of that? How can any disabled person trust it? How can Professor Harrington fail to address it in his recommendations?

Chapter 6: The Decision Making Process.

This chapter is perhaps the strongest of the review, identifying major weaknesses in the balance of the assessment process that mean it is not working as defined and outlining corrective action. Unfortunately the needs of the assessment process may run counter to historical social forces.

Professor Harrington acknowledges that the system is designed to provide for DWP decision makers to consider all of the evidence available and to overrule ATOS reports when needed, but that the decision makers themselves have identified that they are uncomfortable overruling decisions by ATOS medical staff ‘because they’re doctors’ and states that their training should be bolstered to support them in this. However this fails to address a widespread societal problem relating to the historical perception of the doctor-patient relationship. The perception of doctors as godlike figures of wisdom is still regrettably common and cannot be overcome simply by a day or two of extra training, yet the system as designed depends on precisely that.

The report also acknowledges that a high percentage of disabled people are apparently unaware that they are able to present medical evidence with the ESA50 and at the WCA itself, not simply at the appeal stage, while those who do present it frequently believe that it is simply being ignored by the ATOS assessors. The ability to present medical evidence is simply not being made known to disabled claimants, yet there are no recommendations to change this. Equally the failure of ATOS assessors to address medical evidence contrary to their conclusions in their reports to the DWP is clearly an area in need of urgent attention. It would not be unreasonable to consider the suppression of contrary medical opinions, particularly as part of a quasi-legal process, to be a serious breach of professional ethics.

Chapter 7: Appeals

In discussing appeals Professor Harrington implies that many appeals are filed because of ignorance of the assessment process on the part of claimants. This may be true in some cases, but cannot explain the very high rare of successful appeals: over 30% of decisions are being appealed, 40% of those are being upheld. Any quality department in any business would be horrified by a 12% reject rate and heads would roll if it was not fixed, The report acknowledges the high rate of appeals and hopes that they will be reduced by the additional training to be provided to assessors and the additional communication to take place with claimants, but the real problem here is not the rate of appeal, but the rate of success appeal. 4 out of 10 assessments taken to appeal are being judged to be incorrect. Imagine the outcry if a similar situation happened in the Criminal and Appeal Courts, yet the report simply glosses over this by hoping additional training will fix it.

I cannot help but be extremely concerned by Professor Harrington’s recommendation that appeal tribunals should be reminded of the benefit of work. It is impossible to construe this as anything less than an attempt to undermine the independence of the tribunal system. Is work beneficial? In general, yes; but tribunals are not dealing with the general case, they are dealing with the specific, and for many disabled people, forced into the appeals system by the failures of the WCA, work means pain, distress and the likely worsening of their conditions. An attempt to bolster the case for work without parallel reminders that this is not generally applicable to the population of disabled people who find themselves arguing their case for justice before a tribunal distorts and brings into clear question the fairness and impartiality of the appeals process. This appears to be a case of Professor Harrington thinking solely as an occupational health physician, hanging doggedly onto one of that discipline’s sacred Shibboleths come what may, and forgetting his responsibility to approach the context of the review impartially and with due regard for the needs of both the people operating the system and those who find themselves struggling to navigate it.

Chapter 8: A Programme of Work For Year 2

The approach for Year 2 necessarily draws on the conclusions discussed above, repeating the same flaws already identified. That is not to say that there is no value in the work proposed, simply that it fails to address major areas of concern. A major focus for the year is looking at the descriptors used in the process, but nowhere is there any discussion of considering whether the use of descriptors is actually appropriate, nor is any review definitively proposed outside of the area of mental, cognitive and intellectual impairments, even though identical concerns over descriptors are acknowledged by the review to exist for fluctuating and pain and fatigue based impairments. The possibility of looking at these is raised, but no more than that.

Conclusion

The conclusions repeat the tired assertion that work is universally good for you and the WCA the way to get the disabled population into work. There is no real evidence of independence of thought here, simply someone who believes the problem and the solution are precisely as the government has outlined and merely wants to smooth the process. That not all disabled people can work is barely acknowledged, that the UK workplace in general is not remotely disability friendly is never touched upon.

Not Addressed

Completely missing from Professor Harrington’s assessment is any reference of the physical suitability of DWP and ATOS premises and those of their training contractors, an issue that is frequently raised on disability discussion boards (and an issue which I for one included in my submission to the review). People have arrived for WCA and other ATOS or DWP operated assessments and meetings to find offices without on-site disabled parking, offices that are inaccessible to wheelchair users, offices that have failed to provide needed adjustments in seating and other areas. If the basic building stock is not fit for purpose, then how many disabled claimants are deciding that if the system treats their most basic needs with this contempt then they have no hope of a fair hearing and give up their claim? I know that I very nearly did. Access is not a luxury, for many of us it is an essential, our right to it is enshrined in law and failure to provide it can throw us into days, weeks, or even months of exacerbated symptoms. 

Fit for Purpose?

There is clear value in parts of Professor Harrington’s report, he has identified major failings in the operation of the WCA system, but he has done it from what is largely an establishment viewpoint and has signally failed to address the needs and concerns of the disabled people who find themselves at the sharp end of the system’s decision-making process, even in cases where he has identified and reported on those concerns. The failings in the review may result from its rushed nature, but that explains rather than excuses. To sum up the report: D-, must do better next year, and, unfortunately, the personal opinions in relation to work expressed throughout the report mean that I think we may have the wrong man for the job.

And, as always, looking at ESA and the WCA only addresses a small part of the difficulty of moving disabled people into work. The active and deliberate disablism that forced many of us out of the workplace in the first place and that continues to deny us positions within it will not magically disappear by forcing hundreds of thousands of disabled people onto JSA, it will simply obfuscate the intolerance we face and draw a polite curtain across the existence of that den of bigotry at the heart of British industry.