Disability testing isn’t working as it should – and Conservatives must have the courage to admit it
Unhappy and they know it: it is essential that the Conservatives see through a successful overhaul of the benefits system Photo: Getty Images
When government makes a mess of a big contract, the Right’s normal response is to make a fuss. Taxpayers’ money is precious, and the state should avoid wasting it. So what if I told you that both this Government and the last have struggled with a contract worth more than an annual £100 million, which has been criticised by auditors and has a costly 17 per cent error rate?
The work capability assessment, carried out by the private firm Atos Healthcare at an annual cost of £112.4 million, needs more scrutiny than it receives. There is a curious blind spot on the Right about this contract, and it is in part down to a desire for the policy – undoubtedly the correct one overall – to succeed. The Coalition continued the tests, which were introduced by Labour in 2008, so as to move claimants from Incapacity Benefit to the new Employment and Support Allowance (ESA), or off benefits and into the workplace.
The steady drip, drip of bad news about the tests – from Wednesday’s court judgment that they disadvantage those with mental health problems to the rising rate of successful appeals – suggests that all is not well. It is no surprise that 40 per cent of the Department for Work and Pensions’s fitness-to-work decisions go to appeal, but what is astonishing is that 42 per cent of those appeals are successful. Their cost is projected to rise from £60 million to £70 million this year.
In October, the National Audit Office identified weaknesses in the Atos contract. In January, the public accounts committee sounded a similar warning, saying the DWP was “getting far too many decisions wrong” and “at considerable cost to the taxpayer”. MPs – including Conservatives – also held a Commons debate after complaints about the process jammed their letterboxes.
So what is going wrong? Atos is subject to extraordinary levels of vitriol, but charities representing sick and disabled people argue that the problem lies as much in the test itself, which was designed by ministers and civil servants. It fails to assess, beyond someone’s ability to move a cardboard box in the test room, whether they are capable of doing a real job. The activities in the test are removed from workplace realities. Can you move that cardboard box every day for a week, after travelling into the office?
People might be surprised to learn that even serious impairments might not disqualify a person for work. For example, someone who “cannot mount or descend two steps unaided by another person even with the support of a handrail” would only score nine points – the threshold for ESA is 15 points – so unless they picked up points under other categories, they could be “fit for work”. Similarly, people who cannot move 200 metres, either on foot or in a wheelchair, without stopping from pain or exhaustion, only receive six points. No wonder so many appeals are successful.
There are some simple changes that could improve the test, although they are unlikely to remedy the inherent flaw: the fact that it doesn’t realistically assess a person’s ability to do a day-to-day job. The National Audit Office has criticised the DWP for failing to collect data from tribunals in order to improve the medical assessment. This would be helpful.
Another useful tweak would be to extend the time period for gathering medical evidence from a claimant’s GP. Currently Atos only has two weeks from receiving the ESA50 form applying for the benefit until it decides whether to call a claimant in for testing; Mark Hoban, the work and pensions minister, told the Commons earlier this year that only 37 per cent of medical evidence forms are returned on time from GPs and consultants. This can result in a terminally ill patient being hauled into an Atos centre when they should automatically qualify for ESA.
The principle of testing is entirely right. People on disability benefits are not on the make – the incidence of fraud is just 0.3 per cent – but there are claimants who would benefit from returning to work with support. Leaving them to rot without paying heed to whether their conditions have improved is not something any compassionate government should consider. However, to endorse the solution simply because you agree with the principle is like buying a dress that didn’t fit even when you tried it on in the shop. It might be a beautiful dress, but if the zipper doesn’t do up, it’s not the right one.
A head-in-the-sand response from the Right also leaves a vacuum for those who oppose testing to make their case. The risk is that the blind spot in the Right-of-centre media, and among all but a worthy handful of Tory MPs, will lead to a collapse of public faith in these tests. It is essential that the Conservatives see through a successful overhaul of the benefits system, as the way Labour scuttled away from attempting anything so radical underlines the Left’s lack of resolve on this issue. If these efforts fail, the catastrophe will be enough to prevent any government looking at welfare reform for another generation.
Normally when a government contract is poorly managed, the emotion it provokes is irritation. Money has been wasted. Someone wasn’t paying attention. But in this instance, more is at stake, because a flawed test distresses people who deserve better. In Britain we can take great pride that we largely mark our level of civilisation by treating sick and disabled people with respect. But we must constantly be on the lookout for any threat to that, rather than allowing a blind spot to develop simply because we are desperate for a reform to work.
Telegraph
There are some simple changes that could improve the test, although they are unlikely to remedy the inherent flaw: the fact that it doesn’t realistically assess a person’s ability to do a day-to-day job. The National Audit Office has criticised the DWP for failing to collect data from tribunals in order to improve the medical assessment. This would be helpful.
Another useful tweak would be to extend the time period for gathering medical evidence from a claimant’s GP. Currently Atos only has two weeks from receiving the ESA50 form applying for the benefit until it decides whether to call a claimant in for testing; Mark Hoban, the work and pensions minister, told the Commons earlier this year that only 37 per cent of medical evidence forms are returned on time from GPs and consultants. This can result in a terminally ill patient being hauled into an Atos centre when they should automatically qualify for ESA.
The principle of testing is entirely right. People on disability benefits are not on the make – the incidence of fraud is just 0.3 per cent – but there are claimants who would benefit from returning to work with support. Leaving them to rot without paying heed to whether their conditions have improved is not something any compassionate government should consider. However, to endorse the solution simply because you agree with the principle is like buying a dress that didn’t fit even when you tried it on in the shop. It might be a beautiful dress, but if the zipper doesn’t do up, it’s not the right one.
A head-in-the-sand response from the Right also leaves a vacuum for those who oppose testing to make their case. The risk is that the blind spot in the Right-of-centre media, and among all but a worthy handful of Tory MPs, will lead to a collapse of public faith in these tests. It is essential that the Conservatives see through a successful overhaul of the benefits system, as the way Labour scuttled away from attempting anything so radical underlines the Left’s lack of resolve on this issue. If these efforts fail, the catastrophe will be enough to prevent any government looking at welfare reform for another generation.
Normally when a government contract is poorly managed, the emotion it provokes is irritation. Money has been wasted. Someone wasn’t paying attention. But in this instance, more is at stake, because a flawed test distresses people who deserve better. In Britain we can take great pride that we largely mark our level of civilisation by treating sick and disabled people with respect. But we must constantly be on the lookout for any threat to that, rather than allowing a blind spot to develop simply because we are desperate for a reform to work.
Telegraph
