Atos have been left reeling after two severe blows to their survival as providers of medical assessments in the course of a week.
First, a government audit has found that their work capability assessments are so poor that not only must all their current health professionals undergo retraining but also new providers are to be brought in to break up the Atos monopoly by next summer.
Second, an upper tribunal judge has ruled that the opinion of a physiotherapist – on whom Atos are heavily reliant both for carrying out WCAs and even more so for PIP medicals - is of no value if the claimant has a mental health condition. The ramifications of this decision could be huge.
Meanwhile, GPs in South Wales have been told by their local governing body to always refuse to provide letters for claimants in connection with benefits claims as it is ‘an abuse of the national health service’. Only requests by the DWP will be met in future.
Elsewhere, rumours that the software for universal credit has had to be scrapped and started afresh continue to grow. It is looking more and more likely that there will be no genuine rollout of universal credit before the next general election.
ATOS LOSES MONOPOLY
Atos healthcare is to lose its long-held monopoly stranglehold on work capability assessments (open access) from next summer. The news comes as the DWP revealed that 41% of sampled Atos reports had achieved only a ‘c’ grade in a recent audit.
Atos has been the only provider of work capability assessment medicals for employment and support allowance and of its forerunner, the all work test for incapacity benefit, since DWP medical services were outsourced. Campaigners have long argued that the assessments carried out by Atos were not of an acceptable standard but, up until now, the DWP have always defended Atos as if they were part of the same department.
Now, however, the government has decided that Atos is not up to standard and that an improvement plan has to be put into place. Measures include retraining and re-evaluating all Atos health professionals, bringing in a third party to assess Atos’ own audits of its work and engaging Price Waterhouse Coopers to provide advice on improving quality assurance.
ATOS PHYSIO’S EVIDENCE OF NO VALUE
Atos could be in even more difficulties following an upper tribunal decision that the opinion of an Atos health professional who is a physiotherapist was of “no probative value whatsoever” where it concerned a claimant who had a mental, rather than physical, health condition.
The case involved a claimant who had been placed in the WRAG but had appealed to be placed in the support group. The claimant’s mental health conditions included depression and bouts of uncontrollable rage. The judge stated that:
“I can only express my surprise that in a case where the only issue was the mental health of the claimant and its effect in relation to the mental health descriptors, the report was prepared by a physiotherapist following a 15 minute interview. It is plainly important that questions of mental health should be assessed by a disability analyst with appropriate mental health qualifications if their opinion is to be of any evidential value. Even then tribunals should beware of placing too much weight on such reports, based as they are on a very short interview with a claimant and without access to medical records.“
Although the decision, which was highlighted on the Rightsnet discussion forum for welfare rights workers, relates to ESA there is no logical reason why similar arguments cannot be employed in relation to PIP, where a very similar points based system is in place. This could pose a massive problem for Atos whose successful bid for the PIP medical assessment contract stated that they would be using the following health professionals:
933 physiotherapists
373 nurses
75 occupational therapists
19 doctors.
There seems little doubt that the DWP will appeal the decision. Meanwhile, however, we’ll be updating our ESA appeals guide in the near future to take account of this decision – and to look at the potential advantages and risks of using it in your own appeal.
Members can read more here.
From IB to ESA support group without medical
“Sorry if this goes on, just wanted everyone to know how wonderful this site is and the best investment I have ever made, a fantastic forum really helps others like me.”
CLAIMANTS ‘ABUSE’ OF NHS RESOURCES
Finally for ESA, GPs in south east Wales have been told by their local medical council (LMC) to stop writing letters for patients who need support with a benefits claim or appeal. The LMC have even issued a standard letter for GPs to send to patients which claims that “making such requests to GPs represents an abuse of NHS resources.”
Whilst patients will still be able to request copies of their medical records for a fee of up to £50, it means that Atos/DWP will be the only ones who will be able to get specific GP evidence and they will also be able to choose not to do so, if it suits them .
However, if GPs have a blanket ban on providing such evidence even if offered payment by claimants but do not have a similar blanket ban for say, life insurance companies paying for evidence, then this may be a relatively straightforward case of disability discrimination. We look forward to hearing from members who are prepared to take legal action against GPs in south east Wales or against the Bro Taf LMC.
More details on this story are available from the BBC website and from the Pulse website.
