Dr Greg Wood writes:
Recently a columnist for the GP’s trade magazine Pulse wrote that Atos were nearly always right in their WCA recommendations. Furthermore, he fell into the trap of claiming that as Stephen Hawking isn’t ‘on the sick’, why should anybody else be?
This was picked up by national newspapers and triggered much dismay among disability campaigners.
I offered to write a rebuttal for Pulse and they readily agreed.
The latest piece from Pulse’s GP columnist showed far too much faith in the work capability assessment, writes Dr Greg Wood
In his column in the August issue of Pulse, Dr Phil Peverley
let out a howl of pain on behalf of his readers – fellow GPs who feel ‘caught in
the middle’ between their patients on Employment and Support Allowance (ESA) and
the Department for Work and Pensions (DWP)’ proxy, the global outsourcing firm
Atos.
But it was a cry from the heart, not
from the head. He began by referring to a DWP press release, put out on 22 July
(the day of the royal birth) about a hypothetical new contractor that might be
invited to work alongside Atos on work capability assessments (WCA) some time
next year.¹
In it, the Government also slipped
the news that it has told Atos to improve the quality of its reports (a quality
drive already underway on the day the royal baby was born).
The DWP also admitted that all Atos
disability assessors were undergoing retraining. As if that wasn’t enough of a
mea culpa, the DWP has called in external auditors, PricewaterhouseCoopers, to
‘strengthen quality assurance processes’ across its disability
assessments.
Dr Peverley claimed that Atos ‘nearly
always gets it right’ as far as so-called fitness-to-work assessments are
concerned, but even the DWP admits that at least 15% of cases are appealed
successfully.²
Furthermore, if you look at the
findings of the tribunals that hear appeals against WCA decisions, the rate at
which these decisions are successfully appealed is now running at
42%.3 Many would argue that the tribunals provide the clearest window
into the accuracy of the WCAs, because an independent doctor and lawyer sit on
them and because they are funded by the Ministry of Justice, not the DWP, and
are thus free from the constraints written into the DWP-Atos
contract.
Stephen Hawking’s WCA
Dr Peverley claims that ‘nearly
everyone is capable of some form of work’. He’s right, in the sense that nearly
all small boys are capable of going up chimneys. It is a common misconception
that the WCA is a fitness-for-work test, a mistake encouraged by those with an
anti-welfare agenda. In fact the test only sets out to establish whether a
claimant has limited capability for work, and if so, whether they have limited
capability for work-related activity.4 In this way, someone can be
awarded ESA yet still apply for jobs: if they get one, great. No one would
consider them a cheat for doing so.
As for using Stephen Hawking as an
example: what was Dr Peverley thinking? Professor Hawking is of retirement age
and way too rich to qualify for ESA, but if he wasn’t, he would obviously be
eligible for the highest level of medical benefits. As Dr Peverley must know,
motor neurone disease doesn’t affect cognitive function, which is why Stephen
Hawking has been able to use his unique intellect to such good effect despite
his physical impairments, which are of the utmost severity. Would Dr Peverley
issue him with a sick-note if he were a postman, not a physicist?
Regarding letters of support,
claimants are in a genuine Catch-22 situation. The DWP says that ultimately
claimants – not the DWP or Atos – are legally responsible for providing any
documents to be used in support of their claim, yet LMCs like Bro Taf have
decreed that their GPs will only provide reports if asked to by
Atos.5,6
Doing things differently
Atos has a £110 million-a-year deal
with the DWP to conduct Work Capability Assessments, and the appeals process is
costing half as much again.7 I would favour channelling some of that
money towards GPs, in return for a willingness to write helpful reports which
describe their patients’ functional limitations during activities of daily
living, and which comment on any risks associated with them being found fit for
work.
I propose we develop two
kinds of sick-note: one for people in work, to give an indication to the
employer of how long the employee is likely to be off sick; and another using a
low standard of proof, simply recommending to the Jobcentre that the DWP pay the
ESA, until a truly fair and truly independent assessment can be carried
out.
Dr Greg Wood is a former GP and
disability analyst for Atos, now a campaigner for WCA reform
References
1 Department for
Work and Pensions (DWP). Hoban – taking action to improve the Work Capability
Assessment. 22 July 2013.
2 Hansard. Work and Pensions Committee; Supplementary written evidence submitted by the Department for Work and Pensions. 29 January 2013.
3 GOV.UK. Tribunals statistics (quarterly) earlier editions. 27 September 2012.
4 DWP. A guide to Employment and Support Allowance – The Work Capability Assessment (ESA 214). January 2013.
5 DWP. Employment and Support Allowance claimant journey Stakeholder information pack. November 2012.
6 Pulse. GP support for benefit claimants is an ‘abuse of NHS resources’, LMC claims. 18 July 2013.
7 Hansard. Written answers. 17 July 2013.
2 Hansard. Work and Pensions Committee; Supplementary written evidence submitted by the Department for Work and Pensions. 29 January 2013.
3 GOV.UK. Tribunals statistics (quarterly) earlier editions. 27 September 2012.
4 DWP. A guide to Employment and Support Allowance – The Work Capability Assessment (ESA 214). January 2013.
5 DWP. Employment and Support Allowance claimant journey Stakeholder information pack. November 2012.
6 Pulse. GP support for benefit claimants is an ‘abuse of NHS resources’, LMC claims. 18 July 2013.
7 Hansard. Written answers. 17 July 2013.
