I beg to move that this House has considered the matter of Atos work capability assessments.
I warmly thank the Backbench Business Committee for enabling me and cross-party colleagues to introduce this debate on Atos work capability assessments. There is enormous concern about the issue both in the country and in this House, as witnessed by the fact that more than 30 Members wish to speak on a Thursday. To try to ensure that they can all do so, I propose to speak for no more than 10 to 15 minutes. I hope that colleagues will accept that, for reasons of pressure on time, I do not propose to take interventions.
As knowledge of the debate has spread, I have been sent nearly 300 case histories, many of which make heart-rending reading. I cannot begin to do justice to their feelings of distress, indignation, fear, helplessness and, indeed, widespread anger at the way they have been treated. Nor can I easily contain my own feelings at the slowness, rigidity and insensitivity with which Atos and the Department for Work and Pensions have responded—or very often not responded—to the cries of pain that they have heard repeatedly. I have time to cite briefly only three examples which show how extreme is the dysfunction and malfunctioning of the Atos assessments.
The first example concerns a constituent of mine who was epileptic almost from birth and was subject to grand mal seizures. At the age of 24, he was called in by Atos, classified as fit for work and had his benefit cut by £70 a week. He appealed, but became agitated and depressed and lost weight, fearing that he could not pay his rent or buy food. Three months later, he had a major seizure that killed him. A month after he died, the DWP rang his parents to say that it had made a mistake and his benefit was being restored.
The second example, also from the Oldham area, concerns a middle-aged woman who was registered blind and in an advanced stage of retinitis pigmentosa. She was assessed at 9 points—well short of the 15 that are needed—and her incapacity benefit was withdrawn. On review by a tribunal, the Atos rating of 9 points was increased to 24.
The third case—I could have chosen from hundreds of others—also comes from the north-west and concerns an insulin-dependent diabetic with squamous cell cancer, Hughes syndrome, which involves a failed immune system, peripheral neuropathy, which meant that he had no feeling in his feet or legs, heart disease, depression and anxiety. Despite his life-threatening condition, he was placed in the work-related activity group.
Those and myriad other examples illustrate incontrovertibly that Atos’s current work capability assessment system is drastically flawed, and for several reasons.
First, Atos is an IT firm and it uses the so-called Logic Integrated Medical Assessment, which is often described as “rigid” and “tick-box” because computer-based systems make it difficult for health professionals to exercise their professional judgment. Because such a mechanistic system has little or no regard for the complexity of the needs of severely disabled or sick persons, the British Medical Association and others have condemned the current WCA as “not fit for purpose”.
As knowledge of the debate has spread, I have been sent nearly 300 case histories, many of which make heart-rending reading. I cannot begin to do justice to their feelings of distress, indignation, fear, helplessness and, indeed, widespread anger at the way they have been treated. Nor can I easily contain my own feelings at the slowness, rigidity and insensitivity with which Atos and the Department for Work and Pensions have responded—or very often not responded—to the cries of pain that they have heard repeatedly. I have time to cite briefly only three examples which show how extreme is the dysfunction and malfunctioning of the Atos assessments.
The first example concerns a constituent of mine who was epileptic almost from birth and was subject to grand mal seizures. At the age of 24, he was called in by Atos, classified as fit for work and had his benefit cut by £70 a week. He appealed, but became agitated and depressed and lost weight, fearing that he could not pay his rent or buy food. Three months later, he had a major seizure that killed him. A month after he died, the DWP rang his parents to say that it had made a mistake and his benefit was being restored.
The second example, also from the Oldham area, concerns a middle-aged woman who was registered blind and in an advanced stage of retinitis pigmentosa. She was assessed at 9 points—well short of the 15 that are needed—and her incapacity benefit was withdrawn. On review by a tribunal, the Atos rating of 9 points was increased to 24.
The third case—I could have chosen from hundreds of others—also comes from the north-west and concerns an insulin-dependent diabetic with squamous cell cancer, Hughes syndrome, which involves a failed immune system, peripheral neuropathy, which meant that he had no feeling in his feet or legs, heart disease, depression and anxiety. Despite his life-threatening condition, he was placed in the work-related activity group.
Those and myriad other examples illustrate incontrovertibly that Atos’s current work capability assessment system is drastically flawed, and for several reasons.
First, Atos is an IT firm and it uses the so-called Logic Integrated Medical Assessment, which is often described as “rigid” and “tick-box” because computer-based systems make it difficult for health professionals to exercise their professional judgment. Because such a mechanistic system has little or no regard for the complexity of the needs of severely disabled or sick persons, the British Medical Association and others have condemned the current WCA as “not fit for purpose”.
Secondly, assessed persons regularly felt that the opinion of their own doctor or of other specialist medical personnel who were treating them was either ignored or overridden. That is all the more serious when Atos’s practices simply do not adhere to the guidance for doctors set down by the General Medical Council.
Thirdly, because of the failure of so many initial assessments, the appeal procedure is grossly overloaded and hugely expensive. No less than 41% of decisions are appealed, of which 38% are won. At £60 million in a single year, the appeals have cost the taxpayer more than half of the £110 million that was spent on the original assessments. Moreover, the National Audit Office has castigated the Department for failing to penalise Atos for what it politely calls its “underperformance” and for not setting “sufficiently challenging” targets.
Fourthly, there are concerns about the responsibility for work capability assessments, in particular that of the Atos chief medical officer. Professor Michael O’Donnell joined Atos from the American company, Unum, formerly UnumProvident, which had a very poor reputation in the US, where it was described as an “outlaw company” by the US authorities, partly because it was regarded as a “disability denial factory”. In that situation, the responsibilities of the Minister and the Secretary of State need to be established clearly.
Against that background, it is frankly not good enough for the Minister to respond to the debate by saying that there have been three Harrington reviews, and that the Department is doing the best it can to improve procedures. The fundamental issue is this: how can pursuing with such insensitive rigour 1.6 million claimants on incapacity benefit, at a rate of 11,000 assessments every week, be justified when it has led, according to the Government’s own figures, to 1,300 persons dying after being put into the work-related activity group, 2,200 people dying before their assessment is complete, and 7,100 people dying after being put into the support group? Is it reasonable to pressurise seriously disabled persons into work so ruthlessly when there are 2.5 million unemployed, and when on average eight persons chase every vacancy, unless they are provided with the active and extensive support they obviously need to get and hold down work, which is certainly not the case currently?
I therefore want to conclude by asking the Minister five specific questions to which I want a specific answer before the end of the debate.
First, it is true that Harrington has produced minor adjustments—implemented at a glacial place—but the underlying system remains largely undisturbed. The BMA and the NAO have therefore called for a thorough, rigorous and transparently independent assessment of the suitability of the work capability assessment. Will the Minister now implement that?
Secondly, will the Minister accept that the current criteria and descriptors do not sufficiently—or even at all—take into account fluctuating conditions, especially episodic mental health problems? How will he rectify that?
Thirdly, will the Minister provide full and transparent details of the Atos contract? They should not be hidden by specious claims of commercial confidentiality when Atos is the sole provider of what is clearly a public service. Better still, given that Atos has failed so dramatically, why does he not in-source the work back into the NHS?
Fourthly, how will the Minister ensure that the medical expertise of disabled persons’ doctors and related professionals is fully taken into account before assessments are completed?
Lastly, I want to provide a full dossier to the Secretary of State so that he fully understands what is being done today in his name, and to bring a small delegation to see him from some of the excellent organisations of disabled people who have heroically battled to highlight and tackle the distress and pain caused by Atos. Can I please be assured that the Secretary of State will see such a delegation?
I repeat that I am sincerely grateful for this debate, for the co-operation of colleagues from all parties, and for the detailed responses I have received from so many hundreds of victims of Atos, but I assure the Minister of this: the debate is important, but it will certainly not be the end of the matter.
Thirdly, because of the failure of so many initial assessments, the appeal procedure is grossly overloaded and hugely expensive. No less than 41% of decisions are appealed, of which 38% are won. At £60 million in a single year, the appeals have cost the taxpayer more than half of the £110 million that was spent on the original assessments. Moreover, the National Audit Office has castigated the Department for failing to penalise Atos for what it politely calls its “underperformance” and for not setting “sufficiently challenging” targets.
Fourthly, there are concerns about the responsibility for work capability assessments, in particular that of the Atos chief medical officer. Professor Michael O’Donnell joined Atos from the American company, Unum, formerly UnumProvident, which had a very poor reputation in the US, where it was described as an “outlaw company” by the US authorities, partly because it was regarded as a “disability denial factory”. In that situation, the responsibilities of the Minister and the Secretary of State need to be established clearly.
Against that background, it is frankly not good enough for the Minister to respond to the debate by saying that there have been three Harrington reviews, and that the Department is doing the best it can to improve procedures. The fundamental issue is this: how can pursuing with such insensitive rigour 1.6 million claimants on incapacity benefit, at a rate of 11,000 assessments every week, be justified when it has led, according to the Government’s own figures, to 1,300 persons dying after being put into the work-related activity group, 2,200 people dying before their assessment is complete, and 7,100 people dying after being put into the support group? Is it reasonable to pressurise seriously disabled persons into work so ruthlessly when there are 2.5 million unemployed, and when on average eight persons chase every vacancy, unless they are provided with the active and extensive support they obviously need to get and hold down work, which is certainly not the case currently?
I therefore want to conclude by asking the Minister five specific questions to which I want a specific answer before the end of the debate.
First, it is true that Harrington has produced minor adjustments—implemented at a glacial place—but the underlying system remains largely undisturbed. The BMA and the NAO have therefore called for a thorough, rigorous and transparently independent assessment of the suitability of the work capability assessment. Will the Minister now implement that?
Secondly, will the Minister accept that the current criteria and descriptors do not sufficiently—or even at all—take into account fluctuating conditions, especially episodic mental health problems? How will he rectify that?
Thirdly, will the Minister provide full and transparent details of the Atos contract? They should not be hidden by specious claims of commercial confidentiality when Atos is the sole provider of what is clearly a public service. Better still, given that Atos has failed so dramatically, why does he not in-source the work back into the NHS?
Fourthly, how will the Minister ensure that the medical expertise of disabled persons’ doctors and related professionals is fully taken into account before assessments are completed?
Lastly, I want to provide a full dossier to the Secretary of State so that he fully understands what is being done today in his name, and to bring a small delegation to see him from some of the excellent organisations of disabled people who have heroically battled to highlight and tackle the distress and pain caused by Atos. Can I please be assured that the Secretary of State will see such a delegation?
I repeat that I am sincerely grateful for this debate, for the co-operation of colleagues from all parties, and for the detailed responses I have received from so many hundreds of victims of Atos, but I assure the Minister of this: the debate is important, but it will certainly not be the end of the matter.
http://www.leftfutures.org/2013/01/my-speech-on-atos-work-capability-assessments/
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