The role of incapacity benefit reassessment in helping claimants into employment - Work and Pensions Committee Contents

Written evidence submitted by Peter Higginson

The government has appointed a private healthcare body, Atos Origin to undertake the disability assessments of the long-term sick from 28 February 2011.

It's important to notice that whilst these interviews are called medicals, they are in fact functional observational tests to determine whether claimants are telling the truth on their ESA50 claim forms. The model for the software used on the Atos computers is taken from insurance company interviews to disprove the validity of a claim for disability, and the onus upon the examiner is to discover the functionality that the claimant does have on the day, rather than the history, testimony and description of their illness by their GPs and Consultants.

With a fluctuating condition like schizophrenia, a highly medicated patient will undoubtedly pass the functionality test because the descriptors require there to be a psychotic break in communication or evidence of harmful behaviour on the day of the interview in order to score any points. Any testimony as to the effects of stress, changes in mood, and the appalling nature of the infrastructural pain of schizophrenia, is marked as not relevant on current evidence (94% of trialled claimants were passed fit for work).

If the patient demonstrates his psychosis however then the session can be ruled invalid because of the failure of the claimant to understand the process. Or it is cancelled on safety grounds. So there is a double-bind written into the base of the tests for the mentally ill.

Over the next three years the DWP will test 1.5 million claimants on these grounds, of whom approximately 500,000 have a severe and enduring mental illness. You can see how there is a potential here for a disaster in mental health services as patients' benefits are cut by up to 80% and they are sent to the Jobcentre to look for work they cannot do, or that does not exist.

The danger with severe mental illness is that when patients are faced with double binds coupled with punishing sanctions, they naturally turn to suicide or contemplate violence as a solution to the impossible problem.

In my own case I will almost certainly pass the medical because I cannot demonstrate my condition without coming off the medication and letting the psychosis I bear manifest itself. This would represent a serious danger of harm to myself and others, and is heavily contra-indicated by medical practice. So I am frightened as I contemplate this problem, which actually represents a "psychotic" proposal to the claimant.

March 2011

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Prepared 26 July 2011