Written evidence submitted by RNIB
1. ABOUT US
As the largest organisation of blind and partially
sighted people in the UK, RNIB is pleased to have the opportunity
to respond to this consultation.
We are a membership organisation with over 10,000
members who are blind, partially sighted or the friends and family
of people with sight loss. 80% of our Trustees and Assembly Members
are blind or partially sighted. We encourage members to be involved
in our work and regularly consult with them on government policy
and their ideas for change.
As a campaigning organisation of blind and partially
sighted people, we fight for the rights of people with sight loss
in each of the UK's countries.
During the next five years we want to tackle the
isolation of sight loss by focusing on three clear priorities:
— 1. stopping
people losing their sight unnecessarily;
— 2. supporting
blind and partially sighted people to live independent lives;
and
— 3. creating
a society that is inclusive of blind and partially sighted people.
We also provide expert knowledge to business and
the public sector through consultancy on improving the accessibility
of the built environment, technology, products and services.
QUESTION 1
The Department's communications to customers going
through the assessment and whether the information, guidance and
advice provided by the Department and Jobcentre Plus is effective
in supporting customers through the process
1.1 The main requirement for visually impaired
people is the provision for alternative formats, if initial contact
with customer is made via inaccessible measure (standard letter)
renders the process will be flawed.
RECOMMENDATION 1
Throughout the assessment process information should
be available and supplied to visually impaired claimants in an
accessible format.
QUESTION 2
The Work Capability Assessment including: the
assessment criteria; the service provided by Atos staff; the suitability
of assessment centres; and customers' overall experience of the
process
2.1 Despite the fact that blind and partially
sighted people have a different impairment, face a different challenge
in adjusting to their impairment, and require different aids and
equipment the regulations conflate sight loss and hearing impairment
within a single descriptor.
2.2 Activity seven refers to both verbal means
and non-verbal means. RNIB interprets this to mean that you may
not obtain 15 points as long as you could communicate by one or
other of these means. Consequently with respect to the first descriptor—"Cannot
understand a simple message due to sensory impairment" a
claimant may not obtain 15 points if they could hear a message
even if they couldn't see it or if they could see a message even
if they couldn't hear it. The Atos guidance for health care professionals
implementing the WCA makes it clear that this descriptor is aimed
at the deaf blind community or people who have a hearing impairment.
2.3 Page 82 of the guidance states, "A person
who is deaf who cannot hear a shout at beyond 1 metre (80db loss)
with macular degeneration to the extent that their vision is moderately
impaired such that they have 6/24 vision, and can only read N16
print with a magnifying glass is likely to have 'significant'
problems. A person who is deaf (80db loss) and has 6/24 distance
vision but can read N16 print with their normal spectacles is
likely to have 'some' problems."
2.4 The only descriptor specifically linked to
sight loss (in the Atos guidance) is the activity "Navigation
and maintaining safety, using a guide dog or other aid if normally
used—Activity eight." This descriptor too is unworkable
in practice.
2.5 Descriptor 8(a) "Unable to navigate
around familiar surroundings without being accompanied by another
person due to sensory impairment" raises the problem that
if the surroundings are familiar to a claimant it is likely that
such a person could already navigate them and thus would not qualify
for 15 points.
2.6 The descriptor 8(b) "cannot safely complete
a potentially hazardous task such as crossing the road without
being accompanied by another person due to sensory impairment"
raises the problems of the fact that the descriptor is likely
to be taken very literally in assessments. If the road has a formal
crossing, has audio signals that would have met the Best Value
Performance Indicator and other standards for accessibility it
might not be a problem to cross. Alternately if the crossing is
being dug up, there is rat running traffic or there are no accessibility
features then it might be a very large problem indeed. It may
be safe to assume that only the blind or partially sighted person
concerned is the appropriate judge of whether a task is hazardous
or not.
2.7 In respect of the descriptor 8(c) "Unable
to navigate around unfamiliar surroundings without being accompanied
by another person due to sensory impairment there are no points
currently inserted though the implication is that nine is the
score.
2.8 Many blind and partially sighted people's
vision is affected by the light condition and consequently their
ability to see fluctuates through the day. Our own experience
of the Atos assessment is that people are being assessed for being
able to complete the minimum level of activity only once and in
the optimum of conditions.
2.9 The wider problems with all the descriptors
affecting people with sight loss are that they are supposed to
be assessing impairment functionality in the workplace but none
of the descriptors apply to an actual work environment. The descriptors
assume that the problem for people with sight loss is simply travelling
to work and whether they constitute a safety hazard to themselves
or others once there.
2.10 There is an implied assumption that all
employers have enlightened attitudes to the employment of disabled
people and have also made all reasonable adjustments to their
policies, premises and equipment, this is unlikely because the
disability discrimination legislation is reactive and not proactive
in the responsibilities it places on employers.
2.11 The previously used descriptors correlated
with work based activities eg visual acuity (reading and communication),
field of vision (navigation, orientation and safety) and ability
to recognise people/workmates (expressive and receptive communication).
The tabled regulations contain proposed descriptors that do not
correlate with a work setting. This leads to the inevitable conclusion
that when taken into account with the suspension of the Work Focused
Health Related assessment the system has been reduced to a medical
and not social model of disability.
2.12 There has been considerable support for
those people like ourselves who are critical of the WCA descriptors.
Professor Harrington's first review identified the need to "look
at 'improvements that could be made' (p 630, The Social Security
Advisory Committee referred to particular groups 'being poorly
served by the design and operation of the WCA' (paragraph 1.2).
Finally the Merits Committee wished to see 'fully appropriate'
descriptors brought forward."
RECOMMENDATION 2
We welcome DWP's recent offer of improved guidance
with respect to the interpretation of the descriptors on communication
and navigation and in order to reflect the challenges faced by
blind and partially sighted people.
The RNIB Group would also wish to see either the
retention of the existing descriptors or the impact of sensory
loss reflected in new descriptors.
2.13 In addition to our concerns regarding the
nature of the assessment we also have some specific concerns relating
to the service provided by Atos staff. Our staff has reported
instances of blind and partially sighted clients enduring some
spectacularly bad assessments, these have prompted us to complain
on several occasions to Atos senior management.
RECOMMENDATION 3
In particular we are concerned that systemic failures
occur because lessons learnt from the appeal process are not fed
back into the assessments or the process for conducting the assessments
via JCP decision-makers. Consequently we recommend that Atos be
asked to report on how their work is modified to redress poor
practice identified by the appeal process.
2.14 All the Atos assessment centres should be
expected to be fully accessible to disabled people. Many assessment
centres are not fully accessible for example our staff in Exeter
have reported one WCA having taken place at a customers home as
the assessment centre was not wheelchair accessible. In addition
our staff have reported that even the signing in process is on
occasion not accessible. The absence of disabled parking spaces
at the centre in Stockport sparked media coverage.[13]
RECOMMENDATION 4
These reports lead us to question whether Atos have
audited their centres and procedures to ensure consistency of
provision for disabled people's access. In order to demonstrate
that they meet their obligations under equality legislation Atos
should be asked to make publicly available access audit reports
for all their assessment centres.
QUESTION 3
The decision-making process and how it could be
improved to ensure that customers are confident that the outcome
of their assessment is a fair and transparent reflection of their
capacity for work
3.1 Atos medical reports are often erroneous;
our staff reports one example where a visually impaired and diabetic
customer's report stated that he had had the pulse in his feet
tested. His GP was astounded, as he has not tested for a pulse
in patient's feet for many years. This case is currently pending
appeal.
3.2 Available evidence from staff supporting
blind and partially sighted claimants suggests that many decisions
are absurd and illogical. For example a service user registered
blind, diabetic and also a double amputee in a wheelchair was
found not to have "limited capability for work". Following
a lengthy appeal process the customer was placed in the support
group. During this process the claimant moved from a position
of securing less than 15 points to scoring 59 points.
RECOMMENDATION 5
We are supportive of the recommendations that emerged
from Professor Harrington's review. We recommend that given that
the Government has indicated its support for these recommendations
that a timetable for their introduction is now published and made
publicly available.
In addition we recommend that the DWP decision making
standards committee be asked to independently review the customer
journey through the WCA.
QUESTION 4
The appeals process, including the time taken
for the appeals process to be completed; and whether customers
who decide to appeal the outcome of their assessment have all
the necessary guidance, information and advice to support them
through the process
4.1 Appeals are taking many months and in some
cases over a year, for example one customers appeal process lasted
16 months. During this appeal no advice or guidance was provided
by DWP. Our staff have reported that only at appeal is specialist
medical information such as a certificate of visual impairment
being taken into account.
RECOMMENDATION 6
Claimants with a visual impairment should be invited
to bring any additional medical evidence including a certificate
of visual impairment with them to the assessment. The LiMA software
used by Atos assessors should be altered to ensure that assessments
are able to capture the significance of this additional medical
evidence.
RECOMMENDATION 7
It shouldn't be necessary for claimants to have to
write to DWP for a copy of their own assessment report. Atos reports
in suitable accessible format should be shared with claimants
as a matter of course.
QUESTION 5
The outcome of the migration process and the different
paths taken by the various client groups: those moved to Jobseekers
Allowance, including the support provided to find work and the
impact of the labour market on employment prospects; those found
fit for work who may be entitled to no further benefits; those
placed in the Work Related Activity Group of the ESA, including
the likely impact of the Department's decision to time-limit contribution-based
ESA to a year; and those placed in the Support Group
5.1 The number of our clients likely to be migrated
stands at 16,470 of whom 5940 are female, 10,530 are male and
the remainder unknown. Our clients represent 0.77% of the total
IB caseload. IB/Severe Disability Allowance caseload for working
age—ICD categorisation diseases of the eye and adnexa, as
of February 2010 (last available update).
5.2 With respect to ESA claimants the picture
is as follows—(from Table 10 of 5.3 of "Employment
and Support Allowance Work Capability Assessment by Health Condition
and Functional Impairment" DWP, dated October 2010 using
the same ICD classification).
| Numbers | Percentage
|
| Placed in the support group | 200
| 4.8% |
| Placed in the work-related activity group |
1,300 | 31% |
| Did not complete the assessment | 1,400
| 33% |
| Still in progress | 100 |
2.4% |
| Found fit for work | 1,400 |
33% |
| 4,200 of our clients in total |
5.3 We are concerned firstly by the high proportion of claimants
not completing the assessment and it is our hope that the reasons
for this will be determined through Professor Harrington's next
review. Secondly we are perturbed by the very high proportion
of our clients that have been found fit for work with the possibility
that these people will neither obtain work nor employment support
to find work. These people will instead be placed on Jobseekers
Allowance where they will face a tougher conditionality regime.
5.4 We are also concerned at the impact of the time limiting
of contributory ESA for the people in the Work Related Activity
Group. The Shaw Trust, a welfare to work provider, has stated
that it doesn't help to rush ESA claimants or place unrealistic
demands on them. Many blind and partially sighted people require
longer term support. Recent analysis on the Pathways to Work Programme
(January 2011) reveals that only 12% of clients with "diseases
of the eye" were able to find employment within one year
of joining the programme. Consequently we are concerned that many
blind and partially sighted claimants will be affected by the
time limiting of ESA. The effect will be to force them onto JSA
where they will receive less support to find work and face a tougher
regime of conditionality. The impact will be to reduce the income
of many by up to a third and leave them with a significantly lower
standard of living.
5.5 The RNIB Group recently obtained findings from research
conducted by the University of Birmingham, into the impact of
the recession on the employment rate of blind and partially sighted
people. The research shows that since September 2008 there has
been an 8% fall in their employment rate. This research highlights
the vulnerability of our clients to the current recession and
the challenges they face in obtaining and retaining work.
RECOMMENDATION 8
The proposal in the Welfare Reform bill to time limit contributory
ESA for those in the Work Related Activity Group should be abandoned.
5.6 Finally we would highlight a gap in provision existing
between the Pathways to Work Programme ending and the new Work
Programme beginning. Disabled clients in the work related activity
group would be left without employment support at a time of very
high and rising unemployment.
QUESTION 7
The time-scale for the national roll-out for the migration
process, including the Department's capacity to introduce changes
identified as necessary in the Aberdeen and Burnley trials
6.1 The Social Security Advisory Committee concluded in their
own report that there was a mismatch between incorporating the
improvements required to ensure fair treatment of claimants and
the time planned for a national roll out of IB migration. We are
aware that the Minister for Work and Pensions has indicated his
willingness to introduce Professor Harrington's recommendations
but is also aware that these changes will not all have been made
prior to IB migration starting. Finally we are concerned that
there may be an as yet unresolved dispute over Professor Harrington's
recommendation that claimants should have the right to have additional
medical evidence taken into consideration (such as a Certificate
of Visual Impairment) and ATOS own willingness to modify the LIMA
software to achieve this.
RECOMMENDATION 9
There ought to be consistency of treatment for all those being
migrated and we would therefore endorse the SSAC recommendation
that the IB migration be suspended until the WCA is fully revised
and the LiMA software suitably modified to reflect this.
April 2011
13
see http://menmedia.co.uk/stockportexpress/news/s/1417282_blue-badge-row-hits-new-centre Back
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