Written evidence submitted by Citizens
Advice Scotland
SUMMARY
— 207,000
people in Scotland claim Incapacity Benefit. The majority of these
claimants will be reassessed in the next three years, involving
over a thousand re-assessments each week in Scotland.
— ESA
has arguably been the most concerning issue for bureau advisers
in the last two years. Advisers regularly report of clients with
significant health problems who they feel are inappropriately
found fit for work.
— The
Tribunals Service and Citizens Advice Bureaux have been overloaded
by a massive caseload of ESA appeals. Figures in January 2011
showed that 31,800 ESA appeals in the UK were cleared at hearing
in Quarter 3 of 2010-11—around 2,600 a week.
— The
underlying principle of ESA is that sickness benefits claimants
that have a capability for work are supported into employment.
However, the reality appears to be that claimants are being moved
from one benefit to a less expensive one, or dropping out of the
welfare system altogether.
— Independent
research has found that only 13% of those found fit for work are
being supported into sustained employment. ESA is being hastily
rolled out to a vulnerable section of society before it has been
shown to meet its aim of supporting people into work.
INTRODUCTION
1. ESA has quickly become a significant issue
for Citizens Advice Bureaux in Scotland, both in terms of the
severity of its impact on clients and the pressure this places
on bureau resources. In particular, welfare advisers report of
many clients with serious health conditions who have been found
fit for work, including clients with Parkinsons Disease, Multiple
Sclerosis, terminal cancer, Bi-polar disorder, heart failure,
strokes, severe depression, and agoraphobia.
2. It is important to note that CAS—and
many groups that support people who live with disabilities across
Scotland—support the principle that those who have a capability
for work should be helped into suitable and sustainable employment.
Our concern, and that of welfare advisers, is that ESA is failing
to meet this principle: that it is failing to adequately assess
many clients, failing to help former claimants to find employment,
and may simply be moving claimants from one benefit to another
or out of the system altogether.
THE WORK
CAPABILITY ASSESSMENT
(WCA)
3. Clients and advisers have reported a range
of issues with the WCA, including problems with the assessment
descriptors and healthcare professionals who do not appear to
be listening to the claimant or who distort their answers. Following
the introduction of the assessment in October 2008, it has quickly
become one of the biggest sources of complaints from bureaux clients.
Based upon the experiences of their clients, welfare adviser concerns
about the WCA include:
— The
WCA is often rushed, and
can last just 20 minutes, leaving claimants with the impression
that they have not been properly assessed
— The
yes/no format of the assessment is too narrow,
leaving little opportunity for the client to explain their condition
— The
health care professionals often fail to listen or interact with
the client, which can lead to mistakes
and a failure to properly assess conditions
— The
descriptors often do not cover a client's condition,
especially mental health conditions, and are not based on "real
world" capabilities.
4. A number of welfare advisers detailed the
problems that clients had reported to them regarding the inadequacies
of the assessment and the conduct of the health care professionals:
"I can tell them [clients] word for word exactly
what they are going to say to me, "I was only in for 20 to
25 minutes, they just asked me questions, they never looked at
me or examined me…" I myself have attended two of these
medicals so I know what people tell me is the truth."
"I have had many comments from clients about
the healthcare professionals who carry out medicals. They do not
appear to listen to their answers, they do not look up from the
computer screen, everything is rushed with clients given no opportunity
to try and explain their situation. Also there are many comments
about the medical report stating things that had never been said."
"Many clients are complaining about the medical
assessment: many feel that they are not being listened to; that
the medicals are rushed; that their words are being taken out
of context; and that the questions asked do not relate to their
particular disability. This seems to affect people with mental
health problems especially."
5. The assessment itself is often very stressful
and upsetting for clients, with some reporting that the WCA has
had an adverse impact on their health. A bureau reported anecdotally
that one client who was initially found fit for work was eventually
put into the Support Group after her condition significantly worsened
as a result of the stresses of the assessment process. A bureau
adviser stated what the assessment process entailed for bureau
clients:
"It is fair to say that claimants always feel
the process is making every condition worse."
THE DECISION-MAKING
PROCESS
6. Clients have little faith in the assessment
and decision making process. The problems experienced at the assessment—including
rushed appointments and healthcare professionals who do not appear
to be listening to the claimant—mean that clients are likely
to feel that they have not been properly assessed and that therefore
the decision that they have received is incorrect.
7. This problem is compounded by the decision
letters that clients receive, which are often full of technical
jargon and fail to explain to the client why the decision has
been reached. Without a clear undertanding of why ESA has been
refused, and a feeling that their assessment was inadequate, many
clients feel that the process has failed them and that their only
recourse is to appeal. Advisers explain the problems with decision
letters:
"The decisions, in some cases, consist of one
or two comments made on the medical report and do not give claimants
a clear understanding of why they have been refused."
"… to the ordinary man in the street they
are just a lot of legal jargon and illegible medical reports from
Atos that they cannot really make head or tail of."
8. A number of clients have complained that their
supporting medical evidence has been ignored by DWP decision makers
who have effectively "rubber stamped" the recommendation
from the WCA. This medical evidence is then often used to succesfully
appeal the decision. The Harrington Review found that decision
makers follow the advice of the medical assessors in 98% of cases.
We strongly support Professor Harrington's recommendation that
the DWP decision maker take a far more active role in making decisions
based on both the assessment and the supporting medical evidence.
THE APPEALS
PPROCESS
9. The Tribunals Service and Citizens Advice
Bureaux have been overloaded by a massive caseload of ESA appeals.
Figures in January 2011 showed that 31,800 ESA appeals were cleared
at hearing in the UK in Quarter 3 of 2010-11—around 2,600
a week.[14]
The DWP had originally estimated that 21,000 appeals a year would
reach an appeal hearing.[15]
10. DWP figures show that around 40% of ESA appeals
are found in favour of the claimant. More than 11,000 assessments
were overturned at appeal in Quarter 3 of 2010-11.
11. The high number of ESA appeals has had a
huge impact on the time and resources of Citizens Advice Bureaux.
Welfare advisers estimate that up to 70% of their time is taken
by ESA claims, mostly appeals, with prepartion for each appeal
taking an average of five hours of adviser time. Welfare advisers
are representing clients at hundreds of ESA tribunals each year:
"In a normal year, I deal with up to 250 appeals
on average… but I'm now at the stage where at this precise
moment, I had had 520 appeals come through by books since April.
I'm overloaded and the Tribunal Service is overloaded."
"The appeals process: this is now taking a ridiculous
amount of time and resources which this country cannot afford
and will only get worse."
12. The pressure on the Tribunals Service has
resulted in a significant wait for clients before they have their
appeals heard. The experience of advisers is that appeals are
taking around six to nine months to come to a hearing causing
considerable financial worry and stress to claimants:
"It's unreasonable to expect claimants to wait
six months before their tribunal hearing and for a decision—stressful
for claimants."
"… the six month wait for an appeal to
be heard does not do the claimant's health any good at all."
13. Despite changes made by the Department to
reduce the number of appeals made, it is likely that the re-assessment
will cause another surge in ESA appeals, placing significant additional
pressure on the Tribunals Service and the advice services supporting
these claimants.
THE OUTCOME
OF THE
MIGRATION PROCESS
14. The performance of ESA thus far, and the
significant press attention devoted to it, means that many Incapacity
Benefit claimants are aware of the upcoming reassessment process.
For some, the impending migration is a source of significant worry
and may be making health conditions worse. A welfare adviser explained
how one client viewed her upcoming reassessment:
"A client phoned in a very distressed state.
A friend of hers had told her to telephone the CAB. She is on
Incapacity Benefit and is very fearful about the changes she is
hearing about that could affect her benefit entitlement. She said
she wanted to be dead and last weekend thought of overdosing…
She cried a lot and there were pauses. I tried to reassure her
and not to worry about what may or may not happen."
15. The effects of the reassessment process on
the health of claimants—even before an assessment has taken
place—must therefore not be underestimated. There is a risk
that long-term IB claimants may not understand the significance
of the reassessment or be unable to cope with the process. In
these circumstances, claimants may fail to respond to communications
or fail to attend medicals. One possible outcome of the migration
process is therefore that thousands of claimants will drop out
of the system altogether and be denied the support that they should
be entitled to. It is imperative that these people are supported
in the process and not written off.
FIT FOR
WORK
16. The Department estimated that around 23%
of IB claimants would be found fit for work in their reassessment.[16]
Initial estimates from the pilots in Aberdeen and Burnley found
that 30% of IB claimants had been found fit for work. This would
suggest that up to 50,000 IB claimants in Scotland will be found
fit for work by 2014—around 45 for every day of the next
three years.
17. The stated aim of ESA is to support those
on sickness benefits with some capability for work back into the
workplace. However, it appears that the majority of former claimants
are not being supported into sustained employment. An independent
review of ESA customers published in December 2010[17]
found that only 13% of those found fit for work in their Work
Capability Assessment have been helped into sustained employment.
The majority of those found fit for work either live on reduced
benefits or rely on the income of a partner instead. 61% of those
found fit for work are neither in employment or receiving JSA.
These findings suggest that the ESA process is not achieving its
stated aim.
18. It is likely that long-term IB claimants—who
have already been deemed unfit for work and who are likely to
have a poor employment history—will face even more barriers
to work and will need significant support to overcome them. It
is imperative that substantial targeted support is provided for
former IB claimants in the new Work Programme. The alternative
is a risk that these former claimants will be "creamed and
parked" by back to work providers.
19. Many former IB claimants will be ineligible
for JSA if their partner has an income or if they have savings.
Anecdotally, many claimants who are found fit for work are dropping
out of the benefits system altogether and relying on the income
of their partner to get by.
20. The result of these issues could be a group
of people with health problems who are not in employment or supported
in the benefit system. Far from supporting people into work, the
outcome of the migration process could be to move sickness benefit
claimants on to a less expensive benefit or out of the system
altogether.
THE WORK
RELATED ACTIVITY
GROUP (WRAG)
21. In the recent pilot phase of the national
reassessment, 39% of IB claimants were placed in the WRAG group.
While we have previously argued that far too few claimants were
being placed in this group—about half of the Government's
inititial estimate—proposed changes to the WRAG group will
have a substantial impact on the claimants placed in this group.
22. Those placed in the Work Related Activity
Group (WRAG) will have a time limit of 12 months for claiming
contributory ESA. If they have not found employment by this point,
they will be moved to income based ESA or moved off the benefit
altogether. Around 700,000 people in the UK will be affected by
the change by 2015-16—around 280,000 would lose entitlement
to ESA after 12 months. The average loss (for those those losing
out) would be £51.85 per week (£2,700 per year) if they
do not find employment.[18]
Research undertaken for the DWP[19]
found that 31% of claimants in the WRAG group did not expect to
ever return to work.
23. Assuming that the figures from the pilot
in Aberdeen and Burnley apply to the rest of the country—30%
fit for work; 39% placed in the WRAG group—then the above
figures would suggest that 30% of claimants would be moved off
sickness benefit after their assessment and a further 12% moved
off ESA after 12 months. All told, the Government is estimating
that more than four in 10 current IB claimants (around 75,000
claimants in Scotland) will be moved off sickness benefits within
12 months of their assessment. Whilst it would be a significant
boost to the economy and to these people's lives if they found
rewarding and sustainable employment, only a small minority would
find sustained work if current trends continue. The remainder
would claim JSA or drop out of the benefits system altogether.
THE TIME-SCALE
FOR THE
NATIONAL ROLL
OUT
24. 207,000 people in Scotland claim Incapacity
Benefit. The majority of these claimants will be reassessed in
the next three years, which will involve over a thousand re-assessments
each week in Scotland. This is a major exercise for the DWP and
Jobcentre Plus, both of whom are concurrantly being asked to cut
their spending.
25. There is a major worry that the national
reassessment is being rushed and pushed through in an ad-hoc fashion.
Any learning from the pilots that have taken place in Aberdeen
and Burnley has a very short time to be fed into the national
reassessment—there was one working day between the end of
the pilot and the start of the national reassessment.
26. On top of this, the Government are attempting
to combine changes recommended by the Harrington Review with its
new ESA regulations. The multiple changes, and the haste at which
they are required to be introduced, do not suggest a settled system
with which to launch such an ambitious national roll-out.
27. We are also concerned that the haste at which
the national reassessment is being pushed through will potentially
leave Jobcentre Plus and Atos staff unable to cope with the rapid
changes. Jobcentre Plus staff will soon be expected to help thousands
of customers with health problems and poor employment histories
prior to the Government's proposed Work Programme coming into
place in the summer. We are worried that the rapid changes that
are being pushed through will negatively impact on claimants in
the national reassessment.
28. Welfare advisers expessed their concern about
the speed and scale of the national reassessment:
"If I am right in thinking it is expected to
be completed by 2014, I think this is ambitious and I am concerned
the right decision for claimants may be compromised because of
the rush for the migration to be completed. [I] expect disaster
for our clients."
"It appears that the DWP are unable to cope
with the number of cases. I've had clients who have been waiting
more than 12 months for an initial medical—and with 1 million
plus IB claimants to reassess this will only get worse."
29. The speed of the national reassessment is
likely to place huge demand on the services of welfare advisers
in Citizens Advice Bureaux. Bureaux currently deal with around
one new issue each year for every three ESA claimants in Scotland—if
this trend is repeated for IB claimants in the reassessment, bureaux
could expect to deal with almost 70,000 new issues on their behalf.
This welfare adviser explains her expectations:
"We are awaiting this process with trepidation
as we expect our workload to increase substantially."
30. It is also worrying that the Work Programme
will be introduced some months after the national transition from
IB to ESA has started. It is expected that 10,000 Work Capability
Assessments of IB claimants will be undertaken each week from
April 2011 with an expected 23% of claimants found fit for work.[20]
This is on top of the 20,000 new ESA claimants that are currently
being found fit for work each month. Therefore, it is highly likely
that tens of thousands of claimants—many of whom will face
significant barriers to work and pose serious difficulties for
JCP staff—will be found fit for work and encouraged to apply
for JSA before the Work Programme is in place. These claimants
may not receive the support to enter the job market that they
deserve and were promised.
CONCLUSION
31. ESA is a benefit without a good record of
assessing capability for work correctly or for improving outcomes
for claimants. Rushing it out one working day after the end of
the pilot, and at the same time as implementing new regulations
and recommendations from a major review, is a huge risk and has
the potential to impact negatively on some of the most vulnerable
groups in society. Many former claimants will receive support
and return to employment—and this is to be welcomed—but
there is a significant risk that the majority of former IB claimants
will find themselves in a worse position, both in financial and
health terms, than their current situation. This is contrary to
the aims of the exercise.
April 2011
14 http://www.justice.gov.uk/publications/statistics-and-data/tribunals/quarterly.htm
Back
15
Impact Assessment of the ESA Regulations 2008 (DWP March 2008)
Back
16
House of Lords, Merits of Statutory Instruments Committee: First
Report,
http://www.publications.parliament.uk/pa/ld201011/ldselect/ldmerit/7/703.htm Back
17
http://research.dwp.gov.uk/asd/asd5/rports2009-2010/rrep707.pdf
Back
18
http://www.dwp.gov.uk/docs/esa-time-limit-wr2011-ia.pdf Back
19
http://research.dwp.gov.uk/asd/asd5/rports2009-2010/rrep707.pdf
Back
20
House of Lords, Merits of Statutory Instruments Committee: First
Report,
http://www.publications.parliament.uk/pa/ld201011/ldsel/ldmerit/7/70tm Back
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