Written evidence submitted by Caroline
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 reliance of telephone communication throughout
the process can cause considerable inconvenience. The use of the
telephone is not compatible to many sick and disabled people.
Mobile phones cannot be relied upon to always have power, credit
or network coverage. Disabled people may not actually have a conventional
phone, or always be able to access one. The use of a non free-phone
number also is a concern, as these numbers, and the length of
calls involved often raise an additional expense to the disabled
1.2 The lead time for appointments is often not
sufficient for the claimant. There appears to be no acknowledgement
or adjustment for disability when the disability means that the
claimant cannot respond in time, or organise their lives, transport,
care to meet the demands of form filling and assessment appointments.
1.3 The complaints procedure is complex, as the
claimant may be complaining about associated actions. The separation
of the DWP and Atos results in complaints being referred between
the two organisations with neither willing to state they are responsible,
and refusing to be accountable. This adds to the stress for claimants
who are already ill or disabled, and struggle with everyday life.
2. The Work Capability Assessment
2.1 The assessment criteria
2.2 Having read the entire ESA handbook for 2011
I am concerned that the criteria for being "fit for work"
or "fit for work related activity" do not correlate
with criteria of "fit to be employed". The criteria
only demonstrate that the claimant has an absolute minimum amount
of functionality, and this bare minimum will not be acceptable
to employers. Some of those found "fit for work" will
have a very limited window of employment, much reduced by their
illness, condition or disability, compared to a person who has
good, very good, or excellent health.
2.3 The handbook refers to jobs that involve
working at a work station. Out of the whole spectrum of career
opportunities available in the UK, the constant referral to one
single occupation suggests that those who are found "fit
for work" or "fit for work related activity" are
actually only being assessed to be working at a work station.
Hence they are actually only being assessed as "fit for work,
or work related activity that occurs at a work station".
Until the assessment criteria tests for all work types it is actually
not a test for work, or employment.
2.4 The service provided by Atos staff
2.5 From the information I have received, and
from Atos's own literature, the recommended amount of time is
not being taken to complete the assessments. The situation of
"pay-by-assessment" should be stopped to discourage
shortened assessments. The ESA handbook has some 181 pages of
explanation, including constant references to observation and
criteria, which, if completed as dictated by the handbook would
mean at least an hour of assessment. Claimants have reported that
the interview was rushed, that few questions were asked, and the
questions asked were irrelevant. The handbook instructs examiners
to avoid this, but it appears that a proportion of examiners are
failing to remain within the guidelines laid out in the handbook.
2.6 A large proportion of the Examining Medical
Professionals (EMP) do not have English as their first language.
Many did not qualify at British training and educational establishments.
Many are newly qualified. When confronted by an EMP who demonstrates
an inability to understand the claimant, or cannot be understood
by the claimant, or does not recognise the claimants' condition,
then the claimant should be able to halt the assessment and request
a different EMP.
2.7 The handbook is not a simple list of instructions
on how to perform the assessment. It includes statements about
the history and reasons for the ESA that will cause bias. The
assessment must be unbiased, and the handbook clearly introduces
a bias, including, amongst other aspects, the bias of where the
claimant would be expected to work, what type of work they would
be expected to do after assessment etc with the constant referral
to a "work station". An EMP may look at a female as
someone who would traditionally fill a work station based job,
and hence be more inclined to judge accordingly. I request that
the references to the reasons for the WCA are not disclosed to
the EMP, and that references to certain work environments are
either removed, or expanded to cover all working types.
2.8 The handbook makes far too many assumptions
about the client group. It suggests that claimants will mobilise
by public transport, will be walking, will be able to be examined
physically and will improve or learn to accommodate their disabilities
2.9 The handbook does not recognise that there
are incurable genetic conditions that will not improve, or that
some of these conditions cause illnesses that are uncontrollable.
Hence the time intervals for re-assessment are far too short.
The data gathered by the DWP and Atos should indicate if a person
has an illness or condition that currently has no known cure or
effective analgesic. When, and if, a cure, advance or analgesic
becomes available then the Chief Medical Officer for the DWP could
ask that these people are then re-assessed.
2.10 The suitability of assessment centres
2.11 All assessment centres should be checked
for suitable access, lighting, parking, toilets, and have seating
suitable for people with disabilities. Also the EMP should have
individual and sufficient medical equipment and experience for
testing sensory disabilities. The handbook suggests using waving
the hands and counting fingers to test for sight, and reduces
a standard hearing test from nine metres to three metres, whilst
stating that this is sufficient. A test is not a test if the rules
are not the same, it is invalid.
2.12 Customers' overall experience of the process
2.13 Customer's experiences vary. There should
be a "Customer Satisfaction Survey" given to each claimant,
and an independent company that collates this evidence. This evidence
should be included in any reconsideration or appeal, and any complaints
procedures that may occur. This simple survey would improve customer
confidence, which is currently very low.
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 At present Atos claim that they only provide
guidance to the Decision Makers (DM), however the DWP claim that
they only "rubber-stamp" the decision of the EMP. The
handbook states that both the DM and the EMP read the claimants'
provided medical evidence, and use it together with the assessment.
However this does not seem to be happening.
3.2 A customer cannot be confident that the assessment
is a fair and transparent reflection of their capacity for work
cannot see the EMP's report.
have been judged to have capacity to work only at a work station.
have been tested to establish minimal functionality, when the
capacity to work and employability requires much greater levels
of functionality than those tested for.
4. The appeals process, including the time
taken for the appeals process to be completed
4.1 The appeals process can exceed the interval
of ESA granted to the claimants. An example of this would be a
claimant placed in the Work Related Activity Group (WRAG) after
assessment for a period of six months, who then appeals to be
moved into the Support Group. The time delay for appeals (currently
in excess of six months) could mean that the appeal takes place
after the period of WRAG has finished. The claimant then has a
re-assessment for the upcoming period of time based on their current
health condition, and then has an appeal based on their condition
some six months plus earlier. If their condition is the same,
then the second award must match the first, which may result in
a second appeal if they are different. And during this six or
seven month period the claimant has had two assessments, one appeal,
filled out another two or three sets of forms, had to comply to
the WRAG activities (possibly to the detriment of their health).
Can this level of activity, stress and reduction in benefits be
considered to be humane to a person who might well be entitled
to the Support Group? It should be noted that six months wait
for an appeal is the shortest time available at present for the
majority of the UK, and that awards are often for three, six or
nine months meaning that the claimant could enter into a constant
cycle of appeals and re-assessments, where the re-assessments
occur before the previous award has been appealed. Disabled and
chronically sick people cannot sustain this level of stress, and
will result in many claimants simply abandoning the benefits they
are entitled to because they are simply not well enough to continue
in a cycle that is destroying their health. These people will
encounter real poverty as a result.
5. 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
5.1 The reduction of funding for CAB and other
welfare organisations means that many claimants are unable to
access adequate support. Atos refuse to assist beyond their minimal
obligations, the DWP provide only the bare minimum of instructions.
Many claimants complain that they are too ill to attend an appeal,
and have no method of having a representative at the appeal.
6. The outcome of the migration process and
the different paths taken by the various client groups
6.1 Those moved to Jobseeker's Allowance, including
the support provided to find work and the impact of the labour
market on employment prospects;
6.1.1 Many of those moved to JSA are not employable
because of the limitations of their functionality. This is caused
by setting the levels of functionality too low. These people are
then moved onto a subsistence level benefit, that is set up to
allow for the minimum expenditure for an average of six weeks.
These people are still too disabled to be employed, and will be
in poverty through no fault of their own, and will be unable to
change this situation. There are no workplace adaptations that
will negate the effects of illnesses that cause pain, confusion,
exhaustion or absences for medical appointments.
These people are not employable because they will
consistently fail the basic requirements of employability, which
are performance, reliability, attendance and punctuality.
6.1.2 These claimants are more likely to be sanctioned
on JSA as they cannot fulfil the basic requirements of attendance
and reliability and punctuality. They may not be able to afford
the transport to the Jobcentre. They may be too ill to attend
the Jobcentre. They may not be able to access that assistance
they need to attend.
6.2 Those found fit for work who may be entitled
to no further benefits;
6.2.1 These people will be entirely reliant on
the charity of others. They will have no money that actually belongs
to them (unless they have substantial savings). They will be the
only group who have no control over their circumstances, and have
no ability to change their situation. Unlike those of good health,
who can find work doing "something somewhere" the sick
and disabled have a very small "employment window" of
choices, and still have to compete with those who have excellent
6.2.2 It cannot be stressed enough that denying
disabled people money of their own is not right. These people
have not made a choice to be disabled and thus limit their employability.
The decision to remove any income will lead to family breakdown,
abuse and neglect, and be seen as a further burden. Partners will
resent having to work and care and pay for a second person when
the option of walking away is available. More disabled people
will be on their own becoming a greater burden on state benefits
and the NHS.
6.2.3 This group of people will be the only people
who are without money. Non-working Mothers receive Child Benefit,
and can always try to find work without handicap. Pensioners receive
pensions in their own right. Teenagers get EMA and also can find
work without handicap.
Those who are sick and ill and disabled will get
nothing at all, and yet they did not enter into this situation
voluntarily. Most of the population are responsible for their
life decisions, sick and disabled people do not decide to become
sick and disabled, and yet are the one group that is denied money
because of circumstances beyond their control.
6.3 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
6.3.1 Whilst in the WRAG claimants will be expected
to attend work-related activities, which may contribute to a deterioration
of their condition.
6.3.2 These people have already proved that they
were employable, that they had skills and often careers. It is
therefore unlikely that they will benefit from Work-Related Activity.
6.3.3 These people paid into a system that assured
them that should they ever be unable to work then they would be
supported. This promise has been broken; the assurance has been
reneged upon. People do not want to become sick, ill or disabled.
6.4 Those placed in the Support Group
6.4.1 People in the Support Group will be constantly
e-assessed, as the Handbook suggests that very few conditions
should not be. It is a cruel system that states a person is severely
disabled and yet needs to check this every three, six, nine or
12 months, up to two years. The obvious examples that should be
re-assessed are those in the Support Group because they are pregnant
or have a highly contagious disease.
The Support Group means very little regarding financial
security. For those who are re-assessed and move into the WRAG,
they then have to appeal. I think it is beyond the comprehension
of many MP's and policy writers that those in the Support Group
are usually massively disabled or very, very ill, and forcing
them to appeal will cause actual mental and physical harm.
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
7.1 Implementing change to criteria before implementing
the Harrington report is wrong, and not the intention of the Harrington
7.2 Implementing change to contributions based
benefits before the Universal Credit (UC) is introduced will cause
hardship, poverty and relationship breakdown. Under UC Mr Ian
Duncan Smith assured that no couple will be worse off if they
live together. The time limited contributions based benefit cuts
mean that couples will be significantly financially penalised
because they have been unfortunate enough to become sick, ill
It appears that the ESA WCA is too either being applied
too strictly, or that the criteria are set for very low levels
The levels of functioning are too low for employment.
Any level of impairment, illness or disability puts
the claimant at a disadvantage in the employment market as there
will almost always be a fit and well person with the same skill
sets available who will be more reliable, have better attendance
and require less adjustments.
There is little recognition of incurable illnesses
There is an assumption that illnesses or conditions
will all be cured in a given time span (to be decided by an EMP
who may not be familiar with the illness or condition), or that
the claimant will be able to "adjust" given time. There
is no adjustment that can be made for pain when analgesia either
fails to work or has side effects that then in themselves restrict
The WCA stereotypes sick and disabled people by only
giving a "work station" as a work place, and working
in a call centre as an example.
The "work station" work place example is
biased towards those traditionally seen as employees in these
EMP's are not Employment Specialists, nor are they
Occupational Therapists, nor are they Employment advisors. They
may have no knowledge of employment beyond what they have experienced.
They are not specialists in disability despite having completed
a five day "in-house" course. The disability training
should be carried out by an independent body and no EMP should
examine a claimant if they are not experts in the conditions and
the implications of the condition.
Repeated assessments at short intervals are not necessary
for most conditions.
Contributions based benefits should not be time limited
until all IB claimants have been assessed and the UC is established.
People should not be denied personal finances because
of a situation beyond their control, ie sickness and disability.
People should not be sanctioned when they cannot
comply with regulations because of a situation beyond their control,
ie sickness and disability.
Couples should not be financially penalised because
of a situation beyond their control, ie sickness and disability.