Written evidence submitted by Equality
2025
1. The intention to re-assess everyone who has been
on IB to establish if they are fit to work or should move to the
ESA Work Related Activity Group or Support Group has, understandably,
provoked a great deal of fear. If not handled in a sensitive and
considerate manner, the fear engendered by the process itself
may well serve to exacerbate some people's health condition/impairment
and thereby have the paradoxical effect of rendering them less
fit for work.
2. We would like to raise four issues in relation
to the migration process for your consideration.
ISSUE 1: THE
DURATION OF
RECEIPT OF
INCAPACITY BENEFIT
(IB) AND NEED
FOR A
HOLISTIC ASSESSMENT
3.Many people have been receiving IB for many years
and some are now approaching retirement age. The condition that
led them to IB has therefore been exacerbated by years of inactivity.
4. There was a large influx of people to the
IB roll at the time of the demise of traditional industries (eg
coal mining). Those of us who were working in the field at the
time were aware that, at this time, many people were actively
encouraged to apply for IB, (at the time there was a commonly
held belief that people were encouraged onto IB to reduce the
numbers who were classified as "unemployed"). Whatever
the reasons for their entry to IB, many who have been on IB for
decades have received little or no treatment for their condition
or vocational assistance and have long ago abandoned any hope
of returning to employment. While we would welcome the provision
of support to a group who have often received none, for many the
accumulated barriers may make re-entry to the labour market extremely
difficult, if not impossible.
5. We are concerned that decisions about the
fitness for employment of those on IB will be based on the Work
Capability Assessment (WCA). The Work Capability Assessment provides
only a narrow assessment of their functional capabilities. It
does not take into account other facets of a person's life and
circumstances that in any holistic, "real world", evaluation,
might significantly impact their possibilities of employment.
6. We would therefore ask that the Select Committee
consider the possibility:
— That
everyone on IB be automatically transferred to the ESA Work Related
Activity Group where they would receive assistance to move towards
work. Anyone wishing to be considered for the ESA Support Group
could then request an assessment for this. This would greatly
decrease the enormous costs associated with the re-assessment
of everyone on IB, as well as the fear engendered by the process,
and ensure that people received the support to return to work
that should be their due.
— That,
for the purpose of assessment of those moving from IB to ESA,
the WCA be augmented/replaced by a more comprehensive social assessment
of the person's work capability that takes into account the manifold
barriers of health, life and circumstances that, in the real world,
influence a person's ability to re-enter employment, what it would
take to break down these barriers, and whether the necessary support/adjustments
are available.
ISSUE 2: THE
QUALITY AND
APPROPRIATENESS OF
THE WORK
CAPABILITY ASSESSMENT
7. We remain concerned about the quality of the
Work Capability Assessment (WCA). Disabled people continue to
fear the process and report that it does not provide an accurate
evaluation of the barriers that they face in relation to work.
These anecdotal reports are substantiated by the large number
of decisions that are overturned at appeal.[76]
If, on the basis of a more thorough review of all the available
evidence, the appeal tribunal so often reaches a different decision
then we consider that this must reflect a failure of the WCA to
collect all the relevant information.
8. The review of WCA conducted by Professor Harrington
identified many shortcomings in the WCA process. While it may
have been possible to implement some of the recommendations made
by Professor Harrington to improve the quality and experience
of the WCA, it would seem premature to embark on the large scale
assessment of everyone on IB without evidence that the measures
he proposed to improve the WCA have had the desired effect.
9. In his review, Professor Harrington acknowledged
that there was particular concern over the WCA mental, intellectual
and cognitive function descriptors and the extent to which these
offer an accurate picture if, as is so often the case, the person
has a fluctuating impairment. He commissioned a review of these
by three major charities, (Mind, Mencap and the National Autistic
Society) in conjunction with an expert scrutiny group of professionals
in the area. This report was completed at the end of March 2011,
but we are not aware that its recommendations have been implemented.
As there are a disproportionate number of people in receipt of
IB who have a primary mental health impairment, it would seem
premature to use the existing WCA as the basis for migrating recipients
from IB to JSA.
10. We would therefore ask that the Select Committee
consider the possibility of:
— Ensuring
that all the recommendations of the Harrington review, (including
the changes recommended to the mental, intellectual and cognitive
descriptors), are fully implemented and their veracity evaluated
prior to use of the WCA to establish the "fitness to work"
of those receiving IB.
— Augmenting/replacing
the WCA with a specifically designed, more holistic assessment
of barriers to work (as indicated in issue one above).
ISSUE 3: THE
AVAILABILITY OF
SPECIALIST DISABILITY
EMPLOYMENT SUPPORT
11. We are concerned about whether those disabled
people who are considered fit for work, or placed in the ESA Work
Related Activity Group will receive the specialist support they
need to help them into employment. The DWP offers a number of
specialist disability employment programmes, including Work Choice,
Employment Support through Remploy, Access to Work and Residential
Colleges. However, the number of places within these is strictly
limited. The migration of people from IB is likely to create a
situation where there may not be enough places on specialist disability
employment programmes for everyone who needs their help.
12. We would therefore ask the Select Committee
to consider the possibility of:
— Requiring
that everyone reassessed be offered the specialist support that
they need either through one of the DWP funded disability employment
programmes or through one of the numerous voluntary and charitable
sector employment support providers that exist.
— Allowing
people to remain on their existing benefit unless, and until,
appropriate support is available.
ISSUE 4: THE
AVAILABILITY OF
APPROPRIATE TREATMENT
13. Sadly, it is too often the case that people
receiving IB have not been offered the treatment that is appropriate
to their condition, (as recommended by the National Institute
for Health and Clinical Excellence - NICE - guidance). While this
may be the case for many conditions that impose barriers to work,
it is widely acknowledged to be the case for people with mental
health conditions, especially the depression and anxiety experienced
by the majority of those claiming IB because of mental health
problems. The Increasing Access to Psychological Therapies programmes
in England were specifically introduced in order to rectify this
shortfall, however they are not yet available to all and it remains
the case that many people with conditions that may benefit from
these interventions do not have access to them. Unless a person
has been offered the treatment appropriate for their condition,
including assistance in managing their condition themselves, it
is not possible to accurately determine their fitness for work.
14. We would therefore ask the Select Committee
to consider:
— Requiring
that the assessments used in the migration from IB to ESA explicitly
consider whether a person has been offered the treatment they
require for their condition as determined by NICE (and related)
guidance.
— Allowing
people to remain on their existing benefit until they have been
offered the appropriate treatment for their condition.
May 2011
76 http://www.dwp.gov.uk/docs/wca-review-2010.pdf Back
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