Migration to ESA

ESA 55

Written evidence submitted by Caroline Richardson

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 person.

1.1. 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.

1.2. 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 including:

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 or illness.

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 9 metres to 3 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. and 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 when;

a) They cannot see the EMP’s report

b) They have been judged to have capacity to work ONLY at a work

station

c) They 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 6 months, who then appeals to be moved into the Support Group. The time delay for appeals (currently in excess of 6 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 6 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 6 months wait for an appeal is the shortest time available at present for the majority of the UK, and that awards are often for 3, 6 or 9 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. 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.

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:

6.1.1. those moved to Jobseeker’s Allowance, including the support provided to find work and the impact of the labour market on employment prospects;

6.1.1.1.1. 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 6 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.

6.1.1.1.2. 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 Job Centre. They may be too ill to attend the Job Centre. They may not be able to access that assistance they need to attend.

6.1.2. those found fit for work who may be entitled to no further benefits;

6.1.2.1.1. 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 health.

6.1.2.1.2. 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.

6.1.2.1.3. 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.

6.1.3. 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;

6.1.3.1.1. Whilst in the WRAG claimants will be expected to attend

WR activities, which may contribute to a deterioration of their condition.

6.1.3.1.2. 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 WRA.

6.1.3.1.3. 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.

6.1.3.1.4. 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 health.

6.1.3.1.5. 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.

6.1.3.1.6. 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.

6.1.4. and those placed in the Support Group.

6.1.4.1.1. People in the Support Group will be constantly

re-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 3, 6, 9, or 12 months, up to 2 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 Burnley trials.

7.1. Implementing change to criteria before implementing the

Harrington report is wrong, and not the intention of the Harrington report.

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 or disabled.

Summary;

It appears that the ESA WCA is too either being applied too strictly, or that the criteria are set for very low levels of functioning.

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 and conditions.

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 claimant.

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 work places.

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, i.e. sickness and disability.

People should not be sanctioned when they cannot comply with regulations because of a situation beyond their control, i.e. sickness and disability.

Couples should not be financially penalised because of a situation beyond their control, i.e. sickness and disability.

April 2011