Migration to ESA

ESA62

Written evidence submitted by Equality 2025

Thank you so much for agreeing to accept a late written submission from Equality 2025. We are very grateful for the opportunity to make a contribution to your work.

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’ 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 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 (e.g. 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 (Harrington review: http://www.dwp.gov.uk/docs/wca-review-2010.pdf). 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 1 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

Prepared 10th June 2011