To be published as HC 769

House of COMMONS



Work and Pensions Committee

ESA and WCAs

Wednesday 21 November 2012

Mr Mark Hoban MP and Dr Bill Gunnyeon

Evidence heard in Public Questions 1 112



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Oral Evidence

Taken before the Work and Pensions Committee

on Wednesday 21 November 2012

Members present:

Dame Anne Begg (Chair)

Mr Aidan Burley

Jane Ellison

Graham Evans

Sheila Gilmore

Glenda Jackson

Stephen Lloyd

Nigel Mills

Teresa Pearce


Examination of Witnesses

Witnesses: Mr Mark Hoban MP, Minister for Employment, and Dr Bill Gunnyeon CBE, Chief Medical Adviser and Director for Health and Wellbeing, DWP, gave evidence.

Q1 Chair: May I welcome you both to this morning’s session, and can I also say congratulations on your new job, although it is not quite so new? Hopefully, you have been in the job long enough that you will be able to answer our questions this morning. Can I just formally ask you both to introduce yourselves for the record?

Mr Hoban: Yes. Mark Hoban, Minister for Employment.

Dr Gunnyeon: And Bill Gunnyeon; I am Chief Medical Adviser and Director for Health and Wellbeing.

Q2 Chair: Thanks very much for coming this morning. We have rather a lot to get through, so I hope you will bear with us. Yesterday, we saw the publication of the third Harrington report, but before that publication, back in July of this year, Professor Harrington told the BBC that while he thought his work was improving the process for work capability assessment, he said it was not dramatically better and was "still patchy". Do you agree with his assessment?

Mr Hoban: I think what we have seen-and Professor Harrington, I think, has endorsed this in his third report-is that the Department is making progress in implementing his recommendations. I think we are seeing signs of progress. If you look at the proportion of people joining the support group, that has increased significantly over recent years, which is in part a response to Professor Harrington’s recommendations. So I do think we are seeing progress but, as I said in the foreword to Professor Harrington’s report yesterday, there is more work to be done.

Q3 Chair: One of the areas where there is still a bit of dispute, certainly from claimants, is that they thought that Professor Harrington had recommended there should be audio recording of many of the interviews. Now, the progress on that is not patchy; it is almost nonexistent. When is that going to happen?

Mr Hoban: Well, I think, Dame Anne, we should look at audio recording and certainly the results of the evaluation that we did. What is interesting is that we do offer audio recording; it is there at the claimant’s request. The take-up rate is phenomenally low: about 40 or 50 people a week ask for the recording. The evaluation suggests that 47% of people would find it helpful, but only 1% of claimants in the pilot asked for a copy of the transcript. There has been no evidence that the audio recording improves the quality of the assessment; the quality is the same whether it is recorded or not. So I think we need to look at what the evidence is and the value that the audio recording gives to claimants and also to the integrity of the process.

Q4 Chair: But do claimants know that they can ask for it to be recorded, because quite a number of the contacts I have had from people, who have had generally unpleasant experiences through the WCA, is that either they did not know they could be recorded or, when they have asked, they have been told that that particular assessment centre did not have the equipment; most assessment centres do not have the equipment.

Mr Hoban: No, but if there is a request for recording we can accommodate that request. I think there is quite a lot of coverage about audio recording in the press and on the internet. It is something that should be widely known. We can think about how we might improve people’s awareness of it. What is interesting is when we did the evaluation only 1% of claimants asked for their transcript, and so that does raise a question about how much claimants value the audio recording. Of course, there is a cost attached to this that we need to take into account as well, and if there is strong demand, then clearly we will be able to acquire further machines to do the recording, but I think we need to look at what value this is adding to the process; the evaluation is slightly questionable at the moment.

Q5 Chair: I have to say that your answer sounds a bit like the one I get when I say to a shop or a venue that they do not have wheelchair access and their reply is, "Oh, that is because we do not have any wheelchair customers". I get that slight sense that people have not asked, but if they did ask there would not be the equipment to do it anyway.

Mr Hoban: No, I am not saying there would not be the equipment. I think we can accommodate requests. The point I am making is that if you look at the evaluation, 1% of those in the evaluation asked for a copy of the transcript, which leads to a question about how valued this is by the claimants.

Q6 Chair: The evaluation was an Atos evaluation. Asking for the transcript is not necessarily an indication of how useful it is, because the fact that it was recorded at all is the guarantee for the claimant that what they said is there and has been recorded. For instance, calls to the CSA are all taped, but very, very few people ask for the transcript. It is only when there is a problem that they ask for the transcript, but the knowledge that it is being taped means that they are probably less likely to ask for the transcript, because there is less likely to be a dispute. That is the point of the audio recording.

Mr Hoban: My point is that requests for the transcript are relatively few, less than 1%, and I will be the first to acknowledge the volume of appeals are much greater than that.

Chair: The whole point is the volume of appeals might come down quite dramatically if, as a matter of course, you did the transcript.

Q7 Glenda Jackson: Just following up on your response, Minister, you said that not all the audio equipment is available at every centre, but that it can be provided. How can it be provided? Does the individual have to, before they go for assessment, say, "I would like my session to be audio-recorded"?

Mr Hoban: Yes, and so therefore, if someone makes a request for audio recording, we ensure the equipment is in the centre at the time that meets the needs both of the assessment process and the claimant.

Q8 Glenda Jackson: What is the time gap between the request and the appointment?

Mr Hoban: I am not sure what the time gap is, but I can certainly find that out.

Glenda Jackson: If you would, I would be grateful.

Mr Hoban: Yes, of course, absolutely.

Q9 Teresa Pearce: Minister, the pilot showed that there was not a huge uptake in people wanting audio recording, but is it not correct that the pilot was restricted to people who were new to ESA, new claimants, and no people being transferred from IB in a work capability assessment were included in that pilot? People who are possibly new to benefits-this is a completely new thing to them-are much less likely to have been through the system and know that there might be a difficulty. I think the pool of people you looked at was going to give that result. Do you think that had you looked at everybody undergoing a work capability assessment randomly, rather than picking people who are new to ESA, it might have given a different result?

Mr Hoban: You make a useful point, and it is something that we can go back and just track, to see whether the take up of audio recording is higher amongst IB reassessment claimants rather than ESA claimants. I suspect the answer may not be very different, but we should go back and check that.

Q10 Teresa Pearce: But the pilot was restricted to that group of people.

Dr Gunnyeon: I do not have the breakdown. What I know is that between March and July of this year, some 706 claimants asked for audio recording, which is significantly less than 1% of all facetoface assessments. I do not, however, have a breakdown of new claims versus IB reassessment cases. We can see if we have that information.

Chair: It may only be 1% but 700 is a lot of people.

Q11 Sheila Gilmore: There are two things about this. First, this was a pilot where people were being told that it was being recorded for the sake of a pilot, for somebody else to monitor. I am not sure that judging take up of the people who were involved in it and saying, "Well, they did not ask for the transcript", is relevant; it is likely they did not ask for the pilot either, so I am not sure that it is particularly relevant to say that only 1% asked. But what Professor Harrington says is that he does not seem to feel that the evaluation evaluated the right thing. The issue is not just, it seems to me, about people being confident, but about whether this is going to improve the quality of assessment and, hopefully, reduce the number of appeals. I think what Professor Harrington says is that there needs to be further monitoring and evaluation on this. Is that going to be happening?

Mr Hoban: We will continue to evaluate it, but I would just make this point that we do have evidencebased policy-making. The reason why we have pilots is to assess the effectiveness of new innovation, particularly given that we are spending taxpayers’ money doing this. Therefore, we do need to demonstrate that there is value for money from introducing a new process. It is something that is common across all of DWP. It is something that we are doing in labour market interventions, on Harrington, the audio recording and other areas too. So I think we should not be dismissive of the fact that it is a pilot, because we do need to see proper evidence and evaluation of initiatives that we make. But we will continue to look at this and continue to monitor the take up and the quality, if there is any improvement in quality as a consequence of introducing audio recording.

Q12 Jane Ellison: I just wondered if it might be helpful to have a bit of an understanding around those costs. You mentioned assessing things in terms of it being a cost to the taxpayer. Do you have any idea of what that would be?

Mr Hoban: I do not have a figure to hand, but what I would say is that this is not just putting your iPhone on the desk and recording a conversation. These are highly sophisticated devices. They are dual-recording. They come from a specialist supplier, so there is a cost attached to commissioning those, and if the demand is there then we will roll more out. At the moment, I think what we have is sufficient to meet the demand that is there.

Q13 Chair: Can you just confirm that the pilot was an Atos pilot limited to 10 volunteer healthcare professionals?

Mr Hoban: I believe that is right, but I do not see why an Atos pilot is any less valid than any other pilot.

Q14 Chair: I think it is the limited to 10 aspect.

Mr Hoban: Again, there are, I think, 600 doctors employed by Atos.

Dr Gunnyeon: There are 330, and 600 nurses.

Mr Hoban: So do we really want a pilot rolled out across 1,000 professionals? We do need to look at it on a sensible basis rather than having a wholesale roll-out and then evaluate it. I think that quite often we will do an evaluation based on a small number of Jobcentres, for example, so I do not think it is unusual to have a pilot based on a relatively small subset of the population.

Q15 Graham Evans: When I get constituency casework coming into my surgeries over various things in terms of work capability, as an exemployer I have employed lots and lots of people with various degrees of capability and so on and so forth. I always make an assessment of them the moment they walk through the door, and I always feel that usually I think they are capable of work, unless there is a clear physical ailment, but even then, within my constituency, there are employers, such as call centres, where people could work in a sedentary position. However, the ones I always feel slightly uncomfortable about are the ones with a clear mental or intellectual cognitive issue. For me, that goes to the core of the problem that we have here, because we have a big chunk of the population who really, with some help and support, could get work, but I think Professor Harrington has made a few points regarding mental, intellectual and cognitive champions and what benefits they have brought to the WCA process. The question I have for you is: how many champions are currently in post? Does Atos intend to recruit more? Do they mainly provide a telephone system or are they located on premises, and is their advice available to DWP decision makers or only the Atos staff themselves?

Mr Hoban: I think, Mr Evans, you have highlighted quite a key issue here. How the system deals with people’s mental health and other issues is a real challenge. We need to get that right. Professor Harrington made a very valuable recommendation when he suggested we should have mental health champions in place. There are 60 of them. They are based in regional centres, so if the mental health champion is resident in that centre, then clearly there is facetoface contact. There is also a facility for the healthcare professionals in each centre to contact the mental health champion and get advice from them, whether it is a particularly challenging case or where they just need more advice and guidance on a particular condition. So there is that interaction that is there, and that is absolutely vital to strengthening the process.

One of the things that is picked up, I think in Professor Harrington’s third report, is that we are seeing more people referred to either the support group or the workrelated activity group who have mental health issues than we saw earlier on in the process. Therefore, it strikes me that the evidence is that that improved resource is helping getting decisions right first time.

Q16 Graham Evans: But the evidence from the mental health organisations was presented about 20 months ago. Why has it taken so long for that to be incorporated into Professor Harrington’s report?

Mr Hoban: We have put the champions in place. We have made sure that the right people are recruited. There is more work we are doing on mental health issues, partly as a consequence of the proposals made in the response to Professor Harrington’s second report, looking at the descriptors of mental health problems. A number of mental health charities put forward proposals about how those descriptors could be used and we are undertaking a review of those at the moment, making sure that the descriptors gather the right evidence to enable us to make the right judgments. It is an ongoing process. We inherited a system that was, I felt, flawed. Professor Harrington’s three reviews have helped improve that system, but there is more work we need to do.

Q17 Graham Evans: Once somebody has been assessed that they perhaps may have a mental issue, but it is not a showstopper-they are perhaps capable of work with help and support-what has been put in place to look at local employers who are willing and able to offer people with cognitive issues or mental issues a place in employment, whatever that may be? I personally have a list of employers within my constituency who I know I can recommend to my constituents: "I know these people have vacancies. Have you applied there? These people are supportive for people with disabilities; you can work there." It is okay saying these people are fit for work and then that is it, but have you thought about which are the employers that have vacancies and have the wherewithal to support people into work? Do we have something in place that can facilitate that?

Mr Hoban: What happens, Mr Evans, is that people who are assessed either as fit to work or, increasingly, as part of the workrelated activity group will be given support by Jobcentre Plus. There is a disability employment adviser in each Jobcentre. The next stage, if that is not sufficient support to get somebody into work, is for someone to be referred to the Work Programme, which is our main vehicle for helping people who are longterm unemployed into work. We rely upon the employment advisers in Jobcentres, and the people who are operating the Work Programme, to identify those employers who are willing to employ people with a whole range of conditions and to ensure, crucially-I think this is one of the important points-that both the employer and the employee get support once they are in work. But it is very clear: there are a lot of people with mental health conditions who are capable of work and who are working. One of the challenges that we face as a society, and one that I think Members of Parliament are addressing, is destigmatising mental health conditions and making a very positive case for people with mental health conditions to be employed in the same way that everybody else is.

Q18 Graham Evans: Absolutely. When will Professor Harrington’s successor be appointed?

Mr Hoban: We will do that shortly. We felt it was important for Professor Harrington to complete his third report and for Professor Harrington to develop his recommendations about what his successor should be addressing, but we will be appointing him or her shortly. I would take this opportunity, Dame Anne, to place on record my thanks and the thanks of the Department to Professor Harrington for the work he has done over his three reviews. I think he has made a major contribution to refining the process and that contribution should be recognised and valued.

Q19 Glenda Jackson: I think, Minister, you said there are 60 champions at the moment. Is that the correct number?

Mr Hoban: Yes.

Q20 Glenda Jackson: How is that number arrived at, given the huge variations there must be in the client count? If I look at my own area of north-west London, for example, I understand there is only one mental health champion for a very, very big area.

Mr Hoban: We discussed with Professor Harrington where people should be located and where the champions should be based. He agreed with us that it should be done on a subregional level, and the regions have been put in place for the management of this contract, but I think that the coverage is reasonable, is it not, Bill?

Dr Gunnyeon: Yes. What is important to recognise is that in the training of the healthcare professionals doing the assessment, there is a significant focus on helping them understand how to deal with people with mental health conditions. We must not assume that healthcare professionals need advice in every case. One of the challenges is to ensure that we are utilising the expertise of the mental health champions as fully as possible and, therefore, rather than trying to have one in every assessment centre, where they might not be used very often, it makes much more sense to have them current and to have them available. There is always somebody available for healthcare professionals while they are doing an assessment, whether they want advice before they start an assessment, or to pause an assessment and go and seek advice, or to seek advice before they complete their assessment report. So they are available; it is about trying to use the resource as costeffectively as possible and trying to make sure that the expertise is available when it is needed, rather than it being there but not necessarily being used.

The feedback from Atos healthcare professionals, and I think Professor Harrington referred to it in his report, is that they have found this extremely helpful. What we do not want is for healthcare professionals to feel that in every case they have to seek advice because they are not able to undertake the assessment. They are looking at the impact of the condition on the individual’s capability for work, rather than looking at the diagnosis and treatment of the condition, so it is that aspect that is important.

Q21 Glenda Jackson: This is entirely anecdotal and specifically from my own constituency, but that additional support is not always there for everyone with a mental health condition and this can affect and impact upon their assessment. Also, I do think there is a gap relating to Jobcentre Plus. You spoke of the individual working with the individual. Again, this is anecdotal but the numbers are rising. What happens, for example, when an individual Jobcentre Plus person who is working with someone with mental health conditions is on holiday, or ill? There is no one to fill that gap, but the individual is still waiting for that kind of assistance and may, in some instances, lose the opportunity to be interviewed for employment. The point I am trying to make is that it is not seamless.

Mr Hoban: No, but we need to strike a balance on resourcing and get that right, because the more resources we spend in one area, the less money we have to spend in others. It should be entirely possible within the Jobcentre Plus network, where someone is away on holiday, for someone to be able to provide support to people with disabilities without having doublemanning all the time.

Q22 Glenda Jackson: I am not saying that there should be doublemanning all the time, but these are real situations, and this is a group of people for whom we were assured by the Department that there would be special kinds of support systems. All I am saying to you is that it does not seem to be working at the moment.

Mr Hoban: That is why we have disability employment advisers in each Jobcentre, and you too acknowledged the point that there should not be doublemanning. So what we do need to do is ensure that, where there are absences, whether it is vacation or illness, there is cover in place so that people do not lose that support, so that it becomes seamless. If you have any particular examples, I am very happy to look into them.

Glenda Jackson: Good, I will write to you.

Mr Hoban: Yes. I think you do quite regularly anyway.

Glenda Jackson: I certainly do.

Q23 Sheila Gilmore: One of the major issues in the second Harrington report was this whole question of the descriptors, not just for mental health but for fluctuating conditions as well. We were told at that stage that there would be a gold standard review; it would be early in 2012. It now appears that we are unlikely to get a result from this until summer 2013. What exactly is happening to test these proposed different descriptors? What process is your Department going through?

Mr Hoban: Bill can talk about this in a bit more detail, the challenge is that a number of charities did raise issues about descriptors; they suggested some alternatives. What we need to do is to see whether those alternative descriptors are more effective in identifying fluctuating conditions. That does require a pilot. It does require evaluation to ensure we get it right, because the aim of the changes we are making is to improve the accuracy of the decisionmaking process. So if we are going to roll out new descriptors for conditions, we need to be certain that they are a better fit and a better predictor than the current ones. But Bill, do you want to talk about the pilot?

Dr Gunnyeon: The assessment is a complex and difficult process, and, interestingly, we have been working very closely with the charities to look at the recommendations they made, both on the mental, intellectual and cognitive descriptors and also fluctuating conditions. I think they also have realised that developing descriptors as part of the assessment that will do what you want them to do, and will be able to be captured in the legal framework that is required, is a challenge.

There are a number of components to the work we have been doing; the first one was to take the descriptors that were in a very general form, which the charities recommended, and to work with them to try to develop those into a format that would be testable, because clearly that is the first stage. That has been quite time-consuming. We have had something of the order of 25 to 30 meetings with the charities as we have developed the descriptors, but it has been incredibly helpful. We then have to put a process in place to test our current descriptors against those new descriptors, and that means that we have to train the healthcare professionals who are going to do the testing, so there is obviously quite a bit of work there. Having done the assessing of a not insignificant number of cases, and we are looking at doing 1,000 cases, there is then a need to put in place the expert panels that will look at the outcome of the existing descriptors, the outcome of the new descriptors and determine how they think that relates to their assessment, given the information about that individual case-whether or not they think it would have been reasonable to expect them to work. On top of all of that, we have to have an evaluation strategy, because clearly the most important aspect of this is to be able to determine, at the end of the day, whether the new descriptors work and whether they work better than the existing descriptors. I suspect we may find that it will not be an either/or, but that there will be some areas where it improves the process and some where it does not. But what is very important is that if we are going to implement significant change to the assessment-and this would be a fairly significant change-we need to be sure that we have the evidence that if we do that it will have the impact that we expect.

So it has been a timeconsuming process. We are broadly on track; we said that we expected to have a report in the spring of next year. The full report, because of some of the detailed evaluation, may be in the summer, but we still expect to have some results during the spring. Obviously we will start to learn lessons as we go through the process, but it is the fact that it has taken quite a long time, and I think the charities we are working with, who have been incredibly helpful, have also found it very difficult, and that has meant it has taken longer as well. However, we are very much progressing as quickly as we can.

Q24 Chair: It sounds as though it is taking you longer to do the alternatives than it did to do the original ones.

Dr Gunnyeon: We did spend quite a long time on the original one as well.

Chair: Yes, but I do not think quite as long as that.

Q25 Nigel Mills: I would agree with Mr Evans here that most of the cases I see in my surgeries are people with mental health conditions who have not got the answer they wanted or, in some cases, I think, pretty clearly have not got the right answer. Do you have data that shows that that is what is happening-that the level of successful appeals is greater for people with mental health conditions than others? Also, I think this whole process is very difficult for someone with a mental health condition. The whole customer journey, as I think you call it, puts a lot of stress on them. They do not really understand what is going to happen, and they are very scared of what the outcome will be. Is that something you are also working on, trying to make this a less harmful process for them?

Mr Hoban: It is important to make sure that this process is as easy as possible for people to go through and that we do as much as we can to guide people through that journey, so there are additional steps in place for vulnerable customers. There is much more communication with vulnerable customers than with other customers, so we do try to make sure those steps are in place. When the Department makes a decision that goes against the claimant, there is a telephone call then to help guide people through what is happening. I think we have improved the contact with vulnerable customers and particularly those with mental health issues. It is important that, where you have evidence submitted by a GP or another health professional, they also take the opportunity to highlight that someone may be vulnerable, so we can give them the right support.

I think one of the other challenges is the way in which Atos has been portrayed in the press over recent months; that has increased the level of stress. I went to Birmingham yesterday to visit one of the Atos assessment centres, partly in preparation for today but also to increase my understanding of the process, and certainly that was one of the issues that the healthcare professionals raised. I think we should recognise, if we look at the evidence from the Tribunals Service, that, where they disagree with the decision the Department takes, in only 0.3% of cases do they put this down to a failure in the Atos medical assessment and the level of complaints against Atos healthcare professionals-doctors and nurses-is lower, proportionally, than complaints against similar healthcare professionals in other sectors.

Q26 Stephen Lloyd: Welcome, Minister. I am reminded for the last two years I have had the joy of harrying you on Equitable Life, so it is good to see that you are now Minister of Employment and in front of me in Work and Pensions. We are moving on to Atos, but just before I do, there are a couple of things I would like to quote back to you from your statement on the Harrington report, because it underpins what the Coalition is trying to achieve with the Work Programme. In the second paragraph you state, "As part of the Government’s ambitious Welfare Reform programme, we are keen to ensure the WCA is as fair and accurate as possible. Those who are assessed by the WCA and found fit for work or with the potential to return to work will be given support to help them do so; those who are unable to work will continue to receive full support". Your penultimate paragraph is, "We welcome Professor Harrington’s assessment that the WCA has improved further over the last year. However, we also recognise that there is more to do and we are committed to improving the system." Obviously that is very definitely on the record and I appreciate that. There is the whole issue and the whole area of concerns around Atos, both from Professor Harrington and, as you have alluded, in the media and on the internet; Atos is a key part of the whole process.

Before that, though, we had a very speedy read of Harrington’s final report, and one thing he emphasised is that the whole effort cannot stop; it really must keep going over the next few years, otherwise all the effort and all the changes that Harrington has recommended and, to a certain extent, DWP have implemented, will just fade away. Are you absolutely committed to keeping the Department’s foot down hard on the accelerator over the next few years to really ensure those recommendations are implemented?

Mr Hoban: Yes, absolutely, Mr Lloyd. I think that it is absolutely right for us to continue to drive through further changes to this process and this system. I think we should accept Professor Harrington’s view that he thinks this is the right process, and that it does not need radical reform but it needs continuing refinement. We have accepted his recommendations in his first two reports, accepted his recommendations in this one-although one is in principle-and we have committed in statute to having a fourth and fifth review. To be honest, even if we were not required to have it in statute, I think we would want to have it anyway, because I think it is the right way to look at this. We will continue to drive through change to increase the proportion of decisions that are made that are right first time.

Q27 Stephen Lloyd: And that is incredibly important, because picking up on what my colleague, Dame Anne Begg, talked about, some of the recommendations are taking a long, long time to bed in. I have been around long enough to know that it is then quite easy, sometimes, for a Government Department to begin to take its eye off that ball. It is absolutely essential that the changes that are happening keep happening, because they will take many, many more months to really bed in, because it is such a complicated area. I am grateful that you have given that absolute commitment, and I know the Select Committee will be following that very, very closely over the next few years.

Moving on to Atos, could you give me that figure again? What was that 0.3% figure?

Mr Hoban: What we have asked the judges to do is, in areas where they overturn the DWP decision, to use a dropdown menu to set out why they have decided to overturn our decision. One of the options is about the Atos medical assessment and they cited that in 0.4% of cases as the reason for overturning the Department’s decision.

Q28 Chair: Can I just be clear on that, because under the figures I have from the tribunal there is 0.2% where the decision maker misapplied the law-I do not know if that is what you mean-and there is a 0.4% where medical/functional assessment report, relied on by the decision maker, contained significant error. Those two together is 0.6%. Then in 33% the tribunal did not give a reason. But there is another category where, on exactly the same evidence that was before Atos and, indeed, the decision maker, 16.2% of tribunal cases reached a different conclusion. So those figures really need to be all added together, because in all of those cases the Atos assessor is coming to a different conclusion to the tribunal, either because of mistakes, misapplying the law or just coming to a different conclusion.

Mr Hoban: I think there are different issues. First of all, let me very be clear-I think you have allied two things here: the decision is made by DWP; it is not made by Atos, so I think it would be inappropriate to add DWP and Atos together. Atos provide medical assessment, which is used by decision makers to reach a conclusion on whether someone-

Q29 Chair: But the tribunal do not separate them out.

Mr Hoban: No, they do. That is why there are two separate lines. There are two separate lines there for a very clear reason: to emphasise the fact that there is a big distinction between the work that Atos does and the work DWP does in making decisions about someone’s eligibility for employment support allowance. I am afraid one of the reasons why there is such adverse criticism of Atos-unfair criticism-is that people make that mistake of confusing the roles of Atos and DWP and I think it is important to separate that out.

The second point I would make is this: one of the things I did yesterday, as well as visiting the assessment centre and talking to healthcare professionals, is I sat in on a training session for a healthcare professional. What struck me was that whether it is the ESA50, which the claimant produces, whether it is the ESA113, which a medical professional completes or whether it is the outcome of the assessment, what we have is a body of evidence and that is at the heart of the process that is being undertaken. I think it is inevitable, when you then make a judgment about whether that means someone is fit to work, should go in the support group or go in the workrelated activity group, that there is a difference of view in that. We know, for example, that DWP decision makers disagree with Atos on 8% of cases, and I think it is right that people employ their judgment.

I think there is a wider point that we should draw from this, Dame Anne, and that is this: clearly there is a difference in view between tribunals and the Department when assessing broadly the same set of evidence. Now, some of this may be because time has elapsed. Some of it may be a difference of opinion, but we need to explore more closely why it is that the tribunal and DWP reach different decisions, and that is work that we want to carry out with the Tribunals Service.

Q30 Stephen Lloyd: I know we have some questions on that later, so let us go back to Atos in particular. In the Work and Pensions 2011 Report, Minister, on the IB reassessment, we raised the issue of Atos’s policy of overbooking of WCA appointments. The Government said at the time that Atos keeps its overbooking policy under constant review and that it had a contractual target that no more than 1% of claimants should be sent home unseen. The National Audit Office has since discovered that Atos failed to meet that target in all but one month between November 2010 and January 2012. Do you regard that as acceptable?

Mr Hoban: There is a real challenge here, Mr Lloyd, and it is something I did pick up yesterday. We want to make sure that every Atos assessment slot is filled and that we do not have healthcare professionals sitting twiddling their thumbs when they could be doing an assessment. I think we would all want to see that. However, given the rate of no show by claimants, for a whole variety of reasons, Atos do need to book more assessments than there are slots, and I was surprised at how high the dropout rate was.

Q31 Stephen Lloyd: What is the ballpark dropout rate?

Dr Gunnyeon: It is about 30%.

Mr Hoban: About 30%.

Q32 Chair: When we asked that question when we were taking evidence the last time we did the report, there was a difference in the dropout rate between those who were IB moving on to ESA, where the dropout rate was much, much smaller, compared to those who were new claimants who, in some cases, had got better or gone back to work or whatever. That seemed to be causing the problem at that time that, in the test areas where the migration was taking place, there were serious problems in terms of overbooking.

Mr Hoban: I will be looking at that in more detail, but the fact is that the dropout rate is 30% is quite high when we are also setting a target of 1% of people having to go home unseen. So I think there is that challenge about how you manage those resources to get that right.

Q33 Stephen Lloyd: I do accept that. However, what I would posit is that if you are going to set a contractual agreement with a supplier and consistently-perhaps for perfectly logical reasons-you do not penalise them for not meeting their contractual agreement, the challenge with that, and it is human nature, is that even if the supplier was the Angel Gabriel, which I suspect many disabled people do not feel Atos is, they are, I think, going to begin to take less seriously meeting the 1%, even though there are difficulties. In other words, either change the 1% to 5%, or there should be some obvious example of where Atos are penalised; otherwise it is a nonsensical figure.

Mr Hoban: But at the same time, Mr Lloyd, what we also want to do is to ensure that we process people as quickly as possible, that people get their assessment as quickly as possible. If we build in more spare capacity into the system, that then increases the backlog and so there is a very difficult process here to manage the right level of overbooking to maximise the use of Atos healthcare professionals’ time and to ensure that we get people seen as quickly as possible. So it is a difficult balancing act and we do need to keep it under review. Also, I think it is incumbent on Atos to think about how they maintain contact with claimants in advance of the assessment, to ensure that we maximise the number of people who do turn up for their slot.

Q34 Stephen Lloyd: I do agree, I really do, but I would just make one point: month in, month out it is not meeting the 1% and the DWP is not doing anything about it with Atos; there is no formal penalising. So either change the 1% or, I would suggest, penalise, because otherwise it does not make sense.

Moving on to access to Atos assessment centres, a number of my colleagues have already talked about some of their own constituents coming to see them. In the examples around mental health, I have had that a lot as well, but equally, I have had a number of constituents come who are wheelchair users. One in particular, a few months ago was complaining, understandably absolutely bitterly, that she could not get into the Atos assessment centre without being lifted, in her wheelchair, up a number of steps. Now, I am sure you are aware that, for a lot of disabled people who are wheelchair users, the wheelchair is their personal space, so that is not something that they are comfortable with at all, understandably. Therefore, my question is on the accessibility of Atos assessment areas. Do you know what percentage of buildings where Atos are holding the assessments are completely accessible, both from a wheelchair perspective and other disabilities?

Mr Hoban: I would say, Mr Lloyd, that there is a challenge in ensuring that Atos assessment centres have wheelchair accessible assessment rooms. There is a proportion-and I am hoping Bill will find the number in the briefing pack and tell me that percentage. I think it is a relatively small percentage. I would be concerned, though, and I would like to know more details about your constituent’s case, because there are steps in place, prior to someone attending an assessment centre, to flag issues about accessibility and mobility, because what we do not want to do is to get people to turn up to centres that they physically cannot access. There are a couple of steps in the appointment booking process that should flag that, and that is why we would also ensure that people can have home visits, for example, as an alternative. But it is a problem that we seek to minimise and it is for the safety of the claimant that we restrict access where we only have an upper floor assessment centre.

Q35 Stephen Lloyd: On the home visiting, because that again was something we drilled down on last time when we had the Minister in front of us, the DWP told us that any claimant whose circumstances made attendance at an assessment centre unreasonable would be offered a home visit. Is the Department monitoring this and have you any idea of the numbers? Have they gone up, are they static, or have they down?

Mr Hoban: It is a real challenge and I can tell you that we have 123 permanent sites, and 31 of those do not have a ground floor assessment room. What we have identified is that there are a small number of sites-six sites-that account for 73% of the people who are being turned away, and none of them are in your constituency. It is an issue that we need to tackle. I think on home visits, it does create a bit of a backlog, to be honest, because it is just that much harder to get people out to do a home visit.

Q36 Chair: That is terrible. It is quite a small number sending all these people away.

Mr Hoban: Dame Anne, I think it is terrible. Let me be very clear: I think it is unacceptable that six centres account for 73%, and that tells me something about the way in which those issues about access are being discussed with claimants who are being sent to that assessment centre. When I saw the figures I was quite concerned.

Q37 Chair: I think they need to find another assessment centre or something.

Mr Hoban: Where we can we do, which I think is important, but I think there is something more. It sounds as if the administrative process relating to those six centres does not work. Given that there are 31 where there is no ground floor assessment room, it is surprising that six account for 73%. It sounds ludicrous.

Q38 Stephen Lloyd: We would welcome, as a Committee, some information about what DWP is doing about those six assessment centres, because clearly if you are getting 73% turned away from six centres that is just potty. I would like some detail on that.

Mr Hoban: Yes, absolutely.

Q39 Glenda Jackson: Are you saying there are only six centres that are inaccessible?

Mr Hoban: No, there are 31, but there are six centres-

Glenda Jackson: That are responsible for turning away-

Mr Hoban: For 73%.

Q40 Glenda Jackson: But in those centres where they know they are inaccessible, when they contact the individual, do they put in that letter, "If you are in a wheelchair, we will arrange a home visit for you". That is in the first letter, is it?

Mr Hoban: Absolutely. They do all that they can to ensure that they understand exactly who is coming and what the physical challenges are in accessing those assessment centres that do not have a ground floor treatment room, because I think it is wasting both the assessor’s time and, more importantly, the claimant’s time to get them to turn up to somewhere that they cannot access.

Q41 Glenda Jackson: How then does the individual claimant get in touch with them? Can they just pick up a phone and say, "I cannot come. Will you come and visit me?"

Mr Hoban: Absolutely, and of course there is the letter, and the Atos call centre agent-sorry, that is a dreadful term-who rings to make the appointment will ask questions about accessibility. That is why I am very surprised there are six centres that account for such a high proportion, because all the processes should mean that the problem should not emerge when someone is at the door to the centre.

Q42 Glenda Jackson: Where are they? Are they in urban or rural locations?

Mr Hoban: I can answer that very quickly. They are in Croydon, Ealing, Birmingham-where I was yesterday-Luton, Mansfield and Norwich. So there is no particular characteristic.

Q43 Mr Burley: It just seems crazy to me that, out of such a small number of assessment centres, there is this issue. Given the job that they are there to do, would it not make more sense for the Department simply to say that all assessment centres in the UK have to be completely accessible for disabled people, as a policy? How on earth have we got into a situation where, out of such a small number of assessment centres, which are designed to assess disabled people’s ability for work, so many of them are inaccessible?

Mr Hoban: What we have tended to do is use existing DWP buildings. The one I was in yesterday was a DWP building. Not all of them are accessible, but I think it is something that, over time, we should drive out.

Q44 Chair: It is not good practice, when you are trying to persuade employers to take on these disabled people and want them to put in the access, when the Department cannot themselves.

Mr Hoban: But I would just say, Dame Anne that in terms of DWP and accessibility for employees, the concern is what happens in an emergency when someone has to leave the building. These buildings are accessible for employees with disabilities and there are procedures around evacuation that will help that. We are less comfortable with employing those same procedures in the event of an evacuation or an emergency at an assessment centre.

Q45 Stephen Lloyd: Nonetheless, Minister, I seek assurance that the Department will let the Committee know what they are going to be doing about those six centres, because that is just daft. Is that all right?

Mr Hoban: It is unacceptable. Yes.

Q46 Stephen Lloyd: Okay. Let us move on, because I know we have an awful lot to get through. Another key part that Harrington talked about, and he has also flagged it up in his latest report, is about increasing the influence of the JCP decision makers to improve the quality of the Atos decision-making. So my question: DWP officials told us in 2011 that JCP decision makers had a role in auditing the quality of Atos assessment reports. If they were of an unacceptable standard they would be returned to be redone at Atos’s cost. We later discovered that the decision makers had returned assessment reports in just 0.22% of cases in March and May. And then, before you answer that, picking up Harrington’s report that came out yesterday, he concluded that the DWP still needs to monitor Atos’s performance more closely and that the quality and depth of the relationship between the DWP and Atos remains variable at a local level. Do you accept that local JCP decision makers still do not work closely enough with Atos to monitor performance? Do the DWP encourage local decision makers to discuss individual cases with Atos healthcare professionals, as recommended by Harrington?

Mr Hoban: I just want to tease out two different issues there. One is about the audit of Atos decisions and the quality of their assessments, and one is about the engagement between the decision makers and Atos when it comes to individual judgments. It is absolutely right that there is a quality assurance framework in place that monitors Atos’s medical assessments and also the quality of decisions made by decision makers. I think it is a fundamental part of getting this right first time that those quality assurance frameworks are in place, and that those audits take place to understand what is happening and to monitor the quality. That quality assurance framework should provide reassurance that we take the quality of reports seriously.

There is then a second issue, which is about the engagement between Atos and decision makers and Atos and JCP and, indeed, decision makers tend to sit in Benefits Centres, rather than Jobcentre Plus offices, so there is a network of individuals there. I think that work is happening to improve the quality of those relationships and to improve the quality of understanding between those people in Jobcentre Plus who are working with people who have been determined to be fit to work or in the workrelated activity group. I think there are improvements in the debate-in the discussion between Atos healthcare professionals and DWP decision makers as well. So I think that is getting better. I am sure there is more progress to be made, but we should distinguish between what we do to monitor quality and what we do to discuss individual decisions.

Q47 Stephen Lloyd: One of the things that occurs to me, and it is probably a question for Bill, is that one of the directions of travel that Harrington has been talking about since his first report was to ensure that the DWP decision makers had more influence, felt that they were able to have more influence and that it was a key part of the quality control, I think, frankly, to stop the rate of successful appeals almost, to have the DWP decision makers more involved. But it seems to me, Bill, unless you completely disagree, that Harrington is still anxious that they do not seem to be playing as much of a role as he thinks would be better for the whole WCA process. Do you agree or disagree?

Mr Hoban: Before Bill answers that, can I just make one point again? We need to separate out the Atos medical assessments from the decision. The decision is made by decision makers who are employed by DWP, and it is they who decide whether someone is eligible for benefits or not. They have to take into account the medical assessment prepared by Atos, and also any other information that is supplied. We should be very clear about that distinction, because I think that it is portrayed in the media and by others that it is Atos making the decision. It most explicitly is not Atos making that decision.

Q48 Stephen Lloyd: That is a fair point, but the 0.22% is the decision makers saying to Atos, "We think that the conclusions you have come to thus far are dubious". That does seem a very low figure.

Mr Hoban: No, I think that is slightly different. I think what we see is that decision makers disagree with Atos’s assessments in, I think, 8% of cases. Do you want to talk about the 0.22%, Bill?

Dr Gunnyeon: There are a number of issues that all tend to get confused here. What is important, as the Minister said, to be clear right at the start, is that the Atos healthcare professional makes a recommendation. Now, that part of the process is important because it is the one independent, objective part: it is independent of the Department’s decision makers, and it is independent of the individual’s healthcare professional, who may provide factual information. It is about determining capability for work, but it is a recommendation, and clearly one of the things that Professor Harrington has been anxious to do is to make sure that where further evidence is required we should be trying to make sure we get that when we need it, at the start of the process, and indeed, you can see from the Government’s response we have committed to that. Because one of the objectives is to make sure that the healthcare professional’s recommendation is as robust as possible and that their reports are clear. So there are two separate issues there.

The ones that the decision makers send back are reports that they consider unsatisfactory, where it is not clear, there are problems with the report and they want it reworked. That is different from the decision maker reaching a decision that is different from the recommendation that the healthcare professional made, because I think it is important to remember that the healthcare professional’s specialist area is disability assessment and the healthrelated issues. The decision maker’s specialist expertise is particularly in the application of the law and the legislation and taking into account case law and all the other things, and they take all the evidence; they check that the report is clear, and that has been helped by one of Professor Harrington’s recommendations, where the healthcare professional now is required to, at the end, clearly justify the recommendation they are making. I think that has been quite helpful. For some of these things it is going to be a little while before we see the full impact. The decision maker then reflects on that recommendation, checking that all the evidence that was available has been taken into account by the healthcare professional.

Now, given the fact that it is the application of the law that the decision maker is focusing on, it is perfectly feasible that the decision maker will reach a decision that may not be exactly in accordance with the recommendation that the healthcare professional has made. One of our challenges, I think, is to ensure that that increasingly reduces, and there is a risk there, because one of the things that is often said is that if the decision maker reaches the same conclusion as the Atos healthcare professional, that must be a bad thing. If we think about this, if we have all the evidence at the start, we have a robust assessment and a clearly reasoned conclusion, the decision maker should then take into account any other evidence. However, we should be looking at the difference in what the healthcare professional recommends and the decision maker increasingly diminishing. So that being small would be a good thing.

So the decision maker can pick up where there are poor quality reports and send them back. That is different, I think, from their assessment of the case, overall, taking into account the Atos healthcare professional’s report. I think those are separate things and we are working on both. Professor Harrington is anxious to make sure that the decision maker can access healthcare professional advice whenever he needs it and there is a helpline available for decision makers to be able to access an Atos healthcare professional, either for general advice or they can communicate with the healthcare professional who did the assessment before they reach their decision.

Q49 Teresa Pearce: Given that Professor Harrington had concerns about what was seen to be rubber-stamping by decision makers, and he wanted real rigour, Minister, are you confident that Jobcentre Plus decision makers are adequately resourced and have enough time and enough staff to be able to deal with this extra rigour?

Mr Hoban: Yes. Decision makers make decisions on a wide range of issues. They make decisions on sanctioning, on mandation-

Q50 Teresa Pearce: But there is an increasing volume.

Mr Hoban: Yes, and I think what we need to do is ensure that we have the right resources in place. One of the things I am keen to explore is how we can maintain the quality of decision-making, but at the same time, look at the speed of the process. Professor Harrington, in one of his recommendations, highlighted the tension between quality and speed, and we need to make sure we get that right, but I am keen to ensure that we are able to deliver both. I have been impressed by the decision makers I have met when I have been visiting Benefits Centres. I think they take their job very seriously. They are very experienced professionals who make tough decisions.

Q51 Teresa Pearce: So will you be reviewing as you go along to make sure that that resource is adequate? Experience is really important, and if you get experienced people who leave and you get new people in, they do not know the person so much and they do not know the background. So will you be reviewing, from time to time, the resourcing of Jobcentre Plus?

Mr Hoban: Yes. We continually review the resourcing of all aspects of our activity, not just Jobcentre Plus but also Benefits Centres, and ensure that we have the right people in place to be decision makers and ensure that they are properly trained to do that job.

Dr Gunnyeon: I think what is important is that in the way that there is a process in place for auditing the quality of Atos reports and recommendations, there is the same process in place now for ensuring the quality of decisionmaker decisions. I think that is very important, because that will cover one of the points of turnover. We will be able to identify any issues that arise if there are new people.

Q52 Teresa Pearce: In July, Channel 4’s Dispatches programme raised an allegation that Atos decisions are monitored to ensure that the number of claimants found eligible for ESA is kept to a level acceptable to DWP. How would you respond to that allegation?

Mr Hoban: It is rubbish. There is no target. Let me be absolutely clear: there is no target in the number of people who should be allocated between workrelated activity group, support group or fit for work. We do not impose any incentives on Atos to encourage people to be recommended to the right group, if there is a right group. What we want is for people to be recommended to the appropriate group for them and their conditions. There is no financial incentive and no target as to the people who should be referred to each of those three groups.

Q53 Teresa Pearce: So did the DWP have to investigate those allegations raised by the programme, or are you absolutely positive?

Mr Hoban: We designed the contract, so we know what the contractual incentives are for Atos, so we did not need to investigate those. Where there is a confusion is in the quality assurance framework. I do not know, Ms Pearce, what your responsibilities were at PwC, but certainly when I was there as an auditor, you look at risk, and that is absolutely right. You look at exceptions, not because you think those risks and exceptions are wrong, but to understand that the proper work is being done. So there is a riskbased framework, but that does not in any way affect Atos’ remuneration or any incentives or any targets we have for the number of people being placed in which group.

Q54 Teresa Pearce: Given that you said earlier that you inherited a flawed system, why did the Government not undertake a costbenefit analysis, delaying the implementation of the IB reassessment before taking the decision to extend Atos’s contract in 2010?

Mr Hoban: It is not a matter of political disagreement between the Government and the Opposition that for far too long people have been left on IB without any contact from government and without any real hope of getting into employment. If we are to help people get back into work we need to work quickly. Some of the evidence that we have seen demonstrates the number of years that people have been on IB, and I think we need to work quickly. Atos had a structure in place to ensure that the work capability assessment was undertaken. I think that, if we are keen to tackle some of the deepseated issues around employment and those who are capable of working, we needed to move quickly.

Q55 Chair: If you wanted to move quickly, why did the new coalition Government, when it came in, stop Pathways to Work, which was the one programme that was working with IB claimants to get them back into work, in some areas, very successfully? Surely it would have been much better to keep Pathways to Work running and get the contract and the delivery of Atos for the cohort to be moved into ESA right.

Mr Hoban: I was not party to that decision-making process around Pathways to Work or IB, but I am very clear that we do need to ensure that we get the reassessment undertaken. It is a long process, and in the long term it will generate benefits. The fact that we are reassessing every IB claimant is the right approach.

Q56 Teresa Pearce: DWP disputes some of the points made by the National Audit Office in its recent report, which found that the Department only applied financial redress for service failures by Atos on 10% of the occasions. So that, by default, means that in 90% of the time no penalty was incurred. Do you think that is acceptable?

Mr Hoban: Bill, do you want to talk about the contract management, since you were in front of the PAC on Monday? But perhaps there is a broader point I might make. There are two ways in which we can deal with service credits. One is to ask for a cash payment and one is to ask for Atos effectively to earn those back. So, effectively, if we are going to have a service credit for delays or a backlog, rather than just simply taking cash off that backlog we ask them to tackle that backlog. So where there is an issue about service there are a couple of options that are available to the Department and we have to make a judgment as to what we think the appropriate form of redress is. Personally, I think that rather than accepting there is a backlog, we should try to do something about it. I think that is the right and the proper thing to do, and it is in the interests of claimants to do it that way. Therefore, if we are asking Atos to work off a backlog, we may not get the cash directly, but there is a cost to Atos of doing so.

Q57 Teresa Pearce: But some of the Harrington improvements they have made they have billed on top of their contract to the DWP for that. So in one way I understand what you are saying: if there is a problem you want the problem solved rather than a cash penalty and still have the problem, but where they have had to make improvements they have not taken that approach, have they, of just making the improvement? They have billed significant amounts to the Department for those improvements that were made.

Mr Hoban: What we recognise is that in a procurement process we have to specify in some detail what it is we are procuring and what the service is. The personalised summary statement that Professor Harrington recommended does increase the time taken to do an assessment. It is a variation on that contract and if we want that variation to be accepted by Atos then there is a commercial negotiation to be had on that, in the same way that if we agree for a builder to do some work on our house and we decide to do more work, we expect the builder to bill more and us to pay more. There is a contract there, which is very tightly monitored, but I think we would expect, where there is a variation that we impose unilaterally, that the contractor would expect some recompense for that.

Q58 Teresa Pearce: Just one last thing: one of the issues that this Committee has been very, very concerned about for as long as I have been on it is the portrayal of people with disabilities and people on benefits in the press. This has led, it is believed, to an increase in verbal and physical assaults on people with disabilities because of the portrayal and the hardening of people’s attitudes. A report by the charity, Turn2us, Benefits Stigma in Britain, which was recently released highlighted some of these occasions in the press. There was one particular occasion, in the Daily Mail in April 2011, that there was a statistic from the Department for Work and Pensions, which said that 1,360 people had been on IB for longer than a year because they had diarrhoea, when in fact they had bowel cancer. As the new Minister, will you commit to tackle that sort of spin when it comes from your Department?

Mr Hoban: First of all, I cannot take responsibility for how newspaper journalists write their reports.

Q59 Teresa Pearce: But can you take responsibility for your Department going forward?

Mr Hoban: What I can take responsibility for is ensuring that the statistics we publish are fair and transparent, and that they present a very objective view of the challenges that we face, and I am happy to be accountable for that. On the flip side, though, I think those who seek to demonise Atos and the process are doing a disservice to Atos employees and to our constituents who are being assessed by them. We have seen a lot of that in recent weeks. It adds to the stress for claimants. We are not afraid of a robust debate, but I think it should be a fair and honest debate, and I do not think we have seen that in recent weeks.

Q60 Teresa Pearce: I accept what you say, and I think the work that this Committee has done has been as a critical friend to the process, more than anything else, because what we want to see is people being able to achieve what they can achieve and be fully engaged. The stigmatisation of people with disabilities, whether they are mental or physical, stops them, in many cases, getting into work, because it builds up the prejudice of possible employers.

Mr Hoban: Absolutely.

Q61 Teresa Pearce: So we are aware of that, but some of the spin in the press has been a major concern of this Committee. You cannot be accountable for what the press write, but what you can be accountable for is what comes out of your Department, so thank you for that commitment.

Q62 Nigel Mills: Minister, I suppose we can all agree that we would all much like the right decision at the first opportunity; we can avoid the cost of delay and probably the unfairness of the whole appeal process. I think the Department’s idea to try to improve this was the mandatory reconsideration, and witnesses to our previous inquiry were concerned that that was a way of persuading people not to go down the formal appeal route or that would just delay the whole process, if you get a reconsideration and an appeal. How do you respond to those kinds of issues?

Mr Hoban: What we want to do is to ensure that the decisions are taken as quickly as possible to a high standard, to seek to avoid overburdening the Tribunals Service and to ensure people get the right outcome sooner. What we have sought to do is, when we make a decision, to speak to the claimant to explain the decision and to ask if there is any further evidence or information they would like to supply us with in the light of that decision. If they provide some new information that enables us to reassess their claim, I think that is a good thing to do at that point, rather than waiting until the tribunal for that new information to be produced. We have seen from the drop-down menu the proportion of cases that are overturned as a consequence of new information being supplied. So I think it is a good step in the process. It is beneficial not just in terms of an opportunity to collect that information, but also to explain to the claimant what we have done and why we have done it, so they understand the decision that has been made. Like you, I have had constituents where the letter from DWP has come as a bolt from the blue. That should not really be the case in something like this, and the mandatory reconsideration is a very helpful step in that process and formalises much of what we are doing on ESA at the moment.

Q63 Nigel Mills: Do you think the reconsideration works very well? Obviously, I get a fair number of surgery cases, and I do not think the people who come to see me would say I was softhearted in any way, but occasionally you do see one where you think the decision is completely wrong and will clearly be overturned on appeal, and no matter how much you try to push and say, "Come on, this should be reconsidered", I very rarely get any change without an actual appeal. Do you think this system works?

Mr Hoban: I think it does. It is very difficult for us as lay people necessarily to look at the assessment, to look at the DWP decisionmaking process, look at the legal basis on which a decision has been made, and to work out whether a decision is right. That is why it is absolutely right to have an appeals process in place and inevitably there will be discussions, as I said earlier on. What we have at the heart of this is a body of evidence that people can look at and potentially reach different conclusions. I think that we see that in the situations where DWP decision makers overturn the Atos recommendation, in the same way that the Tribunals Service overturn DWP decisions. There will be disagreements about this and what we try to do is make things as objective as possible, but there is always that overlay of judgment.

Q64 Glenda Jackson: With respect, Minister, it is not an overlay of judgment, is it? It is simply adding up numbers. You have been talking, with respect, all the time about medical professionals in Atos. Many months ago we were assured by the Department that the Atos was not a medical test; it was an assessment as to whether someone who had a serious condition could still be capable for work, and that definition is defined by numbers. There are numbers given for various boxes and that total is then sent off to the decision makers. With respect, you are constantly asking us to believe that the Atos medical professionals are expert in every single field of mental illness and/or physical disability and can equate on a very fine line of variation and that the same is the case for the decision makers. We all know that that is not the case. They are all overworked, because there are so many new people coming in.

Mr Hoban: Ms Jackson, with respect, it is not about numbers.

Glenda Jackson: Yes, it is.

Mr Hoban: I have sat down and observed the process, and what the healthcare professional is doing is gathering evidence about someone’s functionality, about what they can do every day, how they manage their lives.

Glenda Jackson: And that ability is defined by a number and if a certain number is not reached-

Q65 Chair: If I can clarify, I think what Glenda is talking about is that you have to score 15 points. It is not the numbers who are going through the process, but the fact that there is a scoring system.

Mr Hoban: Yes, but also that score is based on the accumulation of evidence. It is not someone sticking their finger in the air and saying, "This person is a 5". There is an evidential process that underpins that, so it is not just about numbers. That number has to be backed up by the evidence that is gathered in the assessment process and that is quite a detailed discussion between the healthcare professional and the claimant. That is then overlaid with the information on the ESA50, which the claimant produces; it is overlaid by the information on the ESA113, which a healthcare professional nominated by the claimant does.

Q66 Chair: But for all of that they still have to get over 15 points.

Mr Hoban: But that judgment that is taken by a decision maker is not simply based on numbers, and to suggest that it is does a disservice not just to healthcare professionals, not just to GPs and not just to my Department. I think this is a more rounded process than just by numbers would indicate.

Q67 Nigel Mills: Going back to the mandatory reconsideration, I think the Department view now is that there should not be a statutory time limit on that; it should be done by some kind of internal performance management. Is that right?

Mr Hoban: I think one of the challenges, Mr Mills, is to ensure that we get the process right. I am always slightly wary of imposing a statutory deadline, simply because of the unintended consequences that might bring. It may mean that decision-making is done too quickly; it may mean that cases are dropped. So I think we need to get the appropriate guidelines and measures in place, and I think it is the point that Professor Harrington made generally about the trade off between quality and time.

Q68 Nigel Mills: When will that be finalised?

Mr Hoban: Can you remember when that will be-how long the timetable or timings for mandatory reconsideration will take?

Dr Gunnyeon: I am not sure about the timescale. I thought you were looking at when it was going to be implemented.

Q69 Chair: It is not introduced yet. When is it going to be introduced?

Mr Hoban: It is late next year.

Q70 Chair: Late next year, okay, so you are still working on it.

Mr Hoban: Yes.

Q71 Nigel Mills: How are you going to monitor the impact that mandatory reconsideration has? Presumably, you are going to be able to keep data and show that appeals have come down. I guess that is the key one, is it not?

Mr Hoban: It is, Mr Mills. What we want to do is to ensure that the process overall has credibility, is robust, ensures that people are appropriately placed in the three categories. I am not for a moment going to suggest it will eliminate adverse appeal decisions by judges, but, hopefully, mandatory reconsideration will have an impact on both the outcome of appeals and also the volume of appeals.

Dr Gunnyeon: Also, it is clearly very important that we learn from that. In the same way that we want to learn from the reasons that tribunals overturn decisions, it is important that we learn from the mandatory reconsideration. Where we do end up changing a decision, it is important that we learn the reasons for that and we then use that to amend the process at an earlier stage. Clearly, the objective is to try to ensure that, all the way through the process, the decision is the right one, so there is a lot of opportunity to learn from mandatory reconsideration.

Q72 Nigel Mills: We currently have about a 40% appeal rate. What would you regard as a success when this system is running?

Mr Hoban: I am not going to be tempted down that route, Mr Mills.

Q73 Stephen Lloyd: Do we have any details on the new figures, though, because that 40% was crucial? It was always one of the key points that we would see from the Harrington report, if they were beginning to improve the WCA, that the successful appeal rate-call it what you will-would begin to drop down from 40%. Have you seen any movement in that direction?

Mr Hoban: I do not think we have an updated figure. I would also be slightly wary of being caught by a benchmark. The easiest way to reduce the volume of appeals and overturn is to put everyone in the support group, and what we need to do is make sure we get the right decision being made.

Q74 Jane Ellison: You mentioned about understanding why appeals are granted, etc. Going back a stage slightly, is it 33% of the tribunals do not tell you why they overturned a decision?

Mr Hoban: Yes, that is right.

Q75 Jane Ellison: That is a really high percentage. What is being done to get them to cooperate? Obviously, if we knew what that 33% was it might skew several of the results.

Mr Hoban: I think, Ms Ellison, this is a relatively new process that is bedding in. I think it is quite a big step forward in terms of engagement with the Tribunals Service. We would like to get that down as low as possible and also, as Bill said, improve the dialogue between the Tribunals Services and DWP to get a better understanding of where judges are coming from and also for them to get a better understanding of where our decision makers are coming from. That would be quite a helpful move in improving this process. There are a range of different parties engaged in this. We have done a lot of work internally. Atos has done a lot of work.

Q76 Jane Ellison: The tribunals are part of Justice, are they not?

Mr Hoban: They are, yes, and as my predecessor is now Secretary of State for Justice, hopefully we will see a continued strengthening relationship between the two Departments.

Q77 Graham Evans: On the 40% fit for work decisions, there are three categories. There is the unconditional state support, where somebody is clearly in a position where they cannot work. But under fit for work there are two categories: whether someone could work or whether someone could work at some point with the right support. Out of that 40%, how many think that there should be unconditional state support and how many of the other two categories have been told, "You are fit for work" or is it, "You are fit for work with certain support", whether it is mental or cognitive support or job interview support. Out of that 40%, which are the categories?

Chair: That 40% is all fit for work.

Graham Evans: Yes, but there are two categories.

Chair: No. The WRAG is not part of that 40%.

Mr Hoban: Thank you for that helpful clarification, but if you look at the 687,000 fit for work decisions that have been made, only 15% have been overturned. So if you look at the whole pool of decisions made by the Department where people have been judged to be fit for work, only 15% were overturned. So I think we need to get some perspective.

Chair: I have to say that, when I was a teacher, if I had 15% of my marking overturned I would have thought I was a failure as a teacher.

Graham Evans: My question is of those 15%, are they in that third category of requiring unconditional state support?

Chair: No, no, they are not in ESA at all. They are now going to be JSA.

Q78 Sheila Gilmore: Clearly this whole question of the relationship between tribunals and the decision makers is crucial, and in Harrington’s second report he said he was still having great difficulty in even accessing the tribunals. In his third report, he is still saying that he thinks it is unacceptable that the first tier tribunal apparently still think that the independent reviewer, whoever that may be in the future, has no remit to look at the appeals stage. Are you saying that you accept what Harrington is saying? In other words, are you going to ensure that in the future there is a better relationship both between the decision makers and the tribunals, but that the independent reviewer has a real role here in getting involved at this stage?

Mr Hoban: It is worth reminding ourselves that judges are very independently minded, and rightly so. They are an independent executive and legislature. They are very jealous of that independence and of being seen to maintain that independence. So I think the fact that we have moved to a drop-down menu is a good start; I would like to explore ways-and certainly it is something that the Department is keen to do-with the Tribunals Services to see how we can deepen that relationship without compromising their independence.

Q79 Sheila Gilmore: Most organisations see, for example, complaints as a way of improving process and I think the difficulty-and this is what decision makers have said; it is also perhaps, to some extent, what Atos have said at times when they have been asked about this-is that not understanding why decisions are overturned makes it difficult to apply that learning process. I think again, in this new report, Professor Harrington says that it is a good start to have a drop down menu but there needs to be a real dialogue between the judges and decision makers. So do you accept that the drop-down menu really is only a beginning?

Mr Hoban: Ms Gilmore, I think we are, for once, both in agreement. This is a start and you are absolutely right: the best way to understand what is going wrong is what happens when someone complains and particularly what happens when an appeal is upheld. I would like to have a much more open dialogue with the Tribunals Service than we have had in the past, and that is something that we are working to deliver, so I do not think there is any point of disagreement between us on that.

Q80 Sheila Gilmore: One example is that we have a situation here where, of the reasons that were given from the drop-down menu, for 40% the reason given was cogent oral evidence supplied by the appellant. Unless you know what the nature of that was, it does not take you very much further forward, because it perhaps suggests that, indeed, the original process was not getting the information properly, if it was a facetoface assessment-and this goes back to the question of whether the assessment is failing or not. I think some of the points have been made earlier about the fact that, when somebody goes to an appeal, which in many ways might be, I would have thought, more stressful and quite challenging for people, they are able to express themselves better than they appear to have been able-this is one hypothesis-at the assessment. The reason people have given for that is the very mechanical way-this goes back to the criticism that I think Glenda was trying to get at. I am not asking you to guess whether this 40% is the cause and the assessment was too narrow or somehow the judges are better at getting things out of people, but that surely shows just how important it is that we understand this process, because that is a large number.

Mr Hoban: I agree.

Q81 Sheila Gilmore: Can I ask you, therefore, perhaps to consider withdrawing the comments that you have made previously, which were-and I think you were quoted in a BBC interview at one point as suggesting virtually that people were withholding information. The quotation on the BBC website is, "What is happening too often is that people are suggesting to claimants, ‘Just leave the medical evidence until the appeal.’" Now, only 8% of the appeals’ reasons seem to relate to material evidence. Can you take this opportunity to withdraw the suggestion that people are somehow holding onto evidence, because a lot of our constituents say that when they tried to give evidence at an earlier stage it was not accepted.

Mr Hoban: There are a couple of points that I would make on that. First of all, it is very clear that people are submitting documentary evidence later in the process that has led to the tribunal overturning DWP decisions.

Q82 Sheila Gilmore: A relatively small number.

Mr Hoban: But it is still significant. I know from talking to some of my own constituents when dealing with appeals that quite often what they have not had is full medical evidence, for example. They have not had a letter from their consultant, for example. That is why I think it is important that-

Q83 Sheila Gilmore: Whose responsibility is it to ask for that?

Mr Hoban: I will come onto exactly whose responsibility it is. One of the things that happens at the start of the claim process is that the claimant is asked to nominate a healthcare professional who they think will give evidence about their condition and their functionality. When Atos get that, they send out an ESA113 form; it may be to a GP or it may be a consultant. 71% of those forms are returned. I think it is under 40% that are returned within the two weeks specified on the form. So there is a problem there, and that is why we are working with the BMA to improve the understanding of GPs and others about what we are looking for in this process. One of the things that Professor Harrington has recommended is, where we do not seek further medical evidence, we document why we have not done that. I think that is a good recommendation from Professor Harrington; what we are working on now is how we implement that and at what stage in the process.

Q84 Chair: Can I just put it into perspective? The new documentary evidence is that tribunals account for an overturned decision in 8.2%. However, cogent oral evidence given at the tribunal accounts for an overturn in 41.3% and the tribunal reaching a different conclusion on exactly the same evidence as the decision maker and Atos had is 16.2%. So to say that it is new written evidence coming in at a late stage that is materially affecting the appeals is not-

Mr Hoban: I am not sure I said that. What I have said is that there are situations where, if new evidence had been submitted at an earlier stage, we would have had a better outcome and I think that is a fair comment. What we have accepted in Professor Harrington’s report is that we do need to look at documenting where we have not asked for further medical evidence.

Q85 Chair: I think there is a danger that you put all your effort into getting more documentary evidence when in fact it is the oral evidence that appears to be persuading people. That should be based on: why is the LiMA system that Atos is operating not capturing the kinds of information that clearly the Tribunals Service is capturing, in terms of the condition of the individual, without seeing the written evidence or anything else? There is something fundamentally flawed with the LiMA system that Glenda Jackson was talking about, because it is a scoring system and one point below on each of the points means you fail and one point more you pass.

Mr Hoban: I think that is a mischaracterisation of what happens in an assessment. Let us not forget that the judges in the tribunals criticise the Atos assessment and their quality in 0.4% of cases. They do have a mechanism whereby they can refer cases back where they are particularly concerned-protocol 10-and that is a mechanism that is very rarely used. We should not think that it is LiMA, a computer system, that is driving the process. What we want healthcare professionals to do is to use LiMA to record evidence given by the claimant. What we have on LiMA is a combination of questions to be asked, but also a lot of free text boxes to enable healthcare professionals to report and record the evidence given and you will only be able to complete that if you talk to the claimant and get the evidence. Now, you are absolutely right there is a point we need to understand. What is it that the judges are hearing that is getting them to change their mind? If there is something that is flawed about the Atos process-which I do not believe there is, because the overturn rate is 0.4% based on Atos assessments-what is it they are hearing that is getting them to change their mind? That is why we need that dialogue. But I do not think you can say that because the judges ascribe their reason to oral evidence it means that the Atos assessment is flawed. We should move away from this misconception that it is a "computer says no" process. It is not.

Q86 Jane Ellison: My question follows up on the 40% and the need to drill down. I find the phrase "cogent oral evidence" to be very general. We all need to understand in a lot more detail what that really means. Presumably, it could also encompass somebody making cogent oral reference to written documentary evidence from healthcare professionals or their own healthcare professional or whatever. It is such a large percentage and it is such a general description. I would certainly like to see some real work being done to understand what that is and how cogent and how persuasive and what areas it is all in, because it is just such a general description.

Dr Gunnyeon: The tribunal is seeing a claimant many, many months after the healthcare professional did the original assessment and it is entirely possible that one of the reasons, for example, is that things have changed in that time. We know that, for individuals, conditions will remain the same, get worse or get better. So I think you are absolutely right that we do not know what is going on here, but I think it is reasonable to speculate that some of it will be the fact that things have changed for the individual. It will also be the case that individuals have had the time to reflect upon what has been said and so on and, perhaps, to present things in a different way, sometimes in a more convincing way-and I do not mean that in a derogatory way-than perhaps was the case at the assessment. However, I think we do need to learn from it, so that we can see whether there are things we can learn earlier on; this obviously is a step forward, but it is only a step.

Q87 Sheila Gilmore: I am certainly glad to hear that it is going to go beyond the drop-down menu, because it is clear Professor Harrington did not think it was adequate and I do not think members of this Committee think that that is going to get to the root of this problem. I also hope, I have to say, that the Minister does consider not making the sort of statement that he was quoted making before, because I do not think it is helpful to a positive process to suggest that people were effectively withholding evidence.

The other issue that comes up with appeals is about reassessments as well, and there is a link between reassessments and appeals. The periods for assessments could be anything, we are told, between three months and three years. Quite often when people have an appeal, in particular, they are then on a cycle of being reassessed very quickly therefore. So the claim is refused or they succeed in the appeal, and what appears to happen is that the decision on when the reassessment should be is still the original decision, even when it was overturned on other aspects. So you have had a decision maker, on the basis of the recommendation of Atos, say that the prognosis for reassessment is a year. The appeal takes nine months. We still seem to run to a year from the original. This is where people feel they are coming back within three months of a decision being overturned. If the original decision was wrong, it suggests that perhaps the prognosis was also wrong, so should that not be looked at again when people appeal?

Mr Hoban: There is the opportunity for the tribunal to make a recommendation about when reassessment should take place. When that recommendation is made, it is something that the decision maker should take into account. I think there is also an issue about at what point of time is the tribunal disputing DWP’s decision. Is it the point in time the decision was made, which could be nine months earlier, as you suggested, or is it based on what they saw on the day in the tribunal? So there is a lack of clarity there, but I think we should take a fairly clear view about when reassessments should take place, and it is an area that decision makers should work on.

Q88 Stephen Lloyd: My strong advice psychologically, from DWP’s perspective is park any empirical, factual bureaucratic thoughts and think to yourself, if you have gone through the whole process, you then win an appeal and three months later you get called in for a reassessment, believe you me-that is bad politics, in my view. Now, I do not quite know how you square that, but it just is. One of the biggest challenges I have from constituents coming in is-in cases where I have even helped them in tribunals, if I believe that they have a strong case-they have won a tribunal and three months later they get another letter to go through the same process again. I really do not think that is a good way forward. I do not think it is a good way of persuading people that we are trying to do the right things for them.

Mr Hoban: Mr Lloyd, I think it depends on the condition and what the prognosis is. Perhaps there may need to be a more finely balanced decision in some cases than others. I do not think there should be a rigid rule about when somebody should be seen again, like it can be no more frequently than every six months. I think you need to do it on a case-by-case basis.

Q89 Sheila Gilmore: The whole reassessment process is difficult and stressful for people and it is also extremely expensive. I think when the Permanent Secretary was before us a few weeks ago he suggested that this is something he would be looking at. Minister, can you confirm that you will be looking at this further, not just maybe in relation to appeals but more generally.

Mr Hoban: I am not quite sure what you are suggesting.

Q90 Sheila Gilmore: A lot of the reassessment periods are quite short and that is very stressful for people. Even in cases involving, for example, people with Parkinson’s, which is a deteriorating condition-it is not a curable condition-they find being called back for an assessment in a year, for example, is both pointless and stressful.

Mr Hoban: We have to be very careful. We have a process here that covers a wide range of conditions. Some of those conditions, you are absolutely right, do fluctuate, and we need to take that into account. I do not think there is a cast iron rule that it should be X months. There should be a more flexible regime based on people’s conditions and our understanding of how that condition is likely to develop. It needs to be done on a-I do not want to use the word "pragmatic" because I do not think that is sufficiently robust, but there should be a set of principles that are used and, indeed, there are, to get this reassessment period right and we need to continue to refine getting it right.

Dr Gunnyeon: It is only relatively recently that we have started to get an increasing volume of reassessment data that will allow us to start to understand what is happening and look at how we can use that to modify our approach to be more specific about prognosis. Prognosis, as you know, is a difficult thing anyway. It is always an assessment of when you think, all things being equal, someone will have recovered to the point where it is likely to be reasonable for them to look for work. But I think as we get more information we will be able to start to learn from that, and I think that is the importance of the data that we are now starting to get.


Q91 Glenda Jackson: Surely the best evidence would be from that individual’s medical team, would it not? If they win the appeal.

Mr Hoban: Ms Jackson, we need to recognise that there is a difference here between diagnosis and functionality, and this process is meant to highlight that difference. This is a fundamental principle. It is a principle that the previous Government recognised when it introduced these reforms: that there is a difference between diagnosis, which is what doctors do, and the prognosis or the view about functionality, which is what Atos and the decision makers assess.

Q92 Glenda Jackson: Yes, that was the point that I made to you earlier.

Mr Hoban: Yes, but it is wrong to confuse the two, because they are two very different exercises here. Yes, the further medical information evidence might help us with that prognosis period, but let us not confuse the different roles in this process.

Glenda Jackson: No, but we were referring to illnesses that are incurable and tend to progress downwards.

Q93 Chair: I think we have the agreement that you will be looking at this again, because certainly that is where the sense of persecution comes from, particularly for people with-

Mr Hoban: Yes, but let us not forget that some people may have some very difficult medical conditions-they may even be terminal-but that does not necessarily mean they cannot work. You see it in a number of conditions where people do work and work very effectively. It goes back to the stigmatisation that Ms Pearce mentioned. We need to be very careful about this.

Chair: It is not their own decision, but the reassessment.

Q94 Mr Burley: My question is about statistics on work capability assessment outcomes. The latest statistics for December 2011 to February 2012 are that 54% of new claimants are being found fit for work. I think back in 2008-09 it was 65%, so it is coming down. I guess the question is: is the Department surprised, as people move from incapacity benefit to ESA, that still over half of people who were claiming incapacity benefit are being judged to be fit for work? That is an incredibly high proportion of people that were previously judged incapable of any work; over half are now being judged capable of work. Does the Department think that that number will continue to go down?

Chair: The figures are for new claimants.

Mr Hoban: Yes. As I said earlier on, we do not have a target about this. It is not a numbers game that we are aiming for here. What I would say is if you look at the outcomes from October 2008 to May 2012 and compare them with outcomes from December 2000 to February 2012, what we are seeing is a decrease in the number of people being seen as fit for work, from about 59% to 54%, a reduction in the number of people going to the workrelated activity group, from 26% to 20%, and an increase in the number of people going to support group, from 15% to 26%. We can all argue about why those numbers have changed. I suspect that one of the reasons why we are seeing more people going into the support group is a refinement of the process and a more appropriate identification and determination of people’s claims. But I think it does show that there are still people who are claiming benefit who I think would like to be in work and we would want to see in work.

Q95 Mr Burley: Without making a value judgment on the numbers, as you say, does the Department expect that number to continue to decrease from the 65% in 2008 to the 54% now? Not saying whether decreasing is good or bad-just does it see that trend continuing?

Dr Gunnyeon: A lot of the change that we saw came after we introduced the amended WCA last year, following the internal review and also some of the Harrington changes. I think certainly we expected an increase in the support group. Our expectation at the moment is that things are now starting to look as though they approaching more of a steady state than was the case. We have seen things settling down after the implementation of the amended assessment. Our expectation is that it is closing up, but of course if we make further changes again to the assessment process that may have further impact.

Q96 Sheila Gilmore: Do you have figures for the proportion of new claimants for incapacity benefit before we had ESA? What proportion of new claimants for incapacity benefit, say in 2006, were successful?

Dr Gunnyeon: In terms of the entitlement to benefit?

Q97 Chair: I think I can probably answer that. I certainly put down a written question quite some time back to say that the Department did not keep those statistics. In other words, the key comparator is the number who are applying-new claimants for ESA-who are being found fully fit for work and how that compared to, when IB was the benefit, new claimants who applied for IB who were found fit for work. My sense is that IB was quite a difficult benefit to get and those figures might be similar, but we do not know.

Mr Hoban: Let me give you a slightly different set of stats on IB in terms of reassessment.

Q98 Sheila Gilmore: That is not the question, with all due respect.

Mr Hoban: No, as Dame Anne said, we do not have the statistics. What I am trying to give, Ms Gilmore, is-

Q99 Sheila Gilmore: That is unfortunate, because these figures are constantly used to say that there are far too many people who have somehow been cheating and not right, and this new system has suddenly discovered this. In fact, it could be that the rate of new claimants is not so very different from what was always the case.

Mr Hoban: Let me just address the issue about reassessment and what that has demonstrated, because that is up-to-date evidence. It is not going back four or five years; it is up-to-date evidence. 36% of IB reassessments up until February 2012 are classified as fit for work; 39% went in the workrelated activity group and 25% went into the support group. If you look at how long people have been on IB for, 28% of people who had been on IB for over 10 years were fit for work and 9% had been on benefit for more than 15 years.

Q100 Stephen Lloyd: 28%?

Mr Hoban: 28%.

Q101 Mr Burley: So, of the reassessment of people who were on IB, only 25%-

Mr Hoban: 36% were fit for work and 25% were put in the support group.

Q102 Mr Burley: So 25% were totally incapable of any work due to illness or disability, so a quarter.

Mr Hoban: Yes.

Q103 Mr Burley: In terms of the 54% figure of new claimants, do you know what that represents in terms of the number of people and the cost to the taxpayer in terms of what benefits they would have been entitled to?

Sheila Gilmore: There cannot be a cost to the taxpayer if they have never claimed before.

Mr Hoban: The question that Mr Burley is asking is not an unreasonable one, although I do not have the answer to it, because what we are saying is what happens if their claim had been successful and what would they have got if they had gone into the support group, and therefore is it then about the process we are going through to identify and assess people, but I do not have those numbers to hand. In a way, it is counterfactual. What would the cost be if we did not have this process and therefore what the costbenefit is of this process.

Q104 Mr Burley: Yes. Okay, just moving on to the different cohorts of claimants and properly tracing them through the process, the Permanent Secretary told us last month that work was being done to ensure that the outcomes could be properly traced. When do you think the statistics will start coming out to provide that information, because it is quite difficult to track it all the way through the system, is it not?

Mr Hoban: It is, and it is work we are continuing to undertake. It is absolutely right that we do as much as we can to track the effectiveness of this programme, but we do need to make sure that we have the mechanisms in place to do that and to get the evaluation of that right. So I do not have a date when we are going to publish those statistics by, but it is absolutely the right thing to highlight.

Q105 Mr Burley: Finally, will it be possible for the new statistics to show, for each monthly cohort of new claims or IB claims referred for reassessment, what proportion are at which stage of the process, so who is waiting for a WCA outcome, who is waiting for a JCP decision, who is waiting for an appeal? Does it go to that level of granularity?

Mr Hoban: The answer is that I am not sure, but I think the point you are making is a good one in terms of data collection. I do not know whether Bill has any insights into that.

Dr Gunnyeon: We have been looking at it very closely, because you are right about trying to join up the cohort data from initial claim all the way through to outcome of appeal-and the outcome of the appeal bit is a challenge, because it is a different database-and link that into the data we get from Atos. In fact, there is an even earlier stage that we will eventually need to look at, which is why those people who have been in work are going on to benefits in the first place and trying to join all of that up. There is a lot of work going on. We do have quite a lot of management information; it is the issue of quality assuring that, so that it can be used with confidence. But what I can say is that there is a very significant focus on this now, because it is quite important to us in being able to demonstrate that some of the claims about the assessment, for example, may not necessarily be correct, but we need to be able to produce the evidence to show that.

Q106 Jane Ellison: In the previous reports, before I joined the Committee, there was concern about the large proportion of claims that were closed before the WCA had taken place. I think that your predecessor gave a commitment to look into that and do some research about it and I think Citizens Advice expressed the view in particular that they thought some people just recovered from ill health and basically opted out of the process. What have you discovered in your research about that?

Mr Hoban: We have some statistics on that, but it is clear that people get better, and there are quite a high proportion of people who are no longer unwell. Their unfit for work notice has been withdrawn by the doctor, so they are capable of working. Bill, do you have some stats for us?

Dr Gunnyeon: Of 31% who withdrew their claims, 36% were as a result of people who were fit for work or were looking for work while claiming JSA; 27% had gone back to work because they still had a contract of employment or had found a job; and about 8% said that they had found the process either too stressful or bureaucratic, and that was the reason for their withdrawal.

Q107 Jane Ellison: 8%? So the vast majority was some other reason.

Dr Gunnyeon: Yes.

Q108 Jane Ellison: I would also just note for the record a positive: there has been a lot of concern about the media reporting and, Minister, you have said you do not control the press. But I think the Committee would want to note that the press release on 6 November was much more measured and factual. So I think we would want to record that we felt that was progress in the right direction and we wondered if it reflected a tweak of the comms strategy.

Mr Hoban: No, we hope we are always measured in our approach.

Q109 Chair: We did have a serious of questions around work outcomes and things, but as we are just launching an inquiry into the Work Programme and because you, as the Minister responsible, will be in front of us with regard to that, I think we will keep those questions for another day.

Mr Hoban: I shall look forward to it, Dame Anne.

Q110 Chair: Can I just ask one thing? Something has been concerning me particularly and it has not featured very much at all in the evidence that we have got either around Universal Credit or, indeed, in response to this. It is about the position of permitted work. We do not yet know what the earnings disregards are going to be. Well, you maybe do know what the earnings disregards and the taper are going to be in Universal Credit for permitted work. But can you assure us that ESA claimants who are allowed to do permitted work up to 16 hours a week and therefore earn £99.50 and keep their benefit, will not be worse off when we move to Universal Credit?

Mr Hoban: I am not the Minister responsible for Universal Credit, but I will come back to you with an answer on that. I think that Universal Credit and the way it works for people with disability or ill health issues is meant to be a much more straightforward process, which is why we are removing permitted work and having quite a generous disregard, but let me just check on that transitional arrangement.

Q111 Chair: I would be grateful, simply because there might not be a problem, because people have not raised it, but there might be a problem that nobody has noticed.

Mr Hoban: I know it is something Lord Freud has looked at. We recognise the challenge about the restraints that are caused by permitted to work and how we want to change the system. What I need to just look at is what the transitional rules are and what the protections are in that situation where someone is already in permitted to work.


Q112 Chair: And which part of ESA you have to be in, in order to get permitted work. Whether you have to be in the support group or whether you are able to be in the WRAG and to keep the permitted work. That would be useful as well. Thanks very much for coming along this morning. As I said, we had lots and lots of questions, but we have got through quite a few, so thanks for your answers.

Mr Hoban: Thank you very much.

Prepared 28th November 2012