Testing times | Work capability assessments distress disabled

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18 THE BIG ISSUE IN THE NORTH · 7-13 NOVEMBER 2011

In November last year, sevenmonths after Atos began the tests, anindependent report commissioned bythe Department for Work andPensions (DWP) found that theprocess was “impersonal,mechanistic and lacking in clarity”,and could cause “psychologicaldistress with effects on physical andmental health”. The governmentadopted a series of recommendedchanges and last month claimed thesystem had as a result been“substantially improved”.

However, across the UK peoplewith disabilities who have recentlyundergone a WCA continue to voice

serious complaints.

One year ago the governmentaccepted the system was flawed andvowed to fix it. But controversial benefit assessments continue tocause severe stress and anxiety fordisabled people, in some casesmaking existing conditions worse, aninvestigation by The Big Issue in theNorth has found.

After announcing plans to cut thenumber of people claiming sicknessand disability benefits in 2010, theConservative-Lib-Dem coalitionsigned a contract worth £100 milliona year with French-owned companyAtos to put 1.5 million peoplethrough a work capability assessment

(WCA).

Testing timesIf you can’t get to the appointment you face having your benefits cut.

If you can get to the appointment you’re fit to work – and might have

your benefits cut. Ryan Gallagher reports on the catch-22 tests that

are causing distress to disabled people

Thirty-year-old Wesley Barry wasdiagnosed with severe depression in2009. His employment and supportallowance (ESA) payments werestopped by the DWP without warningin May after he missed a scheduledAtos assessment. He says he neverreceived the appointment letter andthat the DWP refused to reschedulehis appointment, telling him hecould not make another claim withthe same illness for 18 months.

“For the first time in about twoyears I was actually making progress,and I was doing really well. But because of all this my doctor has saidit’s probably put me back a year,” hesaid. “I have since then been toldtwice my claim has been closed andmust be started again, but it can’t bestarted with my previous illness eventhough the illness never went awayor changed.”

During the assessments an Atosdoctor or nurse asks the claimant anumber of questions, awarding ascore of between zero and 15 pointsdepending on the answers (anythingless than 15 means the claimant isjudged fit to work). Conversationalquestions about how the persontravelled to the appointment can beused to indicate mobility and

competence.

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The author of the government’sindependent report, ProfessorMalcolm Harrington, criticised thequestions, known as “descriptors”.He wrote that they did not

“adequately measure” how seriousmental health problems andconditions with fluctuatingsymptoms – such as ME and HIV –affect an individual’s capability forwork. Harrington is writing aseparate report, expected inDecember, that will propose specificchanges to the descriptors.

Stephen Johnson*, 50, is HIVpositive and has been through arecent WCA. He scored less than15 points, but then took his case toappeal, which he won. On some dayshis health is much worse than others,which his initial assessment did not

take into consideration.“They only base it on what theysee on the actual day – they don’t base it on how you are sometimes.They ask you questions to trick you,like ‘how did you get here?’ and ‘didyou come on your own?’ Theyassume that if you came on your ownthere’s no problems with you gettingout and about,” he said.

“The whole process really gets youdown. You feel like you’re beggingfor money; you feel like they makeyou out to be a liar. You come out of there and you just feel absolutely

worthless. The whole process is verydegrading.”

Johnson added that his stress levelshad gone “through the roof” becauseof his experiences dealing with Atos,

causing his doctor to inform him thatit could worsen his condition, whichsees him bedridden two days a week.“It makes your depression worse andit makes the side-effects of the HIVmedication worse,” he said. (AnAmerican medical study, publishedlast year, concluded stress can have“toxic effects” on people with HIV,causing the body to be lessrespondent to anti-viral treatment.)

Lisa Power, policy director at HIVcharity theTerrence HigginsTrust, is concernedabout the impact

Atos assessmentsare having onpeople with theillness.

“Theseassessments areincrediblystressful, which is

damaging because there are alreadyheightened levels of anxiety anddepression amongst people withHIV,” she said. “We talk to lots of people with HIV who aredisproportionately anxious becauseof these reassessments. People areabsolutely terrified the moment thatthe letter drops on their doorstep.

“We’re clear that Atos are not goodat understanding HIV. We’ve offeredto give them training, we’ve offeredto meet with them, but they haven’tdone so as yet.”

A number of other claimants withnegative Atos experiences contactedThe Big Issue in the North, includingseveral individuals suffering from theneurological disease ME, and otherswith fibromyalgia, a chroniccondition that causes symptoms of acute pain and fatigue.

Carol Chapman*, a 46-year-oldsuffering from fibromyalgia, said shehad endured “two years of hell”

because of a series of failed Atos

WCAs, followed by a long andstressful appeals process, which sheeventually won.

“They have simpled me, mockedme when they thought I wasn’tlooking,” she said. “And after the lastmedical I even turned to drink asthey upset me so much. I don’t drink, but I just wanted to blot out theexperience.”

Around 11,000 WCAs areconducted by Atos every week in theUK. On average 20,000 appeals arelodged every month by claimantsagainst decisions, with 40 per centsuccessful. The appeals process coststaxpayers an estimated £50 millionper year.

WCAs were originally introduced by Tony Blair’s New Labour in 2008

as part of plans to replace incapacity

ATOS AND GOVERNMENT RESPONSEAn Atos spokesperson said: “Atos Healthcare places enormousemphasis on the quality of the service that it provides customers.Its dedicated doctors, nurses and physiotherapists receivecomprehensive training in disability assessment. They understandthat many illnesses produce symptoms that vary in intensity overtime from mild to severe, and are instructed not to base theiropinion solely on the situation as observed at the assessment.”

A Department for Work and Pensions spokesperson said: “Thework capability assessment (WCA), which determines whethersomeone is fit for work, has been substantially improved. Weasked Professor Harrington to undertake a review of the WCA andthe majority of his first year recommendations are now in place.Changes have been made including making improvements to thedecision making process. A second independent review of theWCA will be published before the end of the year.”

MEDICAL NOTES

The doctors and nurses Atos uses toconduct work capability assessments havecome under increased scrutiny in recent

months, amid complaints from benefitclaimants that they have acteddishonestly.

In response to the rising controversy,the General Medical Council (GMC)released a statement on Atos in March. Itsaid: “The first duty of all doctors is ‘tomake the care of your patient your firstconcern’. But that is not the only dutydoctors must observe. Being open andhonest and acting with integrity is also anessential part of medical professionalism.Good Medical Practice provides guidance,not a set of rules, so doctors must usetheir judgement to apply the duties andprinciples defined in our guidance to the

various situations they face as a doctor,whether or not they routinely seepatients in a therapeutic or any otherrole.”

In August it was reported that the GMCwas investigating 12 Atos doctors overallegations of improper conduct. Atos saysit takes all complaints extremely seriouslyand is “committed to providing a high-quality, professional service and requiresthese standards of all its employees”.

The processcould cause“psychologicaldistress witheffects onphysical andmentalhealth.”

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benefit and income support withESA. Moving to scrap the old system,the current government has rapidlyaccelerated the changes by hiringAtos to retest all incapacity benefit

claimants.In July a parliamentary select

committee headed by Labour MPAnne Begg produced a report intohow WCAs have been implemented by the coalition government. Itconcluded that the process, in itscurrent form, does “not accuratelyassess claimants’ employability andneeds in the workplace”. The DWPwas given two months to respond tothe report, but three months on hasyet to do so.

“When the government gave usevidence at the beginning of thesummer they assured us that as a

result of some of the changes put inplace after theHarrington reportthese things wouldimprove,” Beggtold The Big Issuein the North. “I’mcertainly veryconcerned thatthings haven’timproved at all.

“It’s anenormous waste of the government’smoney if they’re carrying out anassessment which they’re gettingwrong, and there’s a high level of appeals and a high success rate in theappeals. They need to be getting thedecisions right the first time. Thatwould cut down on the stress for theindividual but also save money.”

Neil Coyle, policy director of thecharity Disability Alliance, called fora moratorium on Atos assessmentsuntil the problems have beenresolved. “There are ways that have been suggested to the government toimprove the system that are beingignored,” he said. “The governmentadmits this system doesn’t work – sowhy are we still making people withhealth problems go through it?”

* Names have been changed

SOAP STAR FIGHTS CUTS

Coronation Street star Julie

Hesmondhalgh, who plays Hayley Cropperin the ITV soap, joined hundreds ofprotesters recently outside ManchesterTown Hall to campaign against proposeddisability benefit cutbacks.

Hesmondhalgh came straight fromfellow Street star Betty Driver’s funeral to join other speakers, including local LabourMPs and disabled people affected by thecuts, at the Hardest Hit rally inManchester, one of 12 demonstrationsthat took place in a national day of action.

Separately from the work capabilityassessments receiving widespreadcriticism, the government’s WelfareReform Bill proposes a time limit onEmployment and Support Allowance anda reduction in the benefit that will replaceDisability Living Allowance.

Joined on stage by fellow actorsCherylee Houston (who plays the disabledcharacter Izzy Armstrong in the soap) andAli Briggs (who played Emily Bishop’s deafniece Freda), Hesmondhalgh spokepassionately about the unfairness of theproposed changes to the benefits system.

“People who are at the bottom of thepile bear the brunt of these cuts,” shesaid. “There are offshore bank accountsand bankers’ bonuses, yet they continueto get away with it while the people atthe bottom, the most vulnerable insociety, are being targeted.”

Speaking after the rally, Hesmondhalgh

explained that one of the reasons sheagreed to speak at the event was becauseshe knew people personally affected bythe cuts. She is also open about using thepublic’s love of Coronation Street to helpout the campaign.

“Corrie is a powerful force in manypeople’s lives,” she said. “And it’s aprivilege to use that level of recognitionto help give this campaign a higherprofile.

“People with disabilities have beenfighting for years for disability rights, andhave only just won a number of thoserights. The cuts to these benefits,especially the Disability Living Allowance,will affect paying for transport, for carers– all the things that enable disabledpeople to play an equal part in society. It’staking people’s freedom away, theirrights, their equality.”

Hardest Hit is a campaign groupestablished to fight the government’s cutsto benefits and services for disabledpeople.

According to research by the thinktankDemos, the proposed welfare reforms willsee 3.5 million disabled people lose over£9.2 billion of critical support by 2015,pushing them further into poverty andcloser to the fringes of society.

CHRISTIAN LISSEMAN

Coronation Streetstar JulieHesmondhalgh atthe Hardest Hitrally in

Manchester

“You feel likeyou’rebegging formoney, likethey make youout to be aliar.”

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Testing times | Work capability assessments distress disabled