Strictly this isn’t historical, but does relate to the work I did a few months ago at the Parliamentary Office of Science and Technology.1
Some basic explanation to start with. Atos Healthcare are a private company with expertise in IT and database systems. They are hired by the Department of Work and Pensions (DWP) to administer the tests which determine whether people are medically eligible for Employment and Support Allowance (ESA).
This is the benefit you get if you are out of work because of a health condition.2
There is controversy because Atos is certifying a number of people as “fit for work” who previously were considered “unfit for work”. The government have been accused of simply accepting Atos’s decisions without question because it means they can get away with paying fewer benefits. There are, of course, many sides to this debate, and this is why these figures released today are quite interesting.
Atos and the Government
The WCA – Work Capability Assessment – has three parts:
- A self-assessment questionnaire (ESA50) which the claimant completes along with their doctor’s evidence. This shows the various effects their health condition has on their lives.
- A medical assessment made by Atos. This asks questions about how far people can walk, whether they can lift a box, how well they can communicate, whether they are continent, and so on. Each “limitation” carries a points score depending on the severity. If a person gets more than 15 points, they are considered to be eligible for state support. Or put another way, if you get fewer than 15 points you are expected to find work.
- But this can be overturned, because a DWP decision maker has the final say, utilising all the evidence at her disposal. So, while the Atos assessment may only produce 10 points, say, the medical evidence and the ESA50 may well be compelling enough for the DWP decision maker to overrule the Atos decision.
Disability organisations are adamant that the Atos testing procedure is inherently flawed. Part of this argument says that the functional test is broken. It does not measure what it is supposed to measure; Atos staff do not take enough time to properly assess claimants; and the test cannot take into account the changable nature of conditions such as MS or mental health issues.
If, for example, a person with clinical depression has their assessment on a “good day” then they may be considered fit for work – even if for the other 30 days of the month that person has been bedridden.
Of course, none of this would matter if the Government genuinely took the other evidence into account and overturned the Atos recommendation. This is supposed to happen. This is the counter balance to ensure the right decision is made first time. But it plainly hasn’t. 40% of “fit for work” decisions are appealed, and around 40% of those appeals have been successful. Although that rate is now falling.
Is the DWP decision maker doing his/her job?
In my POSTnote1 I included a chart which showed that the amount of cases where Atos’s initial decision was overturned either by appeal or because the DWP disagreed with the recommendation. But these were aggregate statistics. In an e-mail conversation I had a few months ago, I outlined the proportionate decisions like so:
Month Total decisions made Decisions which went against Atos recommendation % May-10 33900 900 2.65% Jun-10 38300 900 2.35% Jul-10 40300 1100 2.73% Aug-10 36900 1200 3.25% Sep-10 38700 1300 3.36% Oct-10 38100 1900 4.99% Nov-10 41200 2600 6.31% Dec-10 28500 2300 8.07% Jan-11 34200 2700 7.89% Feb-11 37200 3100 8.33% Mar-11 44700 3700 8.28% Apr-11 31200 2800 8.97% May-11 34900 3100 8.88%
For data sources see foonotes.3
I say this not just in the interests of balance – the government has significantly improved its performance in this regard. An independent review had criticised the Government for “rubber stamping” Atos’s decisions and not taking into account vital subjective evidence in assessing reasonable capacity for work.4 These figures show a definite improvement, from around 2.5% up to nearly 9%.
These figures only show where the DWP decision maker disagreed with Atos. They do not take appeals into account.
The latest figures released today show that – once appeals were taken into account – 13% of all final decisions between October 2008 and November 2011 differed from Atos’s recommendation.5 Obviously being over such a long period we cannot say whether things have got better or worse. Still it would indicate that slowly things might be looking up.
However – disabled people can’t afford to wait. Literally. They can’t afford the loss in income while the lengthy appeals process chugs on. Today’s figures also reveal that in over two thirds of cases in 2011, the assessment procedure takes longer than 13 weeks.6 Earlier this year, appeals were taking longer than 24 weeks to process.1 Presumably, therefore, many people are having to wait over 9 months before they have any idea whether they can claim disability benefit long-term.
And they can’t afford to wait until the government gets its act together. Even if things are improving, they are still at woefully unacceptable levels.
1 Gareth Millward, Peter Border, Assessing Capability for Work, PN-413 (London : Parliamentary Office of Science and Technology, July 2012).
2 This is, of course, a massive simplification. ESA is also divided into two parts – a Support Group for people who are very unlikely to work again; and a Work Related Activity Group (WRAG) for those who are expected to work again if the right support is made available. Claims on the WRAG are time-limited to 12 months.
3 Figures here take the raw total decisions made from the DWP – < http://research.dwp.gov.uk/asd/workingage/index.php?page=esa_wca > – and the total decisions made that differed from the Atos recommendation as quoted by Chris Grayling in Hansard – < http://www.publications.parliament.uk/pa/cm201212/cmhansrd/cm120321/text/120321w0001.htm#12032182000035 >
4 Malcolm Harrington, An Independent Review of the Work Capability Assessment (London : DWP, November 2010), p. 10.
5 So far for 2012 things are even worse, though to be fair we only have data for January and February. DWP, ‘Employment and Support Allowance: Atos recommendations and post appeal Work Capability Assessment outcomes’ (12 September 2012).
6 DWP, ‘Employment and Support Allowance: Assessment Phase Durations (Tables)’ (12 September 2012) < Excel Spreadsheet >