Atos Healthcare

Lord Grayling Excerpts

Tuesday 4th September 2012 Westminster Hall

[Dame Anne Begg (Aberdeen South) (Lab)]

Congratulations to my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing this important debate. This is my first time speaking after my extended absence and therefore a good subject.

[The Minister of State, Department for Work and Pensions (Chris Grayling)]

On behalf of everybody in the room and in the House, I welcome the hon. Lady back to the House. We are delighted to see her in such good shape. We were sad to hear of the difficulties in the long period of recovery she has had to go through. She is very welcome.

[Dame Anne Begg]

I thank the Minister for being gracious. He may not be quite so gracious by the time he has heard what I have to say. I do not think that the Government have grasped how disastrous the ESA assessment system is. It is not something that can be fixed by a few tweaks here and there; we tried that with the Harrington review. What we have heard today in the Chamber—and in the “Dispatches” and “Panorama” programmes filmed in June this year—suggests that not much has changed. The people complaining are not just the usual suspects, not just the radical crips, the workshy or those who want money without being assessed. They are ordinary people, most of whom worked hard all their lives until the sky fell in and they lost their job because of an illness or an acquired disability.

It is not enough for Government to say that the genuine claimant has nothing to fear. In too many cases, genuine claimants are not scoring any points in their initial assessment. There is something fundamentally wrong with the system and the contract that Atos is delivering. When the British Medical Association votes at its conference to say that the work capability assessment is not fit for purpose there is something wrong with the system. When GPs are reporting an increased workload, not just as a result of providing reports but as a result of treating patients whose condition has worsened as a result of their WCA experience, there is something wrong with the system.

When my constituent, who has lost his job because he has motor neurone disease, scores zero on his WCA and is found fully fit for work, there is something wrong with the system. When that same constituent appears in front of a tribunal and in less than five minutes is awarded 15 points, there is something wrong with the system. When people with rapidly progressive illnesses are not automatically put in the support group, there is something wrong with the system. When some people would rather do without the money to which they are absolutely entitled rather than submit to the stress of a WCA, there is something wrong with the system. When someone with a severe illness has to fight for a year through an appeal to get the correct benefit, only to be called in almost immediately for another assessment, there is something wrong with the system. When the recall and assessment happen the following year, and the following year, there is something wrong with the system. When people feel so persecuted, there is something wrong with the system. To top it all, they lose their contributory ESA after only a year if they are in the WRAG group.

When up to 40% of appeals are successful and there is no penalty for the company carrying out the assessments, there is something wrong with the contract. When so many appeals result in an award of ESA support group status when the original assessment was no points, there is something wrong with the contract. When there is no penalty for a high percentage of wrong decisions, there is something wrong with the contract. When there is no incentive for assessors to get the assessment correct first time, there is something wrong with the contract.

It is time for the Government to act, because there is something fundamentally wrong with the whole system.

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[The Minister of State, Department for Work and Pensions (Chris Grayling)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I know that this is an issue of great concern to many Members, as it was always going to be. I totally accept that this is a long and difficult process, and I have always said that, both in this Chamber and in the House. I will not be able to respond to every individual point. One or two hon. Members have raised individual constituency cases, and if they write to the Department, I will ensure that it addresses their specific questions.

Let me make one point in relation to a comment made by the hon. Member for Hayes and Harlington (John McDonnell). He drove to the absolute heart of what we are trying to achieve, and this is an ambition that was and is shared by both the Opposition and the Government. If people can make a return to work, even if it is a different form of work from the one they did before their health issue arose—[Interruption.]

[Mr Philip Hollobone (in the Chair)]

Order—[Interruption.] Order. Parliamentary rules state that there should be no noise at all from the Gallery—[Interruption.] Madam, if you persist in carrying on talking and shouting, I will have no choice but to suspend the sitting and clear the Gallery—[Interruption.] This is your last chance. If there is any more noise from the Gallery, I will have no choice but to suspend the sitting, meaning that no one will hear from the Minister.

[Chris Grayling]

If people can make a return to work, even if it is a different form of work from what they were able to do before their health condition arose, that is better for them than spending the rest of their life on benefits. That is the principle that we are working towards.

[Helen Goodman (Bishop Auckland) (Lab)]

rose—

[Chris Grayling]

I will briefly give way once, but that is all.

[Helen Goodman]

If the Minister has read the current descriptors, will he explain what kind of work a person could do when their engaging in social contact with someone unfamiliar is always precluded due to difficulty relating to others? There are those who have reduced awareness of everyday hazards, which means that they face significant risk of injury to themselves or others, and those who are at risk of loss of control leading to extensive evacuation of their bowel and bladder. What work can these people do?

[Chris Grayling]

Let me pick up on that point straight off. It is all well and good for Opposition Members to stand up and rail about the system, but it is a system that was created by Labour four years ago when they were in government, and it is a system that we have consistently tried to improve.

Let me be absolutely clear. I put it on record that this is not a financial exercise. There are no targets attached to the reassessment of people on incapacity benefit—[Interruption.] The assessment that is in place for new claimants for employment and support allowance—

[Mr Philip Hollobone (in the Chair)]

Order. If there is any more noise from the Public Gallery, I am afraid that, under the rules of Parliament, I have no choice but to suspend the sitting and clear the Gallery. I understand that people are very concerned about this issue—my constituents are concerned about it as well—but under the rules, I will have to clear the Gallery if there is any more noise. This is the last time that I will say it: if there is any more noise, I am afraid that I will have to suspend the sitting.

[Chris Grayling]

It is really important to emphasise that the reassessment of people on incapacity benefit is not a financial exercise and that there are no financial targets attached to it. It is about finding the right number of people who can make a return to work. It is not an exact science—it never was and never could be—but it is all about trying to help people back into the workplace if they can possibly return to it. That was the previous Government’s motivation when they established the work capability assessment. When we took office, we put in place the changes that they themselves had put in the pipeline through the internal review of the work capability assessment.

When we took office, I fully accepted that the process needed to be improved. That was why we brought in Malcolm Harrington and it is why I am absolutely clear that we have implemented his recommendations. I have regularly met and talked to Malcolm Harrington, and at no point has he said to me that the process is not fit for purpose. At no point has our independent adviser, whom I believe has the confidence of most people in the charitable sector who are involved in this work, said to me that this system has to stop or is unfit for purpose. He has made suggestions about improvements, and we have followed his advice in that regard. Our objective is to do the right thing, but of course this is not an exact science. We will never create a system that is perfect, which is why people have a right to appeal.

[Stephen Lloyd (Eastbourne) (LD)]

Following the substantial improvements that the Government have made, does my right hon. Friend the Minister agree that the number of people who have been moved into the support set of the ESA has increased by 20%?

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[Chris Grayling]

It is a matter of record that since we implemented changes as a result of the Harrington process and the internal review that we inherited from the previous Government, the number of people going into the support group, including the number of people with mental health conditions, has increased. That is a good thing and I am pleased that we made those changes.

The issue of cancer has been raised. It has taken us longer than I expected to address that, because of various issues that arose in our discussions with Macmillan Cancer Support, but I believe that we are now in the right place. We will be making a formal announcement very shortly, but I have said before that I believe that we should extend to those receiving oral chemotherapy the access to the support group that is offered to people receiving intravenous chemotherapy.

[Stephen Timms]

Will the Minister give way?

[Chris Grayling]

I will give way very briefly, but this is the last intervention that I will take.

[Stephen Timms]

The Minister will acknowledge, however, that the new descriptors that have been proposed for mental health conditions and for fluctuating conditions are nowhere near being implemented. When does he expect that they will be implemented?

[Chris Grayling]

I will make just one more point and then I will answer that question.

It is really important to put it on record that Atos does not take decisions. In no circumstance does Atos take a decision about whether somebody receives a benefit or does not. A claimant will be asked to fill in a form that goes to Atos for consideration of whether they should be put to an assessment, or passported straight through to the benefit. Atos carries out the assessment, but the decision about benefits is taken by a Department for Work and Pensions decision maker in Jobcentre Plus. It is really important that people understand that Atos does not take decisions.

When we talk about Atos, we are talking about a team of perhaps 1,500 health care professionals, many of whom have trained in the NHS. Those professionals are carrying out an assessment that was designed by the DWP under the previous Government and that has been continued under the current Government. Atos does not take the decisions itself.

As a result of the Harrington recommendations, we have gone out of our way to address people much more directly. Rather than letters, they now receive phone calls, in which they are asked to bring forward additional evidence. A question was asked about the mandatory reconsideration phase. Effectively, that phase already happens. Every case in which the person says they are not happy will now involve a reconsideration within Jobcentre Plus. I am keen that we have that second opinion, because we will not always get things right and I want to try to see whether we can bring forward further evidence that would enable us to make the right decision before a case ever reached the tribunal service. Effort is being put in to make that happen.

The right hon. Member for East Ham (Stephen Timms) asked about recordings. Let me be clear that Harrington recommended that we carried out a pilot to test recordings. I was keen that we just did it, but Harrington said to me, “Actually, it may not work, so I really think that you should pilot it. It may prove to have a negative effect.” We therefore tested recording and found that there was little enthusiasm among those being assessed to have their assessment recorded. In the end, the conclusion was that we should make recording available on a voluntary basis, but it should not be something that we do across the board.

I do not rule out recording. If there was overwhelming evidence showing that it was necessary, I would make it available, but let me give some statistics. There are 300 claimants waiting for an audio-recorded assessment, while Atos is conducting 8,000 assessments a week. We are ordering additional audio-recording machines so that people can have their assessment recorded, if they want. They are perfectly entitled to bring their own recording equipment to an assessment as long as it can record two copies of an assessment, because they need to be able to take one copy with them and leave the other behind. That is why we have to buy what is fairly expensive equipment, and we have ordered additional equipment because there has been an increase in demand in the last few weeks.

I am perfectly relaxed about recorded assessments and perfectly happy to make recording facilities available. However, the advice that I received from Malcolm Harrington was that we should test recording. The result of the pilot was not only that there was not a need for recording, but that many people felt uncomfortable being assessed with a tape recorder running.

The right hon. Gentleman also asked about the new descriptors that were brought forward by the charities, but he is out of date. The charities have been working with us for the past few weeks on the assessment project of the package that they brought forward. The work was finished last week. The charities wanted more time to work with us because the process is complicated and we are trying to mesh mental health issues and fluctuating conditions. As I said in Westminster Hall about 12 months ago, the problem that I had with the recommendations that the charities made in the first place was that they came forward not simply with adjustments to the existing descriptors, but instead with a comprehensive reorganisation of the assessment, which would also have involved a redesign of the physical descriptors. Given that the right hon. Gentleman has carried out such projects in the DWP, he will know well that that would be a two or three-year project.

We have tried to take forward some of the suggestions that the charities made and embed them into elements such as the ESA50 form, and we are now working with the charities to road test all this work to see whether it really makes a difference. However, I am not going to embark on a major overhaul of the whole exercise based on recommendations that are not backed by evidence without our having tested them in the way in which the previous Government tested recommendations: by putting real cases against proposed descriptors and making a comparison between the outcomes of the theoretical new descriptors and the old descriptors. Such work is on track. We are pushing the charities to make progress, because I want to get the work done, and we are still on track to complete the gold standard review in the spring.

The hon. Member for Rutherglen and Hamilton West (Tom Greatrex) referred to the National Audit Office report. I have had the benefit of having read that report, although I know that he has not. The reality is that the report highlights a number of what I regard as not particularly major areas of improvement. If he reads the report, he will see that it reflects a big and complicated contract. It makes some suggestions for improvement, but it is not as he portrays it.

When the hon. Gentleman talks about the performance of Atos during the last two years, the key point he must remember is that the recommendations that Malcolm Harrington made, combined with some fluctuation in volumes coming through to Atos, which are certainly beyond its control, have caused significant operational difficulties. I can give him my word that I have sat in meetings with representatives of Atos and put them under intense pressure. Atos has brought in extra capacity at cost. We have made sure that we deliver at every stage. However, it is not possible to change the goalposts totally and then expect the subcontractor to take it on the chin with no consequences.

We have seen some consequences of the introduction of the Harrington recommendations, particularly the personalised statement. However, as I stand here today, we are on track to close the backlog time to where it should be later this autumn. The numbers that the hon. Gentleman gave are already well out of date. We have brought down the backlog in the number of appeals that we inherited two years ago, but it is a big task. We are dealing with a large number of people and this is a big challenge.

Let me be clear that we want to get this process right and we want to do the right thing. I want people who need long-term ongoing support to be in the support group. The Government have no interest in doing anything other than looking after those people who need that, but we will also give encouragement and support—and a bit of a push—to those who can get back into work, because I believe that that is the right thing for them.

[Mr Philip Hollobone (in the Chair)]

I thank those Members who have attended this important debate for coming along today, and I encourage everyone to leave Westminster Hall quickly and quietly so that we can proceed to the next important debate.