Work Capability Assessments

Cathy Jamieson Excerpts

Wednesday 1st February 2012 Westminster Hall

[Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Williams. I thank my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) for securing the debate and for his tenacity—I think that would be the best word—in pursuing this issue. He has submitted what is probably a record number of parliamentary questions on it, and my constituents and I are grateful for that, because we have seen that someone is taking it seriously and cares passionately about it.

I want to concentrate on a number of issues raised by constituents. They were keen that I should take this opportunity to make representations to the Minister. People often feel that they are on their own and that they are the only ones having particular difficulties. Given what we have heard already, my constituents’ experiences appear to be very similar to those of constituents elsewhere, and I hope the Minister will take account of that.

I want to echo what my hon. Friend said. Neither I nor my constituents have a problem in principle with the notion that someone who is fit and able to work should do so if work is available. Many people with disabilities wish to hold down jobs and they can do so. Other people will require support, adaptations and particular circumstances to enable them to work. The constituents who come to me most frequently about work capability assessments, however, are those with fluctuating and perhaps long-term conditions. They tell me and my caseworker that the work capability assessment report does not accurately reflect their day-to-day experiences. They often say that they feel as if the wrong report has been sent in. They wonder whether people are making generalisations on the basis of their answers to questions.

People with these conditions also make the point that if they are having a good day, they will probably get along to the work capability assessment. However, if they are having one of their bad days, they simply will not be able, in some circumstances, to attend or to cope with the assessment. In addition, people with mental health issues, in particular, tell me that they do not get a fair assessment. They feel that because their condition is apparently invisible the assessor often seems to know little about it.

Of course, there are problems. Chronic but intermittent conditions can mean that claimants sometimes find themselves moved from ESA to jobseeker’s allowance and back to ESA, with all the work capability assessments in between. That leads to real difficulties because people often find themselves with no financial support while DWP processes are under way, with one claim being closed while another is being opened.

The most frequent cause of concern for constituents is apparent inconsistency. In a recent case in my area the maximum 15 points were awarded by the health care professional; that award was overturned by the DWP decision maker. The GP, the hospital consultant and Atos agreed that the person was unfit to work, but the decision maker in the DWP disagreed. In another example from my constituency a man with a progressive and incurable kidney condition, which requires him to undergo surgical operations every six months, was awarded 15 points; but that award was overturned by the decision-maker in the DWP, even though the decision-maker stated in correspondence:

“I am satisfied that the descriptors have been fully justified with clinical findings, observations and extracts taken from the typical day history provided by Mr A. The medical report…was appropriate, complete and covered all the area of incapacity described by Mr A as well as including a comprehensive typical day history and full set of clinical findings.”

We can understand why constituents find it difficult to understand why, when all the medical professionals and, indeed, Atos, appear to agree, someone in the DWP without a medical background apparently can overturn their findings.

I should like the Minister to tell me how many people—and what percentage—he is aware of who, having been awarded that maximum 15 points, have had the award overturned by the DWP decision maker, and how many of those have had appeals upheld. That may be useful for our understanding. As my hon. Friend the Member for Rutherglen and Hamilton West mentioned, there is concern about the cost of appeals, and I hope that the Minister will tell us the average cost of an appeal, and how much time is spent processing all the associated paperwork.

[Kerry McCarthy (Bristol East) (Lab)]

My hon. Friend makes a powerful case. I went to an appeal with someone with ME who scored zero points. She took with her the medical evidence from the experts at the hospital; when the panel looked at it, it was a case of giving it a tick and telling her that of course she was not fit to work. However, those dealing with the form-filling and Atos stage were not prepared to consider it. It seems ludicrous that my constituent must go through the expense and stress of an appeal, and that the expert evidence cannot be considered earlier.

--- Later in debate ---

[Cathy Jamieson]

My hon. Friend makes an important point. I wanted to give some examples of constituents who have had to appeal. One is a man almost at retirement age who has worked in a manual job since leaving school at 15, who became unfit to work. He requires a tube to be inserted into his gullet so that he can eat and drink. He could not bend forward during the assessment process or when he came to speak to me, because if he did so anything in his stomach would be emptied out; he has no muscular control. Initially he was told that he was fit for work. With our assistance he won his appeal. On the other hand I have another constituent, with a progressively degenerative eye condition, who is registered blind and can just about read a 42 point font, which is fairly large. She lost her appeal. There seem to be different circumstances and different approaches.

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

The hon. Lady makes an important point. My concern about people who must go to appeal is that they do not get the advice and support they need. People who get it are more likely to succeed in their appeals, but Citizens Advice talks about a threefold increase in impact on its services since the process was introduced. I am sure that many hon. Members have had increased mail in that time.

[Cathy Jamieson]

The hon. Lady makes an important point. I do not think that anyone would doubt that there is pressure on advice services. Organisations for individual conditions, such as Parkinson’s UK or the Multiple Sclerosis Society in my area, will talk about their concern that, although they can help so many people, there are others they cannot reach. I know from my case work that more people are coming to me to raise their concerns. They want to be put in touch with advocacy services to help them with appeals; my office cannot take on the job of representing people at every appeal, on account of the numbers involved.

[Nia Griffith]

Does my hon. Friend agree that, given the evidence we have heard today, and our own experiences, the DWP should seriously consider what to do about people with long medical histories of degenerative disease who are continually called in? It seems a complete waste of taxpayers’ money and it is a disgrace that we do that to those people. Will my hon. Friend suggest to the Minister that we might consider some way to exempt such people?

[Cathy Jamieson]

My hon. Friend makes a powerful case, and I am sure that the Minister is listening. On the point about people with long-term degenerative conditions, another constituent called at my office in great distress, when I happened to be there. The lady could hardly open the door to come in without assistance. She was extremely upset having just had a phone call to tell her she was deemed fit for work. She told me that she had had MS for 20 years. She has poor eyesight, mobility and memory. I was so concerned about her plight that I immediately contacted her GP, who assisted with taking up her case. He subsequently wrote:

“I have today issued Mrs E with a Med 3 for 13 weeks stating she is not fit for work (as she is patently NOT”—

he underlines that—

“fit for work). Like her I have not received any written communication stating that she is fit for work, as I would have expected. She should receive such written confirmation and the way to appeal clearly outlined in that letter. My role is twofold, firstly, to continue to issue a Med 3 (medical statement) and secondly to provide written information for her appeal Tribunal.”

He has done that. I do not think that we can overestimate the stress and worry that that incident has caused my constituent.

[Julian Sturdy (York Outer) (Con)]

The hon. Lady highlights the stress that individuals go through during assessments. Several constituents have visited my surgery to explain how they went through such stress. Does not the assessment have to be fair, both to the individual and to the taxpayer, as has been mentioned? Also, is not the assessment becoming a tick-box exercise with a one-size-fits-all approach that does not take into consideration the fluctuating conditions from which people suffer?

[Cathy Jamieson]

The point about fluctuating conditions is well made. That is exactly the problem. Some people with such conditions, in some circumstances, will be able, with the right support, to hold down employment, but others will not be able to do so, perhaps because of the cycle of their condition or because their mental health is affected. I am concerned that the process in question appears to be a tick-box exercise.

One more example from my case work involved a gentleman who lost a leg and badly damaged the other in a childhood accident. Clearly he suffered as a result of that disability. He was awarded zero points. If the system is to have the confidence of the public and the people being assessed, it must be seen as fair. My constituents tell me that there are so many inconsistencies that they feel that they are not treated fairly, that their individual circumstances are not taken into account, and that the procedure is indeed a tick-box exercise.

[Fiona O'Donnell (East Lothian) (Lab)]

My hon. Friend is making an excellent contribution to the debate. The information in question is in the public domain, and part of the problem is that that means people facing the process have no confidence in it. It causes such stress, particularly for people with mental health problems, that it has even driven some to take their own lives. How can that be defended?

[Cathy Jamieson]

I hope that my hon. Friend will understand that I take such issues seriously. I am very concerned to hear that she is aware of people being driven to such drastic action as taking their own lives. Going by the correspondence and contact that I have with constituents, I can say only that I know just how difficult it is for people, and that many feel they cannot face the appeal process—particularly those who have suffered from a condition for years and who feel that the process is undignified and that they do not get the right help and support, and who perhaps do not know to whom to turn.

[Michael Connarty (Linlithgow and East Falkirk) (Lab)]

I echo everything that my hon. Friend says about the appeals process and the total lack of credibility of Atos. Earlier, she mentioned the systemic problem of DWP officers overruling all of the evidence, even that from Atos. Will the Minister address the fact that many people who are told that they cannot work again are suddenly taken off the support system in the DWP and put on to the other system, thus causing them great problems? They are made to go through rituals of training and work interviews when everyone agrees that they cannot work again. Surely that power should be clearly defined. If someone is told that they cannot work again, DWP officials should not be allowed to overrule that decision.

[Cathy Jamieson]

I am sure that the Minister will respond to that point, which is also one that I raised earlier. As I had concerns about the work capability assessments for people with a range of conditions, I tabled some parliamentary questions in a bid to find out how many people had been assessed in my constituency. I was disappointed to be told that such information could only be provided at a disproportionate cost.

After hearing about the experiences of a number of my constituents, I tabled another parliamentary question to find out how many assessments had been carried out on constituents who had cerebral palsy, osteoporosis, MS, who were registered blind, who had hearing impairments, who were on the autistic spectrum, who were carers themselves and who had learning difficulties or mental health problems. Those are the people who had come to me saying that they had had difficulties with the work capability assessment. Again, I was told that such information was not available at constituency level. I hope that the Minister can respond to that and tell me whether that kind of assessment, analysis and reporting will be available by parliamentary constituency in the future because it is in the interests of transparency and it would enable us to make comparisons across different parts of the country.

Finally, I have a couple of points around the issue of Parkinson’s, which my hon. Friend the Member for Rutherglen and Hamilton West mentioned in his opening remarks. The Parkinson’s Disease Society says that increasing numbers of people with Parkinson’s are being rejected from the support group. Between October 2008 and November 2010, it says that 45% of people with Parkinson’s who had undertaken the work capability assessment were referred to the work-related activity group instead. As an example, the organisation cited the case of one man who was placed in the work-related activity group despite the fact that his tremor was so severe that he could not hold a pen, walk more than a few steps or button up his trousers himself.

The organisation gives examples of people having long waits for appeals and receiving inconsistent or inadequate support in the work-related activity group. It talks about the ESA assessment process impacting disproportionately or inappropriately on other benefits, the worry for carers and the knock-on effect on other statutory services.

The Parkinson’s Disease Society also gives examples of people who are clearly not fit for work being told that they should get work. A 59-year-old man with Parkinson’s says:

“I feel I could work in the right job, with the right support, but none of this has been forthcoming from the job centre, who wished me well but basically said there are no jobs for able-bodied people let alone someone like me. I’m not surprised that only 6% of people in my position get back into work in 12 months. Everything I’ve done to get back into work I've had to off my own bat.”

On the one hand, we have people who say that they want to work and to cope with their condition and feel that they can do so but who are getting no help, and on the other we have those who feel that they are being hounded. That is not the sign of a caring, compassionate and decent system. I hope that the Minister will take account of what Citizens Advice and others have said and that he will not make this a party political issue. There is agreement across all parts of the House that this system is not working in the way that it should. I hope that in his response, the Minister will consider making some changes and give us some hope for the future.