Work Capability Assessment

Cathy Jamieson Excerpts

Tuesday 13th March 2012 Westminster Hall

[Sheila Gilmore (Edinburgh East) (Lab)]

It is a pleasure, Mr Crausby, to serve under your chairmanship. I hope that the Minister is not tired of hearing from me this morning. During this debate on the employment and support allowance, and the independent review of the work capability assessment, I want to concentrate on the recommendations for new mental, intellectual and cognitive function descriptors, which is a fairly narrow part of the overall picture. Before the Minister jumps up to remind me, I am well aware that the work capability assessment was introduced by the previous Government, and I hope that I would say exactly the same now if my party were in power.

We must not forget that the issue is about people, such as my constituent with mental health problems who has twice scored nil points on a work capability assessment, and who was twice placed in a support group after appeal, having waited seven months and nine months respectively for those appeals. He is currently awaiting the outcome of his third assessment, and the stress of that has affected his recovery.

The issue is a narrow one, but with 35% of the people going through work capability assessments being recorded as having a mental or behavioural condition as their primary condition, it is the largest single group of employment and support allowance claimants, so it is of considerable significance. The Scottish Association for Mental Health, using Government data, says that 43.9% of incapacity benefit claimants who are undergoing reassessment have mental health problems, and in Scotland the figure is 46% of claimants. Getting the assessment right is critical.

In his first review in November 2010, Professor Harrington acknowledged that inadequacies in the descriptors for mental, intellectual and cognitive function were likely to play a substantial role in the high rate of successful appeals. In September 2010, three organisations—Mind, Mencap and the National Autistic Society—were asked to provide recommendations on refining the descriptors. They presented initial recommendations to an independent scrutiny group in December 2010, and both groups jointly submitted their report to the independent review in April 2011.

Following two written parliamentary questions and some initial reluctance to publish, the Minister was good enough to place a copy of the document in the Library on 1 December 2011. Professor Harrington endorsed the report and its recommendations in his second independent review, which was published in November 2011. Parallel with that, there was an internal review by the Department for Work and Pensions, and as a result the descriptors were changed in March 2011.

In the report prepared for Professor Harrington, the charities reaffirmed the importance of getting the descriptors right, and said:

“Some of the problems...are probably attributable to procedural or training factors. However...it is inconceivable that the descriptors do not contribute substantially to this unacceptably high error rate in decisions.”

It concluded that the internal review had not resolved the concerns, and it noted specifically that measuring just one of the relevant aspects of an applicant’s condition, or trying to include more than one aspect on a single linear scale are part of the problem. Although that makes the assessment quicker and easier to carry out, it fails to take account of the multiple features of impairment, and how they interact.

The document explains that the existing assessment does not take systematic and consistent account of the frequency of particular problems, or their severity. If a problem or difficulty is likely to occur infrequently, it could have a very different effect on potential for employment compared with the situation when the problem occurs several times a day.

How will the proposed new descriptors vary? First, the Department for Work and Pensions has been asked to consider reversing the previous reduction in the number of descriptors from 10 to seven. That was done in the internal review. The charities’ view is that by doing that

“Features which have been combined in this way represent separate impairments and…need to be considered separately to ensure a comprehensive assessment.”

Secondly, the proposed descriptors are multi-dimensional. Let me give a brief example:

“Michael experiences frequent spells of anxiety when he finds it…difficult to engage socially with almost all people. These episodes reoccur on average once a month, and tend to last for a few days at a time, after which Michael is usually able to bring them under control with some basic techniques from a short spell of cognitive behavioural therapy which his family paid for.”

It is considered that he is likely to score no points under the current descriptors, two of which relate to social contact. The first is:

“Engagement in social contact is always precluded due to difficulty relating to others or significant distress experienced by the individual”.

That covers engagement with anyone, and scores 15 points on the current descriptors. The second is:

“Engagement in social contact”—

with someone unfamiliar to the claimant—

“is always precluded due to difficulty relating to others or significant distress”.

The word “always” appears in both those current descriptors, and the report’s writers suggest that that is not taken into account in the complexity and difference in that individual’s situation.

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

Does my hon. Friend agree that the problems tend to be compounded when people have to appeal, particularly as appeals require advocates who have some knowledge of mental health issues? They are few and far between, and services are stretched at the moment.

[Sheila Gilmore]

They are indeed, and the issues involve both the still considerable waiting times for appeal, and the fact that appeals may be specialised. We know that those who are represented have a different outcome from those who are not.