Work Capability Assessments

Pamela Nash Excerpts

Wednesday 1st February 2012 Westminster Hall

[Tom Greatrex]

My hon. Friend makes an important and pertinent point that I hope the Minister will address. It is a real concern if some of the facilities used by people undertaking a work capability assessment are in such a state.

[Pamela Nash (Airdrie and Shotts) (Lab)]

I congratulate my hon. Friend on securing this crucial debate. My constituents share the same assessment centre that my hon. Friend’s constituents use in Hamilton, and their experiences suggest that the building is not suitable for carrying out a work capability assessment. It has no disabled access and the car park is 80 yards from the front door. People are only supposed to walk 40 yards, and they feel as if they are being tricked before the assessment takes place.

Another problem is that information is unofficially gathered during the assessments. One of my constituents is deaf, but he was told that he could not possibly be deaf because he heard his name being called in the waiting room. Clearly, while he was waiting he was looking at the door in order to lip-read. Have my hon. Friend’s constituents shared experiences such as those at the Atos centre in Hamilton?

[Tom Greatrex]

My hon. Friend makes a couple of important points. In some ways, a deaf constituent being told that he is not deaf because he heard his name being called is symptomatic of the attitude held by some of the people who carry out the assessments. I am sure that all hon. Members have heard about such experiences from a number of constituents, and it does the principle of helping people into work a gross disservice.

Although it is important to determine whether Atos staff are polite, courteous and accommodating to individuals undergoing the work capability assessment, the most important issue for my constituents is whether Atos gets its assessment right. I suspect that, if the quality survey were completed after the results of the assessment were known, rather than before, the feedback would be substantially different. Will the Minister undertake to consider that issue further, with a view to obtaining a more realistic overview of the claimant’s experience than that currently recorded in the quality survey?

I will conclude by highlighting the case of a constituent that I think best encapsulates all that is wrong with the current system. The Minister is aware of this case, and he was kind enough to meet me last year to discuss it. Nevertheless, I want to put it on the record because, as I said in response to an intervention, I believe that this example is not atypical of many people’s experiences.

My constituent, who wishes to retain anonymity, suffers from Parkinson’s disease. I am no expert on that condition, and I possess only a rudimentary level of knowledge about the illness. I do know, however, that it is an incurable progressive condition, as I am sure Members are all aware. Like many sufferers of Parkinson’s disease, my constituent has good days and bad days. His condition may deteriorate rapidly, or it may get worse over a long period of time—we do not know. We do know, however, that he will not get better.

Despite his condition, my constituent has undergone two work capability assessments, and on both occasions he was found to be fit for work. On both occasions he appealed the decision and was successful in that appeal. Late last year, however, he was called for yet another assessment. Where is the sense in that? If my constituent has an incurable progressive condition and was found to be unfit for work after his first appeal, why was he called in for a second assessment? If he was found to be unfit for work after the second appeal, why was he called for a third assessment?

I understand the need for the continuous assessment of people with conditions that may improve and mean that the individual in question can return to work, and I accept the principle of regular assessment. Being in receipt of employment and support allowance should not automatically mean that someone is on benefits for life. Nevertheless, common sense must be applied. If an individual is never going to get better, why should we reassess them? It is a waste of my constituent’s time and energy—it takes a considerable amount of energy to get to the assessment and the appeals—and it is a waste of taxpayers’ funds. As we know, the cost to the tribunal service of dealing with appeals is projected to be £60 million this year.

Think of the amount of money that has been spent on that one case. There was the original ESA50 limited capability for work questionnaire, the first assessment and the decision maker’s process after the initial WCA, followed by the first appeal and the necessary post-appeal work that must be carried out by Jobcentre Plus staff. That process was repeated a second—now third—time, and will no doubt be repeated again and again until the Government decide to stop the revolving door of continuous assessment and appeal processes that many people have to undergo. Some people are not going to get better or be any fitter for work after the third assessment than they were after the first or second.

As I have made clear, I believe the work capability assessment to be right in principle but wrong in practice. Although its flaws were clear and highlighted by the pilot process and the Work and Pensions Committee report, the Government went ahead with the nationwide roll-out. I have put a number of questions to the Minister, and I am sure we will hear from many other hon. Members. He should address those questions and not seek to avoid them by laying the blame elsewhere. My constituents, and many people in the country, do not object to an assessment to determine someone’s fitness to work. They do, however, object to a system that seems more concerned with hounding those who cannot work, rather than helping those who want to work.

[Yvonne Fovargue (Makerfield) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Williams, and I congratulate my hon. Friend the Member for Rutherglen and Hamilton West (Tom Greatrex) on securing this debate. I have long been concerned with this issue, and it has been raised by the citizens advice bureau in Wigan and by my constituents. The level of accuracy in the work capability assessment reports is staggeringly low. More than one third of local decisions are overturned on appeal, and as my hon. Friend has mentioned, there are long delays to both the initial assessment and the appeal. Worryingly, however, in 60% of decisions overturned on appeal, the claimants scored no points at all in the work capability assessment. In 87% of cases, people were awarded six points or fewer—less than half the number of points required to pass the work capability assessment. We are talking not about margins of error but of assessments that are completely wrong. As more people who previously used reports from medical professionals now have face-to-face interviews, it is more important than ever that such assessments be conducted properly. People must have confidence in the judgment and accuracy of the reports.

One of my constituents came to me last week. He had received his work capability report after a long delay, and the letter consistently referred to an assessment of his leg, claiming that he had no problems. The problem was that all the way through, the letter mentioned the wrong leg. My constituent joked about it and said that he did not have a leg to stand on, but he now needs to appeal that decision with an incorrect report. Confidence in Atos is not high among any of my constituents or the advice agencies to which I speak. I am currently involved in a protracted correspondence with Atos regarding quality standards and how it is mystery shopped. Will the Minister tell the Chamber what mystery shopping takes place, how it happens, and whether there are financial penalties for inaccurate reports? The attitude certainly does not appear to be one of “right first time.” In 2010-11, inquiries about ESA claims and the Atos assessment rose by over 40% in my constituency.

I would like to draw attention to the Citizens Advice report “Right first time?”, which came out in January. There is an in-depth study of cases involving people who had been recruited before they attended the work capability assessment—they had not gone through it, and they were not complaining because it was wrong, so there was no bias. The sample is small because it took quite a lot of in-depth work, and a lot of voluntary advisers helped with it. In all, 37 reports were studied in depth. Sixteen had a serious level of inaccuracy, which meant there were very substantial errors that would have a significant impact on the award of employment and support allowance or disability living allowance. Ten had a medium level of inaccuracy, which meant there were some significant errors that would probably affect the point scoring and potential award of ESA. Only 11 reports had a low level of inaccuracy.

There were five main points of error. There were omissions or incorrect observations. One client, who had really pronounced curvature of the spine and real problems sitting, was marked down as having no problems sitting or standing. There was also incorrect factual recording of medical information. One client said he could not use his left arm at all. He could not dress or shower himself, and his wife helped him. The report said he managed to dress and shower himself, and ESA was refused, but he won on appeal. If the information had been recorded correctly at the first assessment, there would have been no need for that appeal.

Medical evidence has also been inappropriately determined. A client who was registered blind was under a consultant ophthalmologist and had regular sight tests. He said the work capability test was a bit random. The assessor sat there waving cards in front of him at random distances, saying, “Can you see that? What about that one?” That took no account of the fact that the client has regular sight tests with someone who knows him and who is qualified to judge.

Another thing constituents often complain about—this has been mentioned—is the closed questions, the lack of empathy, the incorrect assumptions and the fact that information has not been gathered. Clients who come to me with mental health problems, in particular, say they feel terrorised by the ESA assessment. When they walk into the room, they feel the assumption is that they are trying to cheat the system. Some have said they never want to go for another assessment.

[Pamela Nash]

Does my hon. Friend agree that the issue is not just the assessment’s inability to assess mental health issues, but the lack of sensitivity that is shown? That causes stress for people who are already under extreme pressure and who are suffering from mental health issues, including depression and anxiety.

[Yvonne Fovargue]

I totally agree. I am trying to find out where people go when they are refused ESA as a result of the work capability assessment, and it is quite astonishing that there are no figures. These people do not go on to other benefits, but I cannot find information anywhere about where they do go. Given the experience of my constituents, I believe a lot of people are living off their families because they cannot face going for another assessment.