Atos

Richard Graham Excerpts

Wednesday 12th February 2014 Westminster Hall

[Richard Graham (Gloucester) (Con)]

My hon. Friend is making an important case, which should be heard, and we all have examples from our constituencies, as he says. Does he agree that the situation is difficult, given that the contract was a monopoly one—awarded by the previous Government—and is therefore awkward and possibly expensive for this Government to get out of?

[Mr Williams]

My hon. Friend is right. I am not approaching the subject on a particularly partisan basis, because the problems are experienced in all constituencies, but he is right to talk about the circumstances in which this Government are dealing with the legacy of decisions taken under the previous Government. He is right to highlight that. I have every sympathy with many of the campaigning groups, on behalf of which I will talk in my later remarks, but we need to remember the origins of the decision, which the Labour Government made.

I want to talk specifically about delays. I met Atos representatives yesterday, so I know that they recognise the length of time taken to complete the process. One of my constituents, who I will call Mr P, had his Atos assessment two years ago and was failed. He appealed, and the appeal took eight months to be heard. The appeal judge took only three minutes to uphold the appeal. His backdated benefits were paid, but two months later he received a letter summoning him to another Atos assessment, because the process had taken so long from start to finish that the 12-month period before reassessment was almost up. At the second Atos assessment, my constituent was unable to complete some of the tests without causing himself considerable pain and anguish, so they were stopped halfway through. This went down on his medical report paperwork as a refusal.

The case, now complete, has gone to the ombudsman, and I would like to quote a section from my constituent’s letter to the ombudsman:

“I have paid my NI contributions and taxes all my life believing I would be protected by the welfare system should anything untoward happen to me. For 2 years I was afraid to open my post in case it was another letter stopping money...or another assessment. During this time I have been in pain, had needles...surgeons knives, ligaments removed, bones cut and metal plates inserted into me but I am still made to look like some kind of scrounging criminal by a system that was meant to protect me.”

I condemn certain sections of the press for the way in which they have characterised benefit claimants. A gentleman who is genuinely seeking support from the welfare state, into which he has paid all his life, is seemingly being let down.

In many cases, our constituents want to get on with the process of recovery and do not see benefit claiming as a long-term situation, but the delays make their condition worse. Another constituent who I am dealing with—she, too, will remain anonymous—said:

“I am currently receiving treatment and therapy and my therapist is not keen to discharge me yet. My health is not improving and is in fact being made worse by the anxiety caused from this void of information. I was feeling quite positive at one time that I may be put into the Work Related Activity Group…as this would be a great stepping stone to getting back into work from sickness, but I currently feel so low because instead of being helped forward towards getting back into work, I am stuck in an uninformed place that is not helping me recover at all.”

That indicates to me that the process for some conditions —by no means all of them—is making situations worse and adding anxiety to something that is already causing considerable stress to people.

In developing the debate, I am talking about some of the principles that I believe—I am sure people in all parties believe—should be governing our assessment system. My concern in addition to the delays is that the work capability assessment is not fit for purpose. Indeed, the charity Mind informs me that around 40% of people who are found fit for work appeal against the decision; of those who appeal, almost 40% win their appeal. As we know, capability to work is about not only those suffering with physical disabilities—it might be easier for ATOS assessors to see and report on a tangible factor—but those suffering with an invisible illness. This is true in particular of constituents who are suffering with mental health issues, or conditions relating to autism, which is an especially interesting example.

In my constituency, I was pleased that an excellent charity, Autism Cymru, developed a project to train people in the DWP to have greater understanding of the condition of autism. I used to be a primary school teacher and we had minimal training on this, but one thing that impressed itself on me was one particular feature of autism: asking a direct question gets a negative response. That is the nature of the condition, and it needs to be borne in mind in the assessments. The charities Rethink, Mind, the National Autistic Society and Citizens Advice have all made that point to me. I therefore ask the Minister to reiterate the Department’s concern and to ensure that, whichever providers undertake the work, the assessors are appropriately trained in complex conditions such as autism and mental health, so that the clients may be—and see themselves to be—assessed fairly and comprehensively.

Last autumn, with other Members, I undertook a mock assessment organised by the charity Rethink, to give MPs the experience of taking a work capability assessment. At that meeting was a Rethink campaigner, the retired vicar Dick Acworth, whose son has bipolar disorder and yet was deemed fit for work. People such as Dick’s son with a supportive family are lucky to be able to face the appeals process together, but there must be concern about the number of people who do not appeal, because they cannot face it, or simply do not know how to go about it, and they are very much left to struggle alone.

[Mr Williams]

I thank the hon. Gentleman for making, once more, that point. It is critical that all due consideration is given. I do not agree with the characterisation of constituents as simply going down to their doctor’s surgery, presenting a letter to the doctor and saying, “Sign this”, and then that letter being presented as part of a package for an assessment, or indeed a tribunal. Doctors are the experts. They know their patients and the situations in which they operate, and we need to give them all due consideration.

Concerns have also been expressed about people suffering from progressive illnesses such as cystic fibrosis, multiple sclerosis, Parkinson’s disease and rheumatoid arthritis. It has been asked whether the work capability assessment is fit for purpose for them. I am not sure whether the Minister has received it yet, but I recently signed a letter to him from colleagues from across the House—it is on its way—raising that concern. Organisations working on behalf of people with progressive conditions have found that that 45% of people with those conditions who put in a new claim for ESA between 2008 and 2011 were placed in a work-related activity group and deemed able eventually to return to work. The placement of those individuals represents the Department’s recognition that they were unable to work at the time of the assessment, yet some were given a recommendation for a return to work in few months’ time. But that directly contradicts the definition of a progressive condition, which of course can get worse over time. The letter is on its way, and I am sure that the Minister will respond to it even if he does not do so today.

I will move on to the flexibility of descriptors. I understand that Atos and Capita are under contract to the Department—I was going to raise at this point the point made by my hon. Friend the Member for Gloucester (Richard Graham) about the origins of those contracts—but Atos does not set the descriptors; they are set by Government. Given the concerns that many organisations in the third sector have about the descriptors, will the Minister tell us—I suspect I know the answer—what dialogue he has had with the third sector and what opportunities the third sector has to raise such concerns?

[Richard Graham]

On that precise point, does my hon. Friend agree that Citizens Advice is probably the charitable organisation that has the greatest experience of dealing with the most serious and, often, heartbreaking experiences of people who have really struggled with the assessment and appeal process for WCA?

[Mr Williams]

I agree, and I am sure that the Gloucester citizens advice bureau is as affected as the Ceredigion citizens advice bureaux in Cardigan and in Aberystwyth—although I am sadly not sure how much longer that CAB will remain open. Citizens Advice has that body of expertise, which is hugely important.

I have received an almost endless series of representations. I am mindful of the time, and that I have already spoken for 18 minutes—albeit that I have been generous with interventions—so I will simply make the general point that there are concerns about the extent to which the employees of assessment providers are being wholly sympathetic, about the huge backlog of cases that is leading to delays and, frankly, about the instances there have been of administrative incompetence.

I will give a final case study. One constituent I have been dealing with was assessed recently. He felt that the Atos assessor was completely apathetic to his conditions, and also felt under immense pressure to complete tasks put before him. He self-harmed considerably following the assessment. Several of the tasks he was unable to perform have now been put down as “refusals” on his medical report form. He gets very angry, has suicidal thoughts and is prone to paranoia—I am not being emotive in presenting such cases, as I think that they are replicated more generally. Shortly after the initial assessment, he got in touch with me to start the appeals process. Someone from the DWP phoned him to tell him that his appeal of the Atos decision had been unsuccessful, but we had not even started the appeals process at that point. They then called 10 minutes later to say they had made a mistake and he could appeal.

A simple mistake like that can have huge ramifications for people’s lives. A section of the decision maker’s letter to my constituent, whom I will call Mr Z, says that although it is accepted that Mr Z

“experiences pain and discomfort it should be remembered that activities do not have to be performed without any discomfort or pain.”

It goes on to say that the decision maker had chosen the descriptor that reflected Mr Z’s

“level of functioning for the majority of the time.”

If we look at the Government’s website, there is a contradiction, as that site says:

“The approved healthcare professional will consider all the information and exercise clinical judgement to reach an opinion on the nature and severity of the effects of the disabling condition. They will also take full account of factors such as pain, fatigue, stress and of the possible variability of the condition.”

My constituents—people such as Mr Z, Mr P and the lady I mentioned who is desperate to get back into work—are being let down by the system.

Finally, I reiterate the point mentioned by the hon. Member for Strangford (Jim Shannon). A number of my constituents have failed Atos assessments, but, after a long appeals process, that decision has been overturned by tribunal judges. The judges involved in the appeal are given the same descriptors as the Atos assessor, the same reports and the same medical information from the person’s GP, so why is it that judges who are upholding appeals and the Atos assessors are reaching such wildly different conclusions? For example, a constituent of mine had her Atos medical last March. She was given zero points, but her appeal was upheld and full points were awarded.

To me, that sounds like a system that is making those in our society who are vulnerable and unwell, sadly, more vulnerable and unwell. I look to the Minister for reassurance. I know that his role is in a tentative phase at the moment, but I hope that I have established some of the principles that some of us expect to see in our system of assessment.