Atos Work Capability Assessments

Stephen Timms Excerpts

Thursday 17th January 2013 Commons Chamber

[Stephen Timms (East Ham) (Lab)]

We have a heard a large number—26, I believe—of extraordinarily powerful speeches in the debate. There is no doubt that the current WCA arrangements are causing immense problems and anxiety for people for whom all hon. Members want anxiety to be minimised.

In opening the debate, my right hon. Friend the Member for Oldham West and Royton (Mr Meacher) mentioned the distress, indignation, fear and anger that have been caused. His assertion was amply supported by contributions from both sides of the House. We should not allow the system to continue. It needs fast and fundamental reform. I put it to the Minister—this struck me as I am sure it did him—that calls for such reform have come from both sides of the House, which does not often happen. It certainly happened today.

Part of the background to the debate is that a very small proportion of people who are placed by the WCA in the work-related activity group of ESA are getting into work. The invitation to tender for the Work programme said that the minimum performance standard would be that 5.5% of new applicants for ESA get into sustained job outcomes within one year, but the data published in November show that the proportion was 1%. The Work programme has performed terribly for the group of people we have spoken about in this debate.

What has gone wrong? The structure of the employment and support allowance is right. In the 1980s—my hon. Friend the Member for Edinburgh East (Sheila Gilmore) was absolutely right to remind the hon. Member for Harrow East (Bob Blackman) of this—thousands of people were encouraged to move from unemployment benefit to invalidity benefit in order to reduce headline unemployment. People who worked in benefit offices at that time have explained to me how staff were given incentives to encourage people to make that shift. Once they had gone on to invalidity benefit, later incapacity benefit, that was it—they were abandoned. No further support beyond the cash benefit was provided. It was only in 1997 that that began to change. It was recognised that the vast majority of people in receipt of incapacity benefit would prefer to be in employment, if they could be. Starting with the new deal for disabled people and later with pathways to work, new ideas were developed. Nothing previously had been done to practically support people with serious health impairments into work. The approach can be summarised as: work for those who were in a position to work, and support for those who were not.

Out of that experience was drawn the design of the employment and support allowance. From that, the work capability assessment was designed to allocate people into the three groups: fit for work, work-related activity group, and support group. That is the right structure and architecture for the benefit, but it is the assessment—the topic of this debate—that is now in doubt. The key problem is that very soon after the election, the Government announced that they would reassess the entire incapacity benefit case load on a very fast timetable. At that time, the WCA had been introduced less than two years previously. Problems were still being ironed out and the organisation had not properly bedded down, yet on to this still developing system was placed the enormous burden of reassessment. Atos tells us it carried out 1 million work capability assessments last year. The load has just been too much, resulting in the problems that we have heard about, and which have been expressed so impressively in this debate.

The Minister will be aware of a good deal of concern among disability rights organisations about the Employment and Support Allowance (Amendment) Regulations 2012. They were laid before Parliament just before Christmas on 17 December, and come into force on 28 January. They include the changes that will allow people recovering from cancer to go more frequently into the support group—a welcome change that was referred to by the hon. Member for Aberconwy (Guto Bebb). He said that the changes had already happened, but in fact they will take place on 28 January. A lot of people are worried that the regulations appear to give Atos permission to take account of non-existent, imaginary adaptations or medication in the assessment, and introduce a false distinction between physical and mental impairments. There is a lot of concern and I am sure the Minister is aware of it. Will he be able to say anything to address it?

The Government have recognised that the WCA needs modification. However, as we have heard from a number of speakers, they have gone about the task in an extraordinarily leisurely way, which has been described as “glacial” by a number of Members. I hope that the Minister can encourage us and tell us that the Department will now get a move on. I want to put to him a number of specific points. When will the changes to the descriptors for fluctuating conditions and mental health conditions, which were recommended months ago by the disability organisations, be implemented? He answered a question that I tabled last week on this, and there still seems to be a terrible, lackadaisical approach. He said:

“The Evidence Based Review (EBR) remains a priority for the Department and work is continuing at pace. The final report is due in 2013.”—[Official Report, 7 January 2013; Vol. 556, c. 180W.]

That was the first alarm signal, because his predecessor, in an answer on 25 June 2012, had told me that the final report would be due in spring 2013. Now the Minister is saying it will be in 2013. My hon. Friend the Member for Edinburgh East suggested that it will not be until autumn 2013. If that is right, that is another six-month delay. We really need to get a move on.

In his reply to me last week, the Minister said:

“We have undertaken extensive work with these charities throughout the summer”—

that was an answer last week, and the summer was the season before last. What happened in autumn?—

“to ensure that the ‘alternative’ WCA assessment combines recommendations from both the mental functioning and fluctuating conditions groups, and that the descriptors are suitable for testing.”—[Official Report, 7 January 2013; Vol. 556, c. 181-82W.]

The mental health descriptors were signed off by the charities in March last year. I really hope that the Minister will get the Department to get a move on and not just try these things out, which is what the evidence-based review—when it finally happens—will do, but introduce the changes that are clearly so urgently needed.

On progressive conditions, does it make sense to push everybody with a progressive condition, such as Parkinson’s disease, through regular reassessments when we all know that those conditions are only going to move in one direction and get worse. My hon. Friend the Member for Llanelli (Nia Griffith) made that point in an intervention. The Minister answered a question from me recently about this. He said:

“Around 360 people with Parkinson’s disease in the Work Related Activity Group have undergone a repeat assessment following their initial assessment…Of these, around 20 people…were found Fit for Work at their first repeat assessment.”—[Official Report, 15 January 2013; Vol. 556, c. 725W.]

No doubt some of them will have appealed and had their appeals upheld. Is it really worth putting 360 people with Parkinson’s disease through reassessments in order to find that perhaps 20 should be fit for work—although, as I say, a number of those would no doubt have been overturned? I also asked how much the reassessments were costing. As a number of Members pointed out, the Minister simply will not answer any questions about cost, on the grounds of commercial confidentiality. This is public money, and we need to know where this money is going and how it is being spent.

We need to make better provision for people to be able to supply their own supporting medical information in their assessment—a point made by my right hon. Friend the Member for Oldham West and Royton in opening the debate, and by the hon. Member for Stafford (Jeremy Lefroy) and my hon. Friend the Member for Bridgend (Mrs Moon). The application form should be amended to invite people’s own supporting medical information, and Atos assessors need to be more open to being informed by that information.

Atos assessors should be told why previous assessments were overturned on appeal—a point raised with me by Atos itself some months ago. We have heard how often people have won their appeal, gone back to Atos and immediately been found fit for work again. Part of the problem is that Atos was never told why a person’s appeal was upheld. I believe that changes are in hand or perhaps have been introduced to assess that problem. My hon. Friend the Member for Airdrie and Shotts (Pamela Nash), however, was among those who referred to the seriousness of this revolving door problem. It needs to be addressed. I was also troubled by what she said about the difficulties people had getting their assessments recorded. That was supposed to have been sorted out, but her comments, and those of others, suggest otherwise.

[Sheila Gilmore]

Is my right hon. Friend aware that although tribunal judges are giving brief statements of reasons, these are not enough to help the decision makers or Atos understand?

[Stephen Timms]

My hon. Friend makes a telling point. That information needs to be provided.

The architecture of ESA is sound, but the assessment system is clearly not up to the load it is being asked to bear. That is why we need fundamental and much faster reform, with a much greater sense of urgency than we have seen from Ministers so far.

--- Later in debate ---

[Mr Hoban]

I am going to make some progress, as I have only a few minutes left to speak before the next debate starts.

In March 2011, we also implemented the recommendations of a Department-led review of the work capability assessment, which included the expansion of the support group to cover more people with certain communication problems and severe disability due to mental health conditions.

Hon. Members have suggested that the assessment does not take account of fluctuating conditions, but that is not the case. It gives people with a fluctuating condition the opportunity to explain how their condition varies over time. It is not a tick-box assessment, as some have suggested. There is a discussion between the health care professional and the person making the claim for ESA to determine how their condition varies over time. The questionnaire that customers are sent has been redesigned for that purpose, and people are now asked to give more details about how their fluctuating condition affects them as an individual. If a person cannot carry out a function repeatedly and reliably, they will be treated as unable to carry out that function at all. We all recognise that the capacity of people with a fluctuating condition can change, and it is important that proper regard should be given to that fact.

I want to pick up on a point made by the right hon. Member for East Ham (Stephen Timms). We have committed to a review of the descriptors for fluctuating conditions, and we are working closely with charities on that. We also need to ensure that any new descriptors are as good as, or better than, the existing ones, for the purpose of assessing someone’s condition. That work is going on at the moment.

[Stephen Timms]

rose—

[Mr Hoban]

I know that the right hon. Gentleman is keen to find out when that review will be published, but let me just say this. We want to make changes, if there is evidence to support such changes, and we need to ensure that that evidence is gathered and evaluated. I am as keen as he is to ensure that changes are made as quickly as possible, and that we make the right changes and the best changes to improve the process. I am not in any way seeking to delay the process—we want to ensure that it happens—but we have had to work quite hard to get the right descriptors that will provide the evidence on functional ability, and we are now assessing them.

[Stephen Timms]

rose—

[Mr Hoban]

I will not give way. I have only three or four minutes left and there is a bit more to say.

Some criticism has been made of Atos, with suggestions that—

--- Later in debate ---

[Mr Russell Brown (Dumfries and Galloway) (Lab)]

rose—

[Stephen Timms]

rose—

[Mr Hoban]

I have only four minutes left and I want to address some more questions.

Let me deal with the issue of Atos’s capability. Atos deals with 100,000 cases every month and it consistency meets the quality thresholds. Only 3.6% of assessments are below standard compared with a threshold of 5%. It receives complaints about only 0.6% of assessments. DWP decision makers return to Atos assessments that are inadequate for reaching a decision in only 0.2% of cases.

The hon. Member for North East Derbyshire (Natascha Engel) asked about the appeal rates. Let me be clear about the rate of successful appeals. Of all the fit-for-work decisions taken by the Department, only 15% are overturned on appeal. Only 15% of all the decisions we take, then, are overturned on appeal, which I think demonstrates that while we need to ensure that there is a proper appeals process, we should not be bandying around figures that misrepresent the level of successful appeals.