Work Capability Assessments

Yvonne Fovargue Excerpts

Wednesday 1st February 2012 Westminster Hall

[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.

[Jessica Morden]

Does my hon. Friend agree that the problem with the work capability assessment is that it makes constituents who receive DLA extremely wary about the move to personal independence payments, because they see the same experience being repeated?

[Yvonne Fovargue]

I quite agree. The move to DLA, for which the tests are even more severe, will be a problem for a number of people. The confidence of people who have been through a work capability assessment and who have had to appeal will be at an all-time low when they have to do the same for DLA.

The other issue is that there are inconsistencies in reports. For example, a constituent said he had a hypo attack every week—he was diabetic—but when he received the report, it said he had an attack once a month. The difference meant he did not get enough points for ESA, which he would have done if the report had said he had weekly events of altered state, as opposed to monthly events. He had to appeal that decision.

Although the changes following the independent review were meant to improve the process, the Citizens Advice survey my hon. Friend the Member for Rutherglen and Hamilton West mentioned showed that 87% of advisers said the accuracy of Atos reports had not improved. As has been mentioned, there are improvements that might help. The roll-out of audio recording of assessments might help, but what checks will there be on the accuracy of reports? It is no use just recording and keeping assessments if we do not check the accuracy. The summary of the report sent from the health care professional to the claimant might help—if there is sufficient information to help the claimant check the accuracy, if summaries are sent to all claimants and if they are sent in good time.

The Work and Pensions Committee said we need to do more to learn the lessons from the management of the Atos contract and to improve the quality and monitoring of future contracts. There are a number of recommendations in the Citizens Advice report, which I urge the Minister to read. There is deep concern among claimants and advice agencies about the use of face-to-face assessments going ahead for other purposes, such as DLA, which my hon. Friend the Member for Newport East (Jessica Morden) mentioned, and personal independence payments.

The clients who went to their citizens advice bureaux are the lucky ones; they got their appeal, they got represented and they got help. Unfortunately, the proposal in the Legal Aid, Sentencing and Punishment of Offenders Bill to remove the eligibility of welfare benefits advice for legal aid will mean that the number of advice agencies and individuals able to give such advice will drop, so fewer agencies will be able to help people. I therefore urge the Minister to ensure that the work capability assessment system has the confidence of claimants and professionals and that we do get it right first time.