Tough love or tough luck: assessing disability benefits

Last night there aired not one, but two documentaries about Atos and the Work Capability Assessment. Dispatches and Panorama, which were screened consecutively, used hidden cameras to explore the impact the government’s new assessment scheme is having on some of the country’s most vulnerable people.

Around £13bn is spent in the UK each year on disability benefits, but stories about able-bodied individuals claiming benefits fraudulently have led some to worry that this money is being wasted. And so plans we made to tackle, what David Cameron called Britain’s ‘sick note culture.’

The answer, it was proposed, was a new test to weed out the fraudsters and encourage those able to do some form of work back into the system. Thus, the Work Capability Test was introduced, first by Labour and later developed under the coalition government.

However, as both Dispatches and Panorama reveal, while the test may be helping some, it is also having serious consequences for those legitimately claiming benefits, who are having the support they need wrenched away from them.

Dispatches- Britain on the Sick
The first programme to hit our screens was Dispatches on Channel 4. The 30 minute documentary, fronted by reporter Jackie Long, gave the viewer an inside look at Atos Healthcare, the French company tasked with administering the Work Capability Tests.

Dr Steven Bick, a GP and former Labour political candidate, was sent undercover for 16 weeks of training to become an assessor for the company. Hidden camera footage documents his training, from seminars with his jaded teacher to chats with fellow assessors. What he un-covered was often shocking.

The assessment measures 17 types of activity, such as raising your arms above head or walking 200m. The applicant is ranked on each activity, 0 points if you can perform the task, a maximum 15 points if you can in no way complete the action. The applicant needs at least one maximum score in one of the tasks to be put in the ‘Support Group’ and be applicable for the maximum Employment and Support Allowance of £96 a week.

The secretly filmed footage shows just how hard it is to score the 15 points needed. Bick’s teacher tells him that when it comes to the manual dexterity test, even having lost an arm is not enough to score you top points. ‘It’s almost unachievable,’ the trainer sighs, jabbing the air with her hand, ‘as long as you have one finger and you can just press a button you don’t score anything for manual dexterity.’

Similarly some conditions which one would assume would be counted as limiting a person’s working potential, do not score points. Treatment for breast and prostate cancer is not rated on the assessment, because the chemotherapy is not administered intravenously.

Richard Hawkes, Chief Executive of disability charity SCOPE described the test as  ‘deeply flawed’.  ‘It is outrageous,’ he tells Long, ‘you need to look at a much wider perspective of a individual to determine whether they’re capable of working.’

However, more worrying than the technicalities of the test is the idea that there might be targets on how many people are allowed to pass. Both Atos and the Department of Work and Pensions, the government body that oversees the process, denies the allegation completely. When Bick talks to his teacher and fellow assessors he gets a different story.

Bick’s teacher warns that the numbers of those assessed as being in the top band ‘Support Group’ are closely monitored. If the assessor is assigning more than 12 or 13% to the group ‘you will be told your rate is too high’. He later checks this with a fellow assessor who agrees that she has heard there is a 12% limit and explains she thinks the figure comes from the DWP.

The final decision on whether to award benefits is not made by Atos but rather the DWP, but Dispatches reveals that the recommendations put forward by Atos are followed 94% of the time. Two fifths of all the decisions made by assessors are appealed by claimants. Of those appeals 30% are overturned by independent judges. These appeals are costing £45m a year.

The DWP refused to be interviewed for the programme but asserted that in the first round of the assessment 29% were placed in the Support Group. They also said they are trying to reduce appeals by improving the original assessments and asking judges to give their reasons for overturning decisions.

Despite their poor appeal rate Atos are still in the running to win another government contract administering another disability testing programme in the future.

For Dr Bick, his time as an assessor is over: he quit after two days of working. It seems his teacher was right when she told him ‘This job is frustrating, it’s toxic’.

Panorama- Disabled or Faking It?
Flicking the channel over to BBC 2, the viewer is offered yet another exploration of the Work Capability Test. This time from a slightly different angle, the programme follows two claimants as they secretly film themselves being assessed.

The show’s introduction follows the same format as Dispatches, exploring the reasons behind the introduction of the test. Then, once more, we are introduced to Atos and told that in the four years since they have been running the assessment a third of those assessed have been found fit to work. But, Lawn asks, is it just weeding out the undeserving?

Chris Davies used to work in the steel industry and as a lorry driver before he was diagnosed with emphysema, a chronic lung condition. Davies was claiming Employment and Support Allowance of £90 a week when he was called in to do the Work Capability Assessment. He did not pass the test and was told he was fit for work. Shocked, Davies appealed the decision and won. He is one of many, Panorama tells the viewers that each year 176,000 cases go to appeal, at a cost of £50m, (a £5m discrepancy from Dispatches’ figures.)

Davies then repeats the assessment, secretly filming the process. He is seen being asked to bend and stretch, before his lungs are checked and pronounced clear. Not surprising, Davies explains, his own GP often finds the same but X-rays and blood tests show the extent of his emphysema. The Atos assessors do not have such methodical tests at their disposal. Davies’ assessment takes just 20 minutes, something pressured Atos assessors say is normal.

Much like Dispatches the programme then turns to the idea of targets. The Atos employees contacted by the programme, non of whom would appear on screen, reportedly mentioned 20% as a target, differing to the 12% heard by Dr Bick.

In terms of finding proof of set targets Panorama comes no closer. Lawn waves a copy of the Atos contract but explains it is heavily redacted in places.

DWP Minister Chris Grayling is interviewed. He denies the allegations telling Lawn, ‘there are no targets anywhere in this system for numbers of people to move on or off benefits’. But, Panorama explains, there are government financial forecasts, showing an estimated decrease in spending on disability benefits.

Lawn also interviews Malcolm Harrington, the man tasked by the government with reviewing the current system. He explains how such assessments cannot be purely methodical, but need an element of human understanding in order to make valid judgments. Asked if he thinks the current system is fit for purpose, he admits his recommendations have not permeated the entire system and that it remains ‘patchy.’ ”There will be people, because we’re in this interim period, that will suffer,’ he says, worriedly.

Cases of such suffering are tragic, like Steve Hill who was diagnosed with heart disease but still failed the Atos assessment twice. He had a heart attack and died, just 39 days after Atos found him fit for work a second time.

The Panorama programme also, importantly, touches on the issue of mental health. Lawn travels to the Maudsley hospital, where, we are told ‘they are picking up the tab for a system that has gone badly wrong’. The story of Andy King tells the tale well. Andy is bi-polar and described being asked to undergo the Atos assessment as ‘a body blow’. The impact was so extreme Andy was sectioned in the Maudsley hospital. He was catatonic and unable to speak. While he was in hospital Atos came and assessed Andy, putting him in the ‘Work Related’ group. The hospital appealed on his behalf, but doctors there tell how having to fight such decisions is putting a huge strain on their work load.

It would have been interesting to have more on this, we are left wondering what questions there are, if any, on the Atos test that assess mental health issues relating to performing and holding down a job. If a man in a catatonic state can be judged fit to work surely there is a flaw in the testing?

Second opinion
Both Panorama and Dispatches offer powerful insights into the Work Capability Test and those it is affecting. While it is highly unusual to have two, so similar documentaries aired on one night, watching the two together does give a full picture of the complexities of the situation. The secret filming in Dispatches reveals doctors forced by strict rules and guidelines into clinical, often over-simplistic decisions, a kind of human-MOT. While Panorama’s various human case studies reveal the devastation that can be wrought on the already vulnerable.

Neither documentary manages to fully diagnose the targets as a governmental policy, but both find Atos assessors under the impression that they have to work to certain figures. While denied by both Atos and the government, the fact both investigations touch on the idea shows there is at least confusion within the system.

Not mentioned in either programme is the fact that, despite assertions from the government that the test is part of a policy aimed at getting people into work, Remploy, an organisation designed to provide work opportunities for those with disabilities, has recently announced the closure of half its factories due to government cuts.

Grayling tells Panorama the scheme is a form of ‘tough love’, these programmes prove he is 50% right.

Watch Dispatches Britain on the Sick here and Panorama Disabled or Faking It here. 

First published on www.thebureauinvestigates.com on July 31st 2012.

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