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Sunday, 16 October 2011

The WCA Mess - a view in 1,000 words

The WCA Mess

The Work Capability Assessment (WCA) to determine eligibility for sickness and disability benefits was introduced in 2008. Three years on, it is hard to see any redeeming features of the system.

As a discriminator, its performance is dreadful.  Any other process with a failure rate of 40% would have been scrapped long ago.   Some failures are inexplicable and there is much justified anger at some of the extreme cases where very seriously ill people have been declared fit for work. Likewise people with diseases known to be degenerative have suffered the indignity of a WCA every few months.  What on earth is DWP playing at?  Efficacy aside, what a waste of money.  Mind you, if Atos operates on a piecework basis, is it easy to see how situations like this come about.

The overall process is misconceived, has not been thought through and falls at the first hurdle by not even incorporating a definition of what "work" means.  In is entirely reasonable that a properly and conscientiously conducted WCA should confirm the characteristics of what an individual can do based on the limitations their condition imposes.  This is not just about the design of the workplace, but the disciplines that go with having a job – getting up at the same time every day etc. which are missing completely from the assessment.  As occupational health experts, it is amazing that Atos has let this pass.

Outsourcing the service to ATOS was a mistake.  There is more than enough expertise and capacity to carry out assessments within the public sector at a time when the government more than ever needs to reduce expenditure.  The present format has created a massive backlog of appeals together with superfluous jobs and has become hugely and unnecessarily expensive.  Payments to Atos and the cost of appeals through the Tribunal Service alone have been estimated at £150m a year. 

In addition, the quality of the service Atos is commissioned to provide is not adequately managed and the DWP staff who handle claims and appeals want nothing to do with it.  Despite its claims to the contrary, DWP still does not support claimants, notably through the newly introduced Atos complaints process, which is where it is most needed – in fact, rather the reverse, as they accept and act on the Atos medical report whether it is disputed or not.  Therefore it is Atos which gets the benefit of the doubt, not the claimant.  Admittedly there is an appeals process, but claimants can have their welfare payments cut by 30% whilst waiting for the TS to hear their case and the TS queue can be up to 12 months long.  Although ESA under payments are backdated for successful appeals, this doesn’t help those struggling with day to day living costs over such a long period.  Far worse and with no justification whatsoever, Chris Grayling is now planning to stop ALL ESA payments for the duration of an appeal - guilty until proven innocent it seems.

To add insult to injury, Atos has its own 3-tier complaints system, approved by DWP which is an embarrassment to all.  The third level (the so-called Independent Tier) is shrouded in secrecy – what it is, who it is, how it is appointed, its decision making process, etc. are all kept hidden.  Atos controls its input and output.  Atos appoints it and Atos pays its bills.  The Government insists this secrecy is the only way of ensuring independence.  In addition, even basic questions over Atos operations and standards are deemed subject to the Freedom of Information Act and are usually rejected on the basis that disclosure is never “in the public interest”, when in fact exactly the opposite is true.  So much for the principles of transparency and public accountability!

Whilst Atos does a pretty poor job of monitoring itself and deserves much of the criticism it gets, most of what it does and how it does it is dictated by DWP, so this is where attention must be focussed – of course it rather suits DWP to pretend otherwise.

I really do not know what to make of Professor Harrington’s progress updates from 2011, as they are a mile away from my own experiences, which I have attempted to relay through his second call for evidence.  The other responses I have seen from organisations with a far higher profile than me have been in a similar vein.  Unfortunately, Professor Harrington is trying to adapt and improve a model that is fundamentally flawed and which should be scrapped.  It is adversarial from the outset with no attempt to achieve agreement with the claimant at any stage – hardly a recipe for harmony and success.

Yet with 10,000+ GP surgeries in the UK each one would only have to accommodate 1 or 2 WCAs per week in order to replace the costly WCA system. GPs might historically have been a bit soft issuing sick/fit notes, but surely this is not an insurmountable problem given the benefits it would bring to all concerned –  and we are, after all, on the point of trusting GPs with billions of the NHS budget.  To suggest that Atos/DWP approaches an illness from a different perspective, can only mean they do not have the patient/claimant’s best interests at heart, because that is exactly the motivation of a GP and their staff.  I would certainly trust my GP’s opinion more than I would a total stranger with limited qualifications, no understanding or real interest in my well-being and with highly doubtful motives who will only ever see me once.

At the moment to have one part of the public sector saying I am not fit to work (NHS) and another (DWP) saying I am is untenable and trying to argue the apparently differing perspectives is splitting hairs and does not make the overall proposition any more viable.

Privately, the DWP must know all of this but it refuses to admit it publicly.  This might indicate that the early exit clauses within the contract are costly.  Another indictment of the previous Government perhaps, but the same has had to be faced with other contracts and if you don’t make a start you never finish!  The government should come clean about the WCA and start planning for an improved system for the future.

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