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Wednesday, 23 November 2011

WHY SO MANY ERRORS WITH DECISION MAKING?

Some while ago, I wrote to my MP about WCA errors and he passed the note on to Chris Grayling.  I have just received the reply.  It doesn't say a great deal and certainly does not reveal anything I did not already know, but it warranted a reply . . . as below addressed to my MP:

I cannot recall whether or not I replied to the attached letter from CG, but on re-reading it I will now – for his and your benefit.

I realise that he does not write these letters himself, but please inform whoever deals with them that I have been through three WCAs so there is no point in continually telling me what should happen when it has/does not.  It would be far more helpful to explain why my experience is at odds with policy and what is to be done about it.

There are a number of points in the letter that are not correct – at least in relation to reality rather than theory:

1.       It is absurd to keep calling Atos “independent” – of course they are not.  It is commissioned by DWP and works to its agenda.  Messrs Grayling and Duncan-Smith have made their philosophy quite clear and best summed up by the expression “Arbeit Macht Frei”.  It is equally absurd and quite insulting to call GPs biased.  They are governed by the Hippocratic Oath and the Harold Shipmans aside, indisputably have only their patient’s best interests at heart, which cannot be said of DWP. 

2.       Whether the Atos staff should be called “professional” is certainly open for debate.  At my three WCAs, the Atos HCPs have been largely disinterested in anything other than ticking boxes and getting the job done.  They have most certainly not displayed any degree of professionalism nor attempted to create an atmosphere of trust.  The outcome has on each occasion been a foregone conclusion.

3.       Occupational health is not a new branch of medicine, just a slightly different view on a patients capabilities.  GPs may not have adopted this view in the past, but this does not mean they could not in the future.  Why the  “extensive” training that Atos HCPs are put through is necessary is a mystery.  For each of my WCAs, the HCPs have spent 95% of the time behind a desk typing my answers into a PC (my GP’s receptionist could do this) and the remainder doing little more than checking my reflexes.  There are only two possible conclusions:

                                                               i.      Either the training is unnecessary and a charade, or
                                                             ii.      The HCPs are not doing the job properly (which might of course explain some or the repercussions)

4.       Whatever audit system is in place is clearly NOT rigorous, or all of these problems would have been cleared up by now.  This can only mean that they are not being done properly or are being done against the wrong criteria.  I am very conversant with audit techniques and I have found both Atos and DWP very weak in this area – they simply do not understand the concept and I doubt they use the most appropriate benchmarks.  If this were not the case, there would not be so many basic flaws after all this time.  Without any doubt, each of my WCAs have fallen demonstrably short of the standards laid out in the WCA handbook, which the HCP, Atos auditor, Decision Maker and DWP auditor have all “failed” to notice.  So conspicuous are the errors, one can only assume they do not look as nobody could be quite so inept.  It is not surprising the whole thing has been described as a conspiracy

5.       Denying DMs make a lot of mistakes on the basis that Tribunals have more information is a serious misrepresentation of the truth.  It is not that they have more, but that they take the trouble to look at ALL of it when DMs do not.  This is confirmed by the Justice Dept’s own reports on Decision Making performance.  My own experience bears this out exactly, where highly relevant information I have provided has just been ignored and DWP has admitted that this has been the case.

6.       As regards the “innovations”, they are hardly imaginative or creative, just common sense and should have been included from the outset.  I would dearly like to see the numbers that allow CG to describe the results as “encouraging” – hopefully DMs are making fewer mistakes.

7.       I participated in the 2nd call for evidence and have seen the responses from a variety of organisations and individuals, all of which by and large reflect my own experiences and identify the same failings.  It is therefore difficult to see why CG and Prof Harrington are overjoyed with progress when in fact there has been so little.  It makes one worry about the extent to which the findings will be “massaged” to paint the same rosy picture.

Which brings us back to where we started – “independence” means producing the results you wanted in the first place.

Regards

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