This is constructed from a series of FoI requests of DWP. The main thread is referenced below, but there are a few others. The first part of this blog is the final annotation left on that thread.
I have closed this FoI Act request, but will leave a summary here to hopefully save other people time.
This is actually a very important issue and the reality is self-evident to anyone who has been through a WCA. The difference here is that the indictment is based on DWP’s own responses to a series of connected questions.
1) Although DWP “has no recorded information”, it is still insistent that GPs are not equipped to assess capability to work. It can produce no evidence to support this and cannot see that it is at best ‘opinion’, certainly not fact.
2) It has now to maintain this unsubstantiated position otherwise it undermines the whole outsourced HCP/DM concept. It is not well known for admitting mistakes.
3) It says this despite the fact that GP training includes this very subject and the BMA promotes the occupational health skills of its members to industry, the result being that many GPs are retained by companies for exactly this purpose.
4) The clue is maybe in the DWP phrase “according to legislation”, which tends to imply that it has been drafted to sit outside of a GP’s expertise. Firstly, I do not think this is the case – GP’s are perfectly well qualified. Secondly, if you can teach it to an HCP in a few weeks, you could teach it to GP’s too in probably less time with must better results.
5) GPs engaged for occupational health advice will become very familiar with the working environment of their clients and be able to meaningfully compare individual capabilities with known work situations. By contrast DWP believes that there is something called “general work” although it cannot define what it is or define its characteristics. It can however deem people fit to do it without knowing what “it” is.
6) DWP still disingenuously maintains that a DM only makes an administrative decision over ESA payments. It has to say this because DMs have no medical expertise. It also cannot allow Atos to be seen to be making benefit decisions, so it has created a hole for itself. The ESA decision is a direct result of ability to work – once you have established the latter, the former is obvious. So who decides fitness for work – DM? (not medically equipped) or HCP? (outside of the public sector). DWP talks around this question, but cannot/will not answer it.
7) It (DWP) will not state that its overriding priority is patient well-being. This is a grave concern. It tries to suggest that the ESA decision means the same thing, but of course it does not. This is precisely the difference vs. The NHS.
8) It will not admit it has a duty of care. In countermanding my GPs opinion, the DM must assume the responsibility my GP accepted and never contested i.e. for my health & well-being. If my health suffers as a result of the DM’s decision, he/she is culpable, without doubt.7
9) It also disappears up its own backside over the issue of clinical expertise. Depending on what question you ask, an HCP need it or not. Physios (with all due respect) have limited clinical expertise, so DWP has to say that its process doesn’t need much. If you ask about complicated conditions, medication cocktails and side-effects, HCPs suddenly become qualified to make assessments comprehensively. Sorry DWP, again, you cannot have it both ways.
In conclusion, the fact that DWP will not make clear statements speaks for itself. The ONLY interpretation (they cannot suggest another) is that they are driven to reduce welfare costs come what may and will continually manipulate the rules to achieve whatever £ maximum it has in mind.
It knows that working from the bottom up with patient health as top priority might exceed its spending target, so it has to construct a process under its own control that it can be sure will not.
It will no doubt continue to try to convince us all otherwise in the same transparent manner.