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Tuesday, 17 April 2012

The WCA – GPs are not well enough trained it seems

The WCA – GPs are not well enough trained it seems

Requests for information under the Freedom of Information Act can be a useful way of forcing an admission from DWP or any other Government agency.
They can work both ways – an admission that they do something or an admission that they don’t.  I sometimes just ask for the evidence (information) to support something a Minister has said on the news the previous day.  Quite often (surprise, surprise) there is none and using the Government's own evidence-based philosophy, if there is no clear evidence, whatever it is doesn't exist.  There always has to be evidence of existence.
They don’t have a great deal of respect for the letter of the law let alone its spirit, so there is a certain knack to phrasing requests in a way that does not allow them to easily side-step a legitimate question.  You also have to be patient and accept that you may have to make several passes at the same issue from slightly different directions to circumvent general prevarication and extract what you are looking for.  The final value lies in the fact that the words come from their own mouths and therefore cannot be contested on the basis of supposition, misinterpretation etc.
The Act is about revealing recorded information, so set your expectations accordingly.  There is no point in chasing information they say they do not have, even if you think they should have it.  They will not simply offer comment nor become involved in anything that looks like a debate or discussion and will not express an opinion.  At least in theory, if it has been recorded you can have it, if there is no record that is all they will say.  However, this “negative confirmation” can be useful on the basis of assuming that logically if something has not been recorded it cannot be “official” and vice versa.
This particular request can be found in detail at http://www.whatdotheyknow.com/request/gps_are_not_well_enough_trained
It arose out of the repeated claims by DWP that GPs are not equipped or authorised to perform a WCA correctly.  They attempt to attribute this largely to lack of appropriate training and expertise although they have admitted here that they have no basis for saying this.  More importantly, the legislation has been deceitfully constructed to exclude them, as explained in my closing annotation.  DWP (with the help of Atos and other private companies) has created an artificial new branch of medicine for which it has defined the training and qualifications needed to become a practitioner.  This allows them to control the resources as they wish and change the rules as they wish. 
Note that Atos is does not fall within the remit of the Care Quality Commission, so there are serious questions about how medical standards can be maintained.  As it is, DWP/Atos audit themselves, although they continually say that this is done by independent experts, but as in other areas DWP has its own dictionary allowing it to use words that do not have the meaning you would expect.
This information will not directly help you with your WCA or your ESA claim.  However, by giving you a bit of insight into the hidden agenda and the lengths to which DWP will go to fulfil its aims you might just be better prepared for what is ahead of you.  Remember, if it smells fishy and looks fishy, it is probably a fish.  Within DWP, the end justifies the means, regardless of the collateral damage.

3 comments:

Tia Junior said...

The question is, would a suitably trained GP be approved by DWP so that WCAs could be performed at their own practice independently of Atos, but to at least the same standard. Or has Atos been granted exclusivity and if so why - I can think of a few irritations, but nothing insumountable. Watch this space.

Anonymous said...

When you say that GPs are equipped to perform a WCA, do you mean that they know how to determine someone’s eligibility for ESA, or that they know how to assess someone’s fitness for the kind of work that actually exists in the real world?

In my view, the main problem with the current WCA is that it uses basic functionality as a proxy indicator of work capability. There is a huge difference between true work capability and work capability as defined by the ESA legislation.

Incidentally, these problems have existed since 1995 when the Tory Government replaced Invalidity Benefit (IVB) with Incapacity benefit (IB) and introduced the All Work Test (AWT) – which was renamed as the Personal Capability Assessment (PCA) in 2000.

Eligibility for IVB was decided by GPs, though half of all cases were also reviewed by the Benefit Agency Medical Services (BAMS). IVB was a discretionary benefit in that each case was assessed on its own merits, and non-medical factors such as age were also taken into consideration. The AWT, by contrast, was a regulatory benefit: claimants had to satisfy standardised, statutory criteria to qualify for it.

The old system was considered to be too lax and subjective, and the AWT was brought in to provide a more rigorous and objective functional assessment that ignored all non-medical factors. Adjudication officers, acting on the advice of BAMS doctors, made the final decision on the claimant’s entitlement to IB. GPs’ role in this new system was limited to providing purely medical evidence.

In 1998 medical assessments were contracted out to a private company called Sema Group, which was taken over by Atos Origin in 2004, who then introduced computerised PCAs.

The only thing that has changed is that since the introduction of ESA, the problems with ‘fit for work’ assessments have intensified, affecting more people, and those with more severe impairments, as the test has become increasingly more draconian and fewer people are exempt from it.

Tia Junior said...

Thanks for the post - my response is too long for a "comment" so I created a new post at
http://tia-junior.blogspot.co.uk/2012/04/wca-gps-are-not-well-enough-trained-it_19.html