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Wednesday, 30 May 2012

The Government's Duty of Care

Political affiliations, dogma and individual policies aside, one naturally assumes and expects that one’s elected Government will at least manage whatever it does effectively and with appropriate due diligence to protect those whom it serves.  This is not difficult as there is a wide range of well established management techniques available to assist.  The public sector is, we are told, better paid and better educated than the private sector.  It spends a fortune on training, process improvement and consultancy which whether one agrees with it or not, does at least remove any excuses for adopting anything other than ‘best practice’ in everything it does.  Think again!!!
Nobody expects the Government to get everything right first time or all of the time, but one does expect them to be able to prove that this is what they have tried to do and that they have taken suitable precautions to avoid, detect and remedy any mishaps or unintended, unanticipated consequences along the way.  This is their job.  Applying their own “evidence-based” mantra, just saying this is the case in response to parliamentary questions is not enough; they have to be able to demonstrate that this philosophy is entrenched in everything they do literally day to day.  They cannot.
This is most apparent in their overall approach to risk management – not altogether an awe-inspiring subject, but nevertheless critical to effectively managing process change and guard against any undesirable consequences, particularly if the impact could be disastrous.  They are aware of the technique but only apply it selectively and/or partially and often under sufferance when they have no choice.
Turning a blind eye to adverse consequences does not of course make them go away – exactly the reverse, as left unchecked, they will probably expand rather than naturally contract.
This is the case with the WCA.  No matter how well designed it is and no matter how effectively it is performed, there will inevitably be the odd error.  DWP ignored this in 2008 when the WCA was introduced and has done nothing to redress the ‘oversight’ since despite the body of evidence that points to the fact that a small but significant number of lives have been lost.
We all need to realise that the only explanation is that they simply don’t care – whilst a risk assessment may have been an oversight initially, there has been more than enough time to deal with it since.  To ID-S & CG, any amount of collateral damage is acceptable and can continue indefinitely.  As they refuse to consider a target error rate they regard as acceptable, they cannot estimate how long it will take to get there and indeed won’t know it if they ever do.  They will however continue to try to reassure us with commitments to ‘improvement’ without any clear definition of what this means to their so-called customers.
It is all a charade, so don’t be hoodwinked.  Note too that this overall disregard for loss of life will inevitably manifest itself in policy elsewhere so be on your guard and don’t believe everything you are told – however convincing it might sound.
Personally I would hold DWP in higher regard if they acknowledged the risks and ‘managed’ them rather than just feigned ignorance or pretended they do not exist.

Saturday, 26 May 2012

#WCA #ESA Government Duplicity and their real intensions

The way the Government has implemented and managed the ESA/WCA process is not just a sign of poor judgement or incompetence, it reflects a dogma based on contempt for the sick and disabled, a belief that they are an avoidable drain on society and the sooner they stop it the better.  If they will not pull themselves together and sort themselves out, we (the Government) will have to do it for them.  Society only has room for those that make a net positive financial contribution measured by the standards dictated by a capitalist elite.  We might just feign a little compassion for some of the more seriously ill, but only under sufferance and against our better judgement.  Sorry, this may sound harsh, but this is just Nature at work, first summed up by Charles Darwin many years ago and it is wrong to meddle in the process that God himself probably intended – our attempts at intervention in the past have created the current mess and we do not want that all over again do we?  They don’t put it quite this way, but when you look at what they have allowed to happen (in fact engineered), this is precisely the overall plan and indeed it is going quite well.
Of course, Ministers and the PM fiercly deny that this is the case, but the evidence speaks for itself.  Most telling is the fact that way back in 2008, no risk assessment was undertaken prior to WCA introduction.  If you have not come across the expression before, RA is simply a standard feature of good management practice when changing something whereby you think about all the things that could happen as a result of the change you are making (good, bad & indifferent), assess their likelihood & consequences and put together a prevention strategy, i.e. a proactive plan designed to keep the likelihood of unintended events arising to an absolute minimum, particularly if these events have devastating consequences .
The current Government blames this omission on the previous Government, but it is never too late, so they could easily have initiated an RA once they were in office.  They do point out that they did undertake an RA following the so-called Internal Review in 2011, but don’t mention that it is incomplete - it misses completely the potentially dire consequences of an incorrect fit for work decision resulting in a deterioration in someone’s health.
To be fair, the best assessment process in the world would contain some small risk of an occasional mistake which could never be eliminated completely, but at least one has the comfort of knowing that the risk was recognised and every attempt was made to minimise it.  Not so with the WCA.
Of course there is a risk of error with potentially monumental consequences, but the Government chose to ignore it.  They cannot have been so naive to believe that the WCA process was perfect and would never make a mistake, so the only conclusion one can draw is that they simply don’t care – so what if some people die along the way, one cannot after all make an omelette without breaking eggs, the end always justifies the means and a bit of collateral damage is a small price to pay.
What every voter in the country needs to understand that this philosophy will not be limited to the sick and disabled – it will manifest itself through every Government activity from NHS Reform to motorway speed limits.
More specifically, much criticism is directed at LiMA (the computer system used by Atos), but at the end of the day there needs to be a standardised database for all sorts of good reasons and properly used, this is probably as good as any.  The mischief lies in the simplistic diagnostic algorithm it contains and the way in which it is manipulated to produce the desired results.
The DWP knows this (of course it does), but as long as LiMA/Atos is “doing its job” (designating large numbers as FFW whether they are or not) they do not care.  Its own Decision Makers are perfectly able to rectify an unsound recommendation from an Atos HCP, but rarely do – why should they when they can hide behind the pseudo-intelligence of LiMA – sorry, the computer, it says no.  If DWP had the will, it could change this attitude overnight.
So yes, have a go at LiMA and Atos, but don’t forget who is really driving the “agenda”.   Anyone who has suffered at the hands of a WCA will understand all of this and most politicians do not care, but there is a huge group of people in between that needs to know the true colours of our politicians.  My hope is that we can get the message to them through posts like this, so they know the truth, not the illusion painted in the mass media.

Saturday, 5 May 2012

WCA - Dire consequences

I am sending the note below to a handful of MPs who through questions in the House of Commons appear to have shown an interest in the matter . . . . I have toned down the wording deliberately.

"It may technically be regarded as circumstantial evidence, but there are clear indications that “over zealous” fit for work decisions have brought about premature death, either due to aggravating the underlying medical condition or mental instability and potentially suicide.  The qualifications of practitioners aside for the moment, it seems to me that that the cause is largely to do with little more than the emphasis – the decision that is made when it is not clear cut – who gets the benefit of the doubt????  [In my alternative model, it would be referred for a genuine second opinion by a more qualified individual at this stage rather than AFTER a firm decision has been made].  The only real criticism of GPs is that they give it to the patient, DWP does the opposite with no consideration of the potential consequences.  Given that it is one’s health in the balance, the only responsible & compassionate line is of course the former assumption – DWP has no mandate to take any other and gamble with lives.

I have tried through FoI to establish that DWP’s overriding priority has ultimately to be an individual’s longevity, unfortunately to no real avail, but I am sure that there is a carefully crafted highly embarrassing, question here for Mr Grayling that, perhaps on a couple of passes, forces him to acknowledge the “downside” risk with his approach.  The aim is for him to clarify which of the only two options he favours:

a)      That there is absolutely no risk – clearly absurd given the evidence around, albeit not conclusive (how many coincidences does it take...........??????)
b)      That there is a risk (however small) that then has to be dealt with.  In the absence of risk assessments, registers and the other tools normally used to mitigate risk, he would be hard pressed to suggest he is doing anything to manage it.

If he cannot confirm a), he must accept b) and if he is doing nothing about it, clearly doesn’t care.  QED and a philosophy the public ought to know about – having no particular regard for human life is capable of manifesting itself in all sorts of different ways in a Governments policy decisions, God forbid!"

Thursday, 3 May 2012

The Greatest Indictment of DWP yet?

The fact that there have been some dire consequences of unnecessary WCAs and incorrect ESA decisions is bad enough in itself, but to say that it was never a consideration is worse and the fact that even now there is no interest is worse still.

Changing any process incurs a risk, so they cannot deny one existed however small it might have been perceived at the time and I cannot believe it did not cross anyone’s mind.  Clearly however not for long or as my Tory MP so compassionately put it, “you can’t make an omelette without breaking eggs” – acceptable collateral damage it seems.

To my mind, the venerable Professor Harrington has a responsibility here and should have spotted this serious “oversight”.  At the very least he should now make it clear if he regards this situation as acceptable or not.  He is the only person I can think of that by stating the latter would have an almost instant impact.


Tuesday, 1 May 2012

The disinfecting power of sunlight

The disinfecting power of sunlight

Lot and lots of talk from David Cameron himself about Government openness, honesty and transparency which we all regard with justified degree of scepticism and here is one example of why.
This is a brief exchange with DWP through the FoI Act regarding their intent to comply with the PM’s statement.  As you will see there is none.  Is this down to DWP arrogance or PM bullshit?  You can decide for yourself.

28 February 2012:
Dear Department for Work and Pensions,
In describing the plans for open government and transparency, David Cameron has said,
We understand that people want government to be more effective in what it does, and to do it for less money. That means transforming the way the state goes about its business, using decentralisation, accountability and transparency to reduce dramatically the cost of government. And because sunlight is the best disinfectant, we will bring the operation of government out into the open so that everyone can see whether we are delivering good value for money.”
Given the last sentence here, when will DWP be in a position to reveal the identity of the Atos Independent Tier? Please describe the steps involved and the timeline for each.
If there is no such plan contrary to the PM’s promise, please just say so – I already have your “justification” for the current arrangements – the issue is when will you change them?

Yours faithfully,

26 March 2012 - clarification from me
The question here is about whether DWP has any intention to do this, to comply with the PM’s promise, or will it choose to remain outside of his assurances?
To phrase this differently, do you have any specific information to indicate that the contract with Atos will be renegotiated to bring it in line with the PM’s promises of Government transparency?  Either you have information to confirm this is in hand or you do not, which means you have no intention of complying.
I hope this makes it easier for you – either yes you have the information (and can show where it is) or no you do not.

1st May 2012 – DWP response
The information you have requested is not held by this Department. When the time comes to renew the current Contract, as with all competitive procurement exercises, the Department will establish a tender process and decisions on commercial sensitivity will be made at this time.
I am therefore satisfied that all the information that DWP are able to supply to you has been supplied.
If you have any queries about this letter please contact me quoting the reference number above.
Yours sincerely,

DWP Central FoI Team

The Reconsideration Process in DWP – what is the point??????

The absence of information in response to this FoI request is staggering in the context of effective management.. DWP does not know:

• How many of its initial decisions are appealed
• What the impact (if any) of its internal reconsideration process is, so it cannot possibly determine if it offers value for money, so why not get rid of it?

It is in contrast pushing ahead with a proposal to make reconsideration mandatory rather than (as it is now) optional. It claims to have undertaken a comprehensive impact analysis, which is impossible without this information, so it has no idea of what the effects will be on DWP itself or the Tribunals service and therefore no idea what effect it will have on claimants. This of course means that none of these factors matter, notably the last.

Worst of all, it has no targets – notably the accuracy of right-first-time decision making. How can you possibly manage a process to an end point without knowing what it is? The expression “couldn’t run a heavy drinking session in a brewery” comes to mind.

No wonder the economy is bust