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Sunday, 26 August 2012

Duplicity begets dupicity

Hypocrisy and the use of double-standards are not acceptable characteristics in any situation and there are never mitigating circumstances.  However, through its ill-thought out policies and procedures in many areas of Welfare Reform DWP regularly demonstrates both in abundance.  Increasingly it is important to publicise each example that arises so that is can accumulate the credit it so rightly deserves.  It has yet to understand the vicious circle into which it has manoeuvred itself where its hypocrisy and dishonesty simply begets more hypocrisy and dishonesty.
The fact that DWP is very keen to explain what should perhaps be happening, but unwilling to explain what does is a common cause of disputes and indeed my latest spat, which began with a quite straightforward FoI request as follows:
The WCA Handbook for Atos HCPs is quite clear that all of the evidence brought by the claimant must be considered and logged in their report. They must also consider the ESA50 and where appropriate use all of this to inform the way in which they approach the WCA, the questions they ask and the tests they perform. A comprehensive review of this information is vital to the success of the WCA.
If they fail to do this what action should a claimant take? Many claimants would not be able to raise this with the HCP at the time and it is not possible to "intercept" the ESA85 report before it arrives with DWP and a decision over ESA entitlement is made.”
This was borne from my own experience where the complaint I had raised with Atos before the ESA85 was produced and the ESA decision made was completely ignored by the Decision Maker although he admitting having it to hand at the time.  There is of course also the general backdrop of ongoing DWP & Ministerial promises to better support claimants through the process, but note that they are mainly about help AFTER the event – a personalised summary on the ESA85, a phone call to explain a decision etc. and I am a bit fed up with Prof Harrington continually telling me to be patient.
The best help to offer claimants is of course BEFORE the WCA takes place to better ensure it is right first time.  I would include in this specifically
·         A detailed list of all the information to bring along that might help – scans, X-rays etc.
·         An open offer to audio record the session if required and why this might help the claimant later.
As regards the former, the HCP cannot comprehensively construct the WCA correctly without it to rule out any contradictions that might arise.  It is therefore mandatory, not optional.  The WCA invitation letter makes no mention of this, just the need to identify yourself.  Perversely, DWP then blames its wrong decisions on not having all of the information available!!!  Amazing.  Also, sending it to DWP is sending it to the wrong person – it is the Atos HCP who needs it and is better placed to understand it as DWP Decision Makers are NOT medically trained.
The FOI response provided some useful information and quoted the theory, totally ignoring the thrust of the question (in theory of course this situation cannot arise), so I repeated it asking if all claimants are expected to read the sizable ESA Handbook, which was the source of much of the response – if no, where else are they told about this important area?
The second response insisted the question had been answered but included a bit more information, so I repeated the original question again as a second IR and posted the status at the time as follows:
“DWP has said it (rightly) does not expect claimants to read the WCA Handbook, but also that much of the information of use to claimants is NOT provided anywhere else.
DWP has accepted that only ID + medication is mentioned in the Atos letter – NOT ANY of the useful information that would help a claimant best present their situation.

It tries to tell us that it is doing all it can to help claimants through the process and to obtain the correct result first time, in line with the promises made by Chris Grayling – clearly on this evidence totally empty promises – it could do a great deal more if it wanted to.

The matter of what action a claimant should take HAS STILL NOT BEEN ANSWERED and is therefore the subject of a second IR request. “
Another month or two passed and I received a response that said little more than the previous one and stated that the onus is one the claimant to provide relevant information – perhaps technically so, but where has the help and support evaporated to?
My conclusions were therefore follows:
“What this second IR response confirms is that:

1) Chris Grayling’s promise of more help and support for claimants is a lie. What could be more valuable than making sure a claimant is prompted to take everything relevant to a WCA.
2) Alternatively, DWP has decided to ignore Chris Grayling’s promise and continue on its own merry way.
3) DWP offers no facility to claimants who experience a demonstrably poor WCA other than to allow “nature” to take its
course and fight the uphill battle retrospectively as an appeal.
4) DWP does not understand the meaning of the word “rhetorical”.”
Which I thought would bring matters to a close, but not so.  Quite unexpectedly I received a typically misplaced, partly erroneous and unnecessarily vitriolic attack on my question and me – clearly I had unwittingly touched a nerve.  Of course I HAD to respond:
“Dear DWP DWP Medical Services Correspondence,

I am of course at somewhat of a disadvantage as the person who has composed this latest response (24/08) is able to personalise their vilification of me from the shelter of their anonymity. I cannot describe the tone of it more eloquently and accurately than the annotations here have already. I will expose and respond to the broader issues it raises elsewhere and confine my comments here to FoI and the response itself, particularly as it is both logically and factually incorrect. I would use another vehicle if I knew what it is.

1.         My note dated Aug 9th was patently NOT a question or an IR request, so I am a wee bit miffed at being accused of raising one inappropriately. I am fully aware of the limitations of FoI legislation and the ideology behind the WDTK site. I know they do not like it to be used for debate, but I do feel entitled to respond to the latest DWP posting.

2.          Unfortunately, some sections of the public sector have become so steeped in duplicity that they have lost all ability to distinguish fact from fiction. I will not comment here on why this is the inevitable result of a certain style of management.

3.         The FoI legislation offers one of the few opportunities to attempt to clarify this distinction. Yes, it focuses on recorded
information, but it is safe to assume within an organisation the size of DWP that anything NOT recorded is of no consequence and can be regarded as little more than hearsay or speculation – if it was material, it would most certainly be recorded somewhere.

4.         I doubt the author here has experienced a WCA whereas I have three times over, all wrong! I am therefore somewhat better placed to segregate the theory from the practice. I would happily have the debate face to face if there was such an opportunity as I am very sure of my ground and armed with indisputable evidence (unlike DWP) to support any assertion I make.

5.         The request here sought to define the truth behind a ministerial statement by offering DWP the opportunity to provide some supporting evidence, notably through their intentions behind what is undoubtedly the greatest manifestation of the support they could offer if indeed they are serious about the intention. As they are unable to do this there is only one conclusion that can be drawn – it is NOT an opinion, it is a logically deduced interpretation of the facts as presented by DWP. If there is an alternative interpretation they could have provided it and corrected my misunderstanding, but have chosen not to – clearly there is not one. (Although this too will be labelled as an opinion no doubt).  The evidence-based methodology is the one that DWP itself favours and they are therefore governed by its rules in the interests of avoiding accusations of hypocrisy.

6.         The statement over the proportion of GPs involved IS COMPLETELY FALSE. From its own statistics only around 25% of Atos FTE HCPs are registered with the GMC – the rest are nurses and physios. Also the proportion of WCAs performed by GP’s has been reducing, so clearly the overall expertise being applied is progressively diminishing. 

7.         The knowledge, expertise and rigour applied to maintain both are grossly overstated. DWP cannot even GUARANTEE that all HCPs have kept their registrations up to date and are therefore appropriately qualified at the time they undertake a WCA. It is absurd to state that a physiotherapist (with all due respect to all of them) has “vast experience” with mental disability. The last HCP I encountered whilst a registered nurse was attempting to make a living from a door to door Botox/collagen service and performing WCAs as an income top-up. This not in line with the picture painted here.

8.         The reply claims objectivity, but cannot describe against what standard – after 4 years there is still no definition of “work” nor is there any evidence to support some of the descriptor changes that have been applied, which are of course driven by political dogma which by definition is partisan. There are also no performance measures in place so any suggestion of improvement is pure speculation – even by ‘Lord’ Harrington himself.

9.         The picture it paints is one of a DWP DM sitting with a wealth of information about a claimant all of which is medically orientated, some of which could be highly technical and complex faced with making a decision when that individual has no medical training – how more perverse can one be?

10.      I have no political affiliations whatsoever. I would just like to see the DWP “doing what is says on the tin”. I would remind DWP that they have judged my ability to work wrongly not just once, but on three consecutive occasions. They assure me that I have not been victimised, so I should presumably regard my experience as par for the course. I am already gravely worried about the chances of the next one being right first time, I think with due cause. Perhaps DWP would like to promise me that this will not be the case – surely not too much to ask?

11.     They publicly accept they will make mistakes (by inference occasionally rather than my experience of 100%) and promise to explain why they did and how they will learn for the future. I have had no such explanation and my experience indicates nobody learnt anything. They did not even have the wit to demonstrably try harder third time round and assigned the least qualified, least interested HCP of the three.

12.     I would like to avoid a repeat of the trauma on my next WCA, so I am simply looking for clear signs that next time, DWP will in fact get it right first time. So when someone says something has improved, it is hardly surprisingly that I want to see some evidence as without it the claims are just so much hot air.

13.     My evidence is my own indisputable experience, so DWP, how can you match that??? Are you suggesting I’m making it all up? Just check your records.

14.      Finally I quite like the thought that DWP feels it has no obligation to reply to a (rhetorical) question that by definition, does not require an answer. That at least does make some sort of sense.

Yours sincerely,”

It also referred to the old chestnut about the extensive diagnostic skills needed by HCP – when you point out to DWP that that nurses/physios (with respect) don’t have them they tell you they don’t need them and a few weeks training with Atos is more than enough, but when you question the skills needed to perform a WCA, it appears they do have them.

The only point here is that despite the PR, sound-bites and often friendly tone, do not expect the help you really need to get through a WCA painlessly from Atos or DWP.  The good news is that there are website around that provide exactly this service, thank God.

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