ID-S Deception - only telling half of the story

Ian Duncan-Smith regularly claims to have overwhelming public support for his welfare reforms, which might well be true, but if it is these opinions have not been based on the full story. So of course you will elicit support if you just ask the following questions: Q: Do you want to reduce the overall cost of benefit payments through improved efficiency? A: Damned right I do. Q: Do you want to focus on those with the greatest need? A: Yes, they deserve it Q: Do you want to stop benefit fraud? A: As quickly as possible. Q: Do you want to wheedle out those lazy so-and-sos who just don’t want to work? A: Yes, it’s high time they pulled their weight. Q: Do you want to see more efficient DWP administration? A: What do you think? Q: Well we have a plan that will do all of this, so do you want us to implement it? A: With all possible speed! But there will be consequences, which even if not thought through initially, are more than apparent now. So an open & honest supplement to the above would be: Well, unfortunately the plan is a bit rough and ready so, Q: Are you happy that we will make tens of thousands of decision errors and stop benefit payments whilst they are sorted out by HMCTS at huge cost to the taxpayer? This will create many months of financial hardship for those affected. A: Hang on a minute; I don’t like the sound of this. Q: Do you mind that in thousands of cases these errors will directly result in people’s health deteriorating and quite a few will die. A: In that case, no sorry the plan is not good enough – think again! I wonder how much of the support would fall away if he just told the whole story and made it clear what “price” he regards as acceptable – just how many deaths does would it take for him to change his approach? He really should be made to address this matter or state clearly that he thinks it is irrelevant. The end DOES NOT always justify the means.

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.

WCA/ESA - Performance measurement - no intention!

Some more on this issue of performance measurement through a more recent FoI request:

QUESTION:

Dear Department for Work and Pensions,

On Page 68, paragraph 273 in the publication “Social Justice: transforming lives”

(http://dwp.gov.uk/docs/social-justice-transforming-lives.pdf), Iain Duncan-Smith states that one of the cornerstones of success will be to “agree clear parameters for success”. What such parameters were agreed and are in place to measure the success or otherwise of the WCA? Please also provide the data history for each parameter.

ANSWER:

 There are no specific targets set for the WCA, other than for it to be as fair and accurate as possible.

http://www.whatdotheyknow.com/request/social_justice_performance_param

It appears Government Ministers can say what they like to impress, even if it is an outright lie.

WCA – Surreptitious gathering of information

As I’ve mentioned before, Atos (with DWP’s sanction) uses a number of heavily disguised questions to extract what they consider to be the “truth” from claimants during a WCA.   I have therefore been exploring other areas where other undeclared practices may be taking place, one of which is here.

It is about the use of Voice Risk Analysis (VRA) software, which supposedly is able to detect lies told in a phone conversation.  The innocuous name, is of course all part of the disguise.

In summary, DWP says

1)      It does not use it anywhere within DWP.  It was tested, but found to be too unreliable.  No doubt they will try again at some point.

2)      It does not require any of its business partners to use it.  As this does not mean they do not, I pursued this further with particular reference to Atos.  The response was:

3)      There is nothing in the contract prohibiting Atos from using it, nor penalising them if they do.

4)      If Atos wished to start using it, they would be obliged to seek authority from DWP (note only “obliged”).

5)      Atos could not be using it without DWP’s knowledge.

Unfortunately, because of 3), 4) & 5) presuppose complete trust in Atos to follow what looks like no more than a “gentleman’s agreement”.  Knowing what I know about them (including the way they have chosen to apply LiMA, I could not muster enough trust to disregard this possibility.  Likewise with DWP itself – I would not put it past them to say to Atos: “If you start using VRA, just don’t tell us”, the consequences of which would be:

·         No threat or risk or retribution to Atos from DWP

·         DWP can “legitimately” say ‘not to our knowledge’ whenever they are asked through FoI or any othger route.

My (slightly paranoid) advice as always would be to plan around the worst scenario – assume anything could be going on until you can categorically prove it is not.

http://www.whatdotheyknow.com/request/vra_software_use_by_dwp_business_2

Brief Rejoinder to Michael O'Donnel

http://www.bmj.com/content/344/bmj.e1114?tab=responses

Re: Atos and changes to disabled people’s benefits

15 March 2012

I write to address several points raised in a recent article (Atos and changes to disabled people’s benefit (BMJ 2012;344:e1114) and your editorial column (Through Historians’ eyes (BMJ 2012;344:e1112).

Firstly, Professor Malcolm Harrington has examined the Work Capability Assessment (WCA) in two extensive reviews. All recommendations made to Atos Healthcare in the first review have been implemented. We are now working with the DWP to implement those made in the second review.

Not so – audio recordings of WCAs is not universally available.

Secondly, in his second review, Professor Harrington examined LiMA, the computer software used by Healthcare Professionals to construct assessment reports. He concluded that: “there does not appear to be any fundamental problems with the way in which the software operates” and noted that “many of the comments received ... appear not to be robust or evidence based.” As is now widespread in most healthcare settings, LiMA simply replaces paper as a recording tool.

Not so.  LiMA incorporates a diagnostic algorithm of doubtful reliability.  The WCA handbook specifically encourages HCPs to use only the drop-down options provided, although free-form text fields are available, but cannot be interpreted by the algorithm.

Thirdly, Atos Healthcare and DWP encourage people to submit additional medical evidence at any stage of the process for consideration as part of the claim. Our Healthcare Professionals ask for additional medical information from the claimant’s GP or other medical specialist when an individual’s completed questionnaire suggests that they may have a high level of functional loss, and as such may not require a face-to-face assessment. Unfortunately, these requests are not always answered.

Not so. The Atos appointment letter only tells you what to bring to identify yourself.  I have had 3 WCAs: one glanced at my questionnaire, one didn’t look at it and the latest didn’t even have a copy to hand.  None of them asked for any additional information and all of them ignored completely what I took with me.

Finally, for chronic and fluctuating conditions, we use the same techniques as other clinicians to depending on what question you ask. variability of symptoms, and a detailed functional history ensures the effects of variability on an individual’s abilities are addressed.

DWP cannot make up its mind how much clinical & diagnostic expertise Atos HCPs need depending on what question you ask – supported by FoI requests.  Harrington’s reports specifically highlight shortcomings with assessing condition variability.  There is a standing joke that if you can get to a WCA, you must be fit enough to work – not as much of a joke as many might think I’m afraid.

All our 1,400 doctors, nurses and physiotherapists, are registered with their relevant professional body and are individually approved by the DWP. Atos Healthcare is also a GMC Approved Practice Setting. We want those who are called for a face to face assessment to understand that they will be well treated and properly assessed and by highly professional and dedicated practitioners.

Perhaps, but there are fundamental issues over qualifications needed to do this job, too complex to go into here.

Finally, Harrington himself is far from objective and most certainly NOT independent.  (What happened to Prof Paul Gregg his predecessor?)

There is a view of “disability” that pervades the Health Insurance industry, private sector health service providers and the Government – it is dogma not science as we are led to believe.

There is more at http://tia-junior.blogspot.co.uk/2012/03/reasoned-and-coherent-way-forward-stage.html

Professor Michael O’Donnell
Chief Medical Officer, Atos Healthcare

Competing interests: I am the Chief Medical Officer of Atos Healthcare

A reasoned and coherent way forward - stage 1

The Tory Government is simply doing what Tory Governments do – no surprises there.

If the intention is to unseat them at the next election, the first thing to consider is what would come next, but that’s a thought for another day.  Just be careful what you wish for.

There needs to be a plan, which I think starts with unravelling all of the spurious claims they are making and exposing their policies for what they are.  Personally, I believe the step by step, logical approach will be more productive than “Nazi bastard” vilification.  Whilst this usefully winds up some emotion, it is at risk of alienating the very large proportion of people who are prepared to be sympathetic if than can see the issues in a clear and honest light.

The view of disability that causes greatest upset is the one that regards it as just another form of unemployment, or perhaps more accurately, under-employment.  This is clearly part of the Government’s thinking.  It suggests that there is an absolute formula that can differentiate between those that can work and those that cannot.  It has been allowed to drift and all they are doing now is resetting it to where it should be.  They imply that this new level can be independently and scientifically determined, so their approach is unchallengeable.

This of course is not true.  The cut-off is part of one’s dogma – religious, political, whatever.  The Coalition believes that the bar should be set considerably lower (so fewer are allowed past it) which is their ‘prerogative’, but let’s not lie about its basis.  One way or another, it has formulated an estimate of how many people need to be moved from one side of the line to the other.

Closely linked to this is the “Arbeit Macht Frei” philosophy, so not only is working good for society, it is good for you individually too – it will broaden your outlook, enhance your self-esteem, and improve your health and probably your longevity too.  It will do this both directly and indirectly through you being financially better off.  It is a little vague on how all the wealth created is distributed, but at least everyone gets some.

With such a strong belief in the work panacea, not surprising that one would accept a fair degree of collateral damage as undoubtedly the ends justifies the means.   The horrendous fit-for-work errors that crop up frequently are not personal, nor particularly deliberate: they are just seen as part of the price one has to pay.  The points to get across therefore are firstly that this is not the case and secondly if it were, this price is too high.  The current process is flawed on two counts:

1.       It produces  too many errors

2.       It produces far too many extreme errors

The consequences of both are massively compounded by a very long and convoluted remedial process that has no feedback loop to generate at least some progressive improvement.

They claim their approach is based on need rather than financially driven (bottom up, not top down), but this is splitting hairs if they continually redefine “need” to fit a financial target, which is precisely what we have now.  Cleverly, if WCAs are not producing the required ratios, they manipulate WCA content to make sure they do. Proof is through the descriptor changes made in March 2011

The complementary side of this is of course is the nature of work itself – not how much of it is available, but what characteristics it has.  Quite obviously, if you move the bar downwards, you need to re-specify what work is so that it can accommodate people with what is now a wider range of abilities.  The Government in effect argues that it has already done this and is now just catching up by modifying descriptors accordingly.

This claim is based on the way in which employers of all types have positively responded to equality legislation over the years, to the point where in the typical workplace, disabled employees are no longer at any disadvantage when compared to fully able employees.  This is not just about wheelchair access, but literally every aspect of every work environment.

This is the argument DWP used to substantiate its descriptor changes in March 2011.  It argued that the changes were legitimised by clear scientific and impartial evidence which is simply untrue.  The report on which they mostly rely was indeed commissioned by DWP.  However, its results are far from conclusive and in places diametrically opposed to the Government’s proposition.  Also and somewhat absurdly, the report includes a disclaimer whereby DWP points out that it does not necessarily agree with the authors.  I can only assume that when they quote evidence to support their strategy, they hope that nobody will ever check it out.

It is also worth considering causes and effects as they are often wrongly assigned.  The Government regularly falls back on the proportion of claimants initially found FFW following a WCA.  If they lump together FFW + WRAG, they can quote proportions of around 70%.  This, they say justifies the process they have set up.  What they conveniently forget however is that this is precisely what they have designed the process to do, so it is rather a self-fulfilling prophesy.  In fact, one could argue that given this, the results are actually quite disappointing from the Tory viewpoint – ONLY 75%, when they would like it to achieve something higher.

One final general point and that is over the meaning of “independence”, which in reality is often very hard to achieve.    Most commonly it requires features such as:

·         not controlled by another

·          free from the authority, control, or domination of somebody or something else, especially not controlled by another state or organization

·         able to self-govern

·         Financially independent, not forced to rely on another for money or support.

The prevailing view from most quarters, campaigners included is that much hangs on the infamous Professor Harrington – if they were only to implement all of his recommendations properly, everything would be ok.  NO IT WOULD NOT and this is why.

One of the biggest issues has been around decision making errors, subsequently corrected.  Logically therefore right-first-time decision rates would be an important KPI to monitor.  DWP has not, does not and will not however be using it.  Nor will they declare a target that they are aiming for.  This is just politicians for you – keeping the water muddy, but where is Malcolm setting the target and insisting they meet it sooner rather than later – all conspicuous by its absence.

Secondly, how independent is Malcolm?  Just run through the tests above and make up your own mind.  He has done little more since involvement began than “urge patience”. He has also said:

“My take on things is that [the Department for Work and Pensions] DWP and [Jobcentre Plus] JCP (in collaboration with Atos where appropriate) are energetically implementing all of my recommendations.” and

“In some cases I believe the JCP staff responsible have actually improved on what I had proposed in light of practical experience. I see real progress and am even more confident of improvements than I was in my interim report to the Minister in May. “

I would simply ask

·         What evidence does he have to support any of this?  A few examples would be really helpful.

·         Does anyone who has had repeat dealings with WCA/Atos over the past three years agree that things have changed very much for the better?

It is ironic to say the least that the venerable professor wants to “collect robust evidence about what is and isn’t working, moving, where possible, away from anecdotal reports.”,  when DWP does exactly the opposite.

If you go back to Professor Harrington’s first report in 2010, there are other things conspicuous by their absence, notably a comprehensive PDD (Project Definition Document).  This is very much standard management practice and can be constructively applied in almost any ‘change’ situation to define the scope of the work, its boundaries, its objectives, success criteria, assumptions, inclusions, exclusions etc.  It then provides the key reference point for subsequent work for the duration of the project and I would say it is impossible to manage well without one.  There were some general terms of reference at the outset, but all rather vague – unprofessional or deliberate – who knows?  There was no well-reasoned argument for example that explained why NHS services had been excluded from consideration.  Nothing of this nature has appeared since and his subsequent work just follows the same path.

So we need to reconsider Professor Harrington’s so-called independent role in all of this and if there is a conspiracy, judge if he is part of it.

WCA Improvement - no real measures after all

THIS SPEAKS FOR ITSELF:

Thank you for your Freedom of Information request of 13 March 2012

In your request you stated:

Messrs Grayling & Harrison are agreed that the overriding priority is to ensure that WCA decisions are right first time and it is normal business practice to establish the parameters through which progress can be objectively measured.

You requested the following information:

1) Long term, once the process has settled, what error rate does DWP regard as acceptable and by when?

2) What are historical and current error rates?

3) What milestone dates has DWP set itself to reach the long term acceptable error rate?

At present, DWP does not collect data in relation to WCA Decision Making. It is not therefore possible to provide current or historical information.

As part of a wider quality improvement programme, a Quality Assurance Framework (QAF) was introduced to monitor and improve standards of decision making. The QAF focuses on providing detailed feedback to decision makers to ensure that they give due consideration to all of the available evidence. In the longer term this may involve introducing a measurable error rate however there are no current plans to do so.

Inequality in the Welfare State? [CIRC Report]

Inequality in the Welfare State?

Report written and produced by Clydebank Independent Resource Centre, 627 Dumbarton Road, Dalmuir Clydebank G81 4ET 0141 951 4040: info@irc-clydebank.co.uk: www.irc-clydebank.co.uk:  Registered charity no. SCO37670. November 2011

http://www.oxfamblogs.org/ukpovertypost/wp-content/uploads/CIRC-Equality-Act-Report.pdf

A  few supplementary thoughts.

Prof Harrington has never challenged the basic premise that fit for work (FFW) decisions can be distilled into a set of parameters that can be adequately assessed by a DWP administrator, “supported” by no more than a lowly-trained medic operating under their direction. 

In addition the question of whether condition variability and task repeatability can ever be adequately assessed in a single short WCA has not been sensibly addressed.

Prof Harrington himself does not pass all of the tests to establish his “independence” from DWP & Coalition dogma and a cynic would argue that his vested interest in certain outcomes makes this impossible.

Although many WCAs are poorly performed by Atos, DWP claims to have rigorous quality and audit procedures in place and that Atos routinely achieves its contractual KPIs.  Either this is not true, or they do not work, at least to the standards most would assume.  The fact is that they satisfy only the standards DWP has set – DWP has not on thanking them for their efforts.

Without doubt and despite its protestations to the contrary, the Government largely subscribes to the “benefit scrounging” school of thought.  This can easily be seen in some of the imagery it uses in key publications.

The Government has singularly failed to offer any definition of the work it is glibly passing people fit to perform.  It relies on the concept of ‘general work’ (sic), without even describing its basic characteristics.

DWP has severely criticised the historical contribution of GPs to this process to the point where it has effectively challenged their professional integrity.  Rather than tackle this unsubstantiated proposition directly, DWP has adopted a costly strategy that progressively removes them (GPs) from the process altogether.  It still however claims they (GPs) play an important role to play, albeit from a remote and mistrusted position.  This is one of many contradictions within DWP’s assurances and it is both surprising and disappointing that their representative organisations have not taken great issue with this implication – or is it just a case of same money, less work?

The comments on p15 are not quite correct.  Whilst the Atos HCP does not have direct access to medical records etc, they are required to consider and log ANY evidence a claimant brings to a WCA.  What is missing is a comprehensive briefing for claimants (and their reps) to ensure that they present their situation at the WCA as comprehensively as possible.  The WCA invitation letter covers little more than being able to prove who you are!

The WCA handbook is quite clear (and reasonable) over how a HCP must deal with an apparent contradiction between claimant evidence and their own observations to produce an acceptable report.  It states that the HCP cannot simply rely on their ‘opinion’ and must support any conclusions with evidence of one kind or another – this could take the form of a specifically tailored examination and/or Q&A.  It is therefore vital that the claimant takes everything they can to the WCA or any contradiction might not be apparent – the HCP must not be left in the position where they can (legitimately) say that they were unaware of something relevant to the way the assessment should be performed.

The report rightly highlights DWP’s progressive tightening of descriptor definitions, notably in March 2011.  DWP insists that they are justified based on objective evidence, but this is not confirmed within the documents they themselves rely upon.  In fact in some cases, the reports contain explicit disclaimers where DWP states that it does not necessarily share the views and conclusions of the authors – how absurd it that?

In addition, the joint DWP/Atos process contains a number of surreptitious ‘correlations’ whereby very specific interpretations are placed on the answers to seemingly innocent questions.  A visit to a supermarket for example means being able to cover 800m comfortably and would attract no points.

Worse still, in Mar 2011, ‘walking’ was substituted with ‘mobilising’ again on the surface for legitimate reasons but has given rise to the “invisible wheelchair”.  This allows the HCP & Decision Maker to make the mobility assessment with the claimant in a wheelchair even if they do not normally use one, even if their GP has advised against it and they do not even have to declare that this is what they have done.  All the claimant sees is no points.   The invisible wheelchair can be deployed selectively in that it might appear for mobility assessment on level surfaces, but be abandoned when steps are involved.

DWP insists that a declaration of fit for work does not mean they do not believe you are ill, just that the illness is not severe enough to stop you working.  This is of course (as explained above) despite the fact that ‘work’ is not defined.  Furthermore, it insists that people who find themselves on the job market through this route are at no disadvantage relative to other fully fit job seekers.  It bases this assurance on reports in which it has incorporated a disclaimer (see above) and/or completely contradicts its proposition and universal compliance with long standing disability equality legislation.  The reality is that there is no real evidence to support any of this.

Consultation my arse

It appears that ‘consultation’ means agreeing with what the Government says or buggering off.

Work Experience has a some value.

http://www.telegraph.co.uk/finance/comment/9112078/Sainsburys-chief-Justin-King-Dont-let-work-experience-debate-destroy-its-real-value.html

Trainees of any kind in the work place are often seen by junior management particularly as annoying to say the least and a huge distraction.  There is no denying that to do the training job well, it takes a considerable amount of thought and time to put a programme together that allows the trainee to get the most out of it and sadly, many can’t be bothered.

The first manifestation is usually that the trainee turns up only to find they were not expected – rarely true, more commonly the case that the person who was notified just forgot to tell anyone else.  Not off to exactly the best start and it goes slowly downhill thereafter.  Much of the day ends up being spent with a broom in hand or doing whatever task is the perennial standby – that job that does not appear in any job description or on any work plan, but nevertheless has to be done from time to time.  By comparison, shelf-filing is most certainly one notch up, but only a small notch.

I would not therefore be at all surprised to find that the employers currently being criticised for using “slave labour” did not join the scheme with exploitation in mind and have been let down by the quality of the front-line implementation.  Yes, they are required to make a profit, but the net saving here is minimal in the overall scheme of things and the risk of damage is relatively high as they are now finding out.

Welfare Reform - Overall Plan

Cart before Horse

http://victimsofatoscorruption.wordpress.com/2012/01/30/there-should-be-no-compulsion-for-disabled-people-to-find-or-look-for-work-so-says-ex-government-expert/#comment-3709

It is certainly true to say that the Government has done nothing to create the employment opportunities that would be appropriate for many types of disabled people and this is one of the main reasons its strategy falls down – cart before horse as it were.

Like it or not, if we want to generally improve living standards ,we have to create wealth which in turn requires work. We all know about the demographic changes that have taken place and how this is changing the balance of numbers working and not working, so something has to give. As the Prof suggests, it would be nice to make the option to work purely voluntary, but until a number of other things change, this will not be enough. That does not mean to say that attitudes and motivations should not/cannot be changed, but it requires a re-education process that will take at least a generation to engineer, so the sooner it starts the better.

There is nothing wrong in principle with less than fully able people making what contribution they can given the right backdrop and there is nothing in principle wrong with suitably spaced assessments to check for changes in condition. I cannot thank everyone individually, but I am grateful for the financial support I have received and I am glad I live in a society that makes this possible – I do not believe I have an unerring, unqualified right to either and as soon as I can, I will attempt to return the generosity.

There is a very old management cliché: “if you do not measure it, you cannot manage it”, so the Prof is right to say that it is not acceptable that the Government is doing so little to accurately track the consequences of the WCA outcomes. This is particularly true as whilst DWP regularly claims substantial improvements in the WCA process, even it will not claim an improvement in right-first-time ESA decision making, which is surely what the whole thing is about.

I trust my GP - please don't spoil it.

#DWP rejects using GPs for #WCAs because they are ‘too soft' (I prefer the words ‘sensibly cautious’).  They fear they will damage the 'relationship' and trust that exists between GP & patient.

Firstly, I do trust my GP.  I trust him to always advise in my best interests.  That that would include returning to work if that is what he thought.  After all, this is what the Hippocratic Oath is all about.

Secondly, I also respect my GP.  If therefore he thought I’d be better off working, I’d expect him to hold his ground despite my protestations.  This too is what the Hippocratic Oath is about.

Thirdly, my ‘relationship’ with my GP is professional only and based on hopefully mutual trust and respect.  He is not my best friend.  Having a sensible debate about whether or not work is a good idea is no less than I would expect.

I am absolutely confident that we would quickly reach agreement.  This does not mean he just gives in; otherwise he loses the trust and respect.

Not all GPs would be prepared to display this degree of integrity, but appropriate direction and monitoring from their highly influential professional bodies would soon bring transgressors into line.

PS

Sadly, this could all go for a ball of chalk if they press on with this rather greedy objection to a small cut in pension payments.  That have done very well thank you over the past decade in the face of the general economic difficulties.  They will do even better if the Government gets its way with NHS reforms.  The pensions of many are so large that they will still be in the ‘top earners’ group (over £65k p.a.).  Surely a modest reduction is not unreasonable?

Ongoing DWP Deception & Misrepresentation with WCA (1)

Not a surprise to many that this takes place, but I will continue to highlight examples as best I can to help you avoid the pitfalls and add to the fast growing body of data that exposes the underlying political dogma that lends itself to legal challenge at some point.

This post relates to the March 2011 decision to remove the bending and kneeling test/descriptor from the WCA, the reason given being that these movements are no longer a significant feature of the modern workplace.  Who says?

DWP’s response was that disability equality legislation has been in place for a number of years and this was enough to indicate that the descriptor changes were justified.  They directed me to a couple of reports that would apparently explain the detail and provide the corresponding evidence.

They did nothing of the kind and one even pointed out that overall, there had been deterioration in compliance with the law since 2005!  More ironic was the fact that in the first few pages, DWP has printed is standard disclaimer saying that the view expressed in the report are not necessarily supported by DWP.
If this is the best “evidence” they have, God forbid, but they have been unable to provide anything better to justify the descriptor change.  All this proves of course is that the REAL motivation is coming from political dogma NOT sound scientific evidence – something many know or suspected already.

Sooner or later, this continual drip, drip, drip of undermining and disproving the propositions on which policies have supposedly been based will expose the sham for what it is and bring about the obvious and simple change of direction needed.