WCA Audio Recording - Project management at its very best

The exchange below stemmed from an FoI request and took a staggering 6 months to get some straight answers

WCA Audio recordings (2) 22nd March 2012 Dear Department for Work and Pensions, In 2011, a trial was undertaken and recently Chris Grayling has confirmed that it was successful and the facility is now available on demand nationwide.  Please provide me with a copy of the following, all of which would have been produced before implementation commenced. 1)        The risk analysis 2)        The risk register 3)        The impact assessment 4)        If they are not available, who authorised implementation without them?

23rd  April 2012 In response to Qs 1, 2 & 3 the decision was taken that as the Audio Recording pilot scheme was considered to be an interim solution that there was no requirement for detailed impacting or the undertaking of risk analysis. The Pilot scheme was put in place to allow consideration of the potential volumes of requests and recording methods, to therefore ensure that an appropriate solution to the recording of medical assessments was found.  In answer to Q 4 this decision was taken by Atos Healthcare and the Head of DWP Medical Services – Commercials.

23rd  April 2012 Dear Department for Work and Pensions, Please pass this on to the person who conducts Freedom of Information reviews. I am writing to request an internal review of Department for Work and Pensions' handling of my FOI request 'WCA Audio Recording (2)'.  I would be grateful if you would ensure this is passed to a manager who has the ability to see how absurd the DWP response is. Issue of audio recordings is high profile and a specific recommendation from Professor Harrington. This nprofessional & haphazard approach is therefore a serious letdown to him and his team. The pilot scheme was established to determine the best solution to a problem. Only once the final solution is known, can any other temporary fix be described as “interim”. It is simply impossible to set out to establish an interim answer to anything without knowing what the anything is!!! On this basis, the decision to waive the three key processes was clearly unjustified and fundamentally wrong. An IA was VITAL as the potential consequences of this trail are immense and could spread through the not only JCP, but the TS too. Its omission was therefore a serious dereliction of duty. For the record, Atos has NO part to play in the decision anyway – accountability and responsibility sit EXCLUSIVELY with DWP. There are likewise a number of serious risks – lengthening the WCA for example and to ignore them is an equally serious dereliction of duty. The (unexplained) limitations imposed on the trial rendered it totally incapable of assessing true demand, so this suggestion is not only completely at odds with other FoI responses and information published, it is simply fabricated. The response to another FoI request states that the report and all the associated documents will be available on 04/05/2012. In will be interesting to see how well considered and professionally produced it is.

DATE 21 May 2012 At the time of your request, the Audio Recording Pilot had ended and an interim solution was in place whilst the Department was considering the evaluation. As this was considered an interim solution there was no detailed impacting or risk analysis undertaken. I apologise that the previous response implied that the actual pilot was the interim solution and for any confusion that may have arisen. Since the request under review was made, the full evaluation report has become available using the following link: http://www.dwp.gov.uk/policy/welfare-reform/employment-and-support/wca-independent-review/year-one/ In reviewing your request I uphold the decision of the Freedom of Information Officer in part and have added information where appropriate. I am therefore satisfied now that all the information that DWP are able to supply to you has been supplied.

29 May 2012 Dear Department for Work and Pensions, Please pass this on to the person who conducts Freedom of Information reviews.  I am writing to request an internal review of Department for Work and Pensions’ handling of my FOI request 'WCA Audio Recording (2)'. I’m sorry, but you are hedging the issue. 1)  The report published by Atos is 12 months old and includes a number of questions that it feels need to be answered before a full roll-out can take place. Over the past 12 months what information has DWP produced that addresses these questions? 2)  If as you say DWP has been “evaluating” the pilot, what conclusions has it so far drawn, given it has already had 12 months? 3)  To what timetable is DWP working to produce a definitive statement of what it regards as the final solution, bearing in mind it has had 12 months already? 4)  At what point will the statutory requirements for risk & impact analyses plus a risk register be produced? 5)  DWP will have a defined project plan to ensure the evaluation is completed on time and comprehensively includes all of the relevant issues. Please provide a copy. 6)  Who is DWP “owns” this evaluation and the subsequent implementation – i.e. has direct accountability for the success of both. 7)  Is any form of consultation planned and if so, at what point? Can I respectfully remind you of the overarching requirements of Article 19 of the Universal Declaration of Human Rights embodied within UK legislation (Principles 1 – 3 particularly) adherence to which would have offered this information voluntarily. All I am seeking is a clear understanding of DWP’s real attitude to this piece of work and how enthusiastically it intends to pursue it - the impression you are giving is that you have no enthusiasm, little interest and are actively engineering its failure.

11th Sept 2012 In response to Q 1 the questions in Section 8 relate to national rollout. No final decision has been made about this. The answers to these questions have therefore not been formally considered and are therefore not available. In reply to Qs 2, 3, 4 & 5 DWP are developing criteria in order to evaluate the success of the current approach which will take into account factors such as value for money and the value it adds to the Work Capability Assessment process. Therefore no conclusions have been reached and the information is not available. A timetable and a project plan will be produced as part of the evaluation process which will include the undertaking of risk and impact nalyses. In answer to Q 6 the evaluation of the pilot scheme is owned by the DWP Health and Wellbeing Directorate. In response to Q 7 there has been no decision taken in relation to this point.

Summary Having seen the Atos report from the trial published in June 2011, it rather looks like Atos set it up in reasonably good faith albeit without much thought and rigour, so that the dilemmas that subsequently arose were entirely predictable.  It would have helped if Prof Harrington had provided more guidance and continual reminders as to why the idea ever arose in the first place. The shameful organisation within DWP is apparent from this last response dated 11th September.  In essence DWP has done nothing to constructively take this forward for a year and a half and even now can only offer faint promises for unspecified dates in the future. It is bad enough being screwed by a group of so-called public servants but twice as painful when it is done so inefficiency that it costs a lot and achieves nothing. Full details at:  http://www.whatdotheyknow.com/request/wca_audio_recording_2

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.

More Grayling Duplicity - quality measurement

It is always worth reminding ourselves of the duplicity and double-standards within DWP. 

The Government demands from the organisations it says it consults evidence to back up issues they highlight as needing to be addressed.  Often, without this evidence the recommendations are ignored as being unsubstantiated and therefore purely speculative.  It is however in complete contrast quite amenable to deploying precisely the same tactic itself – making claims and stating intentions that sound laudable, but have no foundation whatsoever – as shown here.

Lots of impressive sounding words in these resoponses, but the fact remains that not only are there no accuracy targets (which there should be) there are no accuracy MEASURES, so Grayling’s “commitment” to improving accuracy means absolutely nothing as he will simply never be in a position to know one way or the other.  This is the perfect position for a politician as although none of his statements can be proved, nor can they be disproved, so he can pretty much make it up as he goes along.

There are two very basic questions that the Goverment continually chooses to ignore:

1)      What is the best level of first-time accuracy we can expect of the current WCA process?

2)      It that good enough?

Or the other way round:

1)      What level of accuracy do we demand of a WCA process?

2)      Can the current process ever achieve it?

If you doubt any of this, have a look at the responses to this FoI request

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

It is equally worrying that the enigmatic Professor Harrington has not latched on to this serious omission and not made an appropriate recommendation to resolve in either of his first two reviews.

Added 18/06/2012 in response to Anonymous comment:

I’m guilty here of committing the sin for which I often criticise Grayling et al in not being clear about my assumptions.  Mine here is that the appeals rigmarole gets it right eventually, so the answer to your question is kind of both rolled together.

I could not agree more with what you say and it is very common for DWP to rely on and quote evidence that at best is not what it seems and at worse does not exist at all.  If there is a conspiracy here, organised or not, the venerable Professor Harrington has allowed himself to become part of it, possibly without realising (giving him the benefit of the doubt is becoming more and more difficult).  Continually telling us to be patient without any indication of what to ultimately expect is a complete cop-out.

The appropriateness of the descriptors is not helped by the fact that there is no definition of “work” either in terms of content or the impact it has on lifestyle.  All employers need above all else reliability and this is the very first thing many conditions prevent – there might be a lot you can do, but only as long as you have total discretion over when you do it.  The WCA has two “variables” – the work itself as well as the individual and the current process only covers one of them.  Interestingly, the roots of Occupational Health (which contrary to one viewpoint is NOT a radically new branch of medicine) are more in adapting workplaces to ensure safety and generate comfort and productivity than assessing individuals in isolation.

Personally, I can accept that the line between people who could do something work-like and people who can’t do anything work-like has been allowed to slip too low and needs to be inched up a bit.  Like it or not and at least for the time being conventional work is needed to generate conventional prosperity and it all falls apart if there are more taking out than putting in.  I can also accept that the “test” is a bit tricky to design in such a way that true working can be effectively simulated, but it is perfectly possible to have a far better fit than there is now.

One of my main beefs is the dishonesty displayed by DWP, which is born out of the ‘benefit scrounger’ philosophy:  we are all cheats and do not want to work so the only way to get an accurate assessment is through deception and subterfuge.  All this does in reality is increase the initial error rate by introducing vague and inconsistent rules of thumb to translate surgery generated data into a meaningful and reliable assessment of capability.  As with everything else, these rules of thumb may sound reasonable & plausible but have absolutely no foundation, which may in other arenas be ok, but not when the consequences of error can be so devastating.  Risk analysis is another management tool that is often conspicuous by its absence here and elsewhere.

Your second paragraph is also spot on so we can add hypocrisy to the list of DWP failings.  It confuses the difference between “consultation” and “support” and tries to claim the latter when is has barely performed the former.  This is all part of the ‘evidence-based’ charade.   In March 2011, the descriptor relating to bending & kneeling was scrapped – not modified – totally removed.  DWP’s justification is that bending/kneeling is no longer a feature of the modern workplace, brought about by hugely effective anti-discrimination legislation.  You can ponder on this when you next visit a supermarket to find that the bottom two shelves are now empty and when you find only the top two drawers in your 4-drawer filing cabinet are now in use.  It was clearly a transparent ruse to cut points.  Even more dishonest is the selective introduction of the hypothetical wheelchair to assess mobility – I have never encountered something so outrageous in all my life!

Another wholesale change as you say is unlikely and the Government is so entrenched in ‘outsourcing’ it is hardly likely to dump Atos, but a lot could be achieved if approached from the right standpoint and with the right priorities, attitudes and compassion.  The true error rate looks to be about 10% - much too high given the potential consequences of an error, but equally not as horrendous as many would have us believe. 

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!"

Exposing the WCA charade (1)

Although its failings are pretty clear to anyone who has experienced a WCA, DWP still insists it is fine and doing the job for which it was intended, which from their point of view (rather than ours) is perfectly true.

They claim their ‘model’ is objective and fair, whereas it is based on little more than political dogma and a dim view of pretty much anyone claiming benefits – we are scroungers first, deserving second, likewise obvious to anyone close.

It is important to continually expose their pretence for what it is and how better than in their own words.  I have therefore tried to use assorted FoI requests to extract if not a clear admission, an admission by inference – often what they will not say is as informative as what they will say.

This is the first of probably many and relates to the FoI request at http://www.whatdotheyknow.com/request/fit_for_work_decision_dm_or_hcp#incoming-269396

Who ACTUALLY decides what and how well qualified they are to do it is a pretty key issue in relation to duty of care over the claimant/patient. As a result, DWP has to apply “post-decisional justification”, i.e. construct an argument that justifies what it has already done, regardless of the logic, or lack of it, involved. If it does not, its entire policy is undermined. This is what we have here.

However DWP attempts to disguise the fact, the KEY issue in this process is my fitness to work – if I am not, I will automatically be paid ESA, if I am, I will not receive a payment. Note that there are no recorded cases of an individual being deemed fit to work, but still awarded ESA or vice versa.

DWP DMs cannot decide fitness to work because they are not medically trained. Atos HCP cannot decide on ESA payments as they are outside of the public sector, so DWP has to juggle with words that suggest clarity and a clear demarcation to show all of the power sits with DWP and Atos is wholly subservient, when in fact the decision is in effect made by the Atos HCP. Remember too that what HCPs do is totally dictated by DWP, so they must be working in complete harmony.

The charade is further maintained by the claim that DM’s consider more information than HCPs – mmmmmm!

Firstly, as the decision should follow the WCA promptly, there is very little opportunity for anything new to arise. Secondly, if it did, chances are it would be medical, which a DM is not qualified to interpret and assess. Thirdly, according to the WCA Handbook, an HCP MUST have ALL relevant medical information to construct the WCA to best effect, so again what extra would a DM have?

DWP does nowhere near enough to coach claimants towards and through a WCA and one has to ask why. Could it be that they have a vested interest in HCP “errors” to further justify the valuable role a DM has to play? You can work that out for yourself.

The WCA - DWP exposed in their own words (as it were)

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.

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

More WCA dishonesty - FoI confession from DWP

When assessing mobility within a WCA, Atos HCPs are allowed to recommend the use of a wheelchair to improve mobility (if they think it will do this) for someone who does not normally use one.  They can do this without any specific discussion with the claimant or their GP.  They are not however allowed to recommend treatment – make sense of this if you can, but as unbelievable as it is, it is true.  Decision Makers are allowed to do the same thing, without specifically declaring it to claimants – all the claimant is told is that for mobility, they have scored (say) zero points.

This methodology was introduced in March 2011, presumably with the approval of Professor Harrington and is dishonest to say the least, as the claimant is not made aware of this trick before, during or after their WCA.

Through appeals, the courts have seen the injustice and dangers of DWP’s approach and have issued guidance.  From this FoI request, it appears that DWP thinks it is outside of the law and can ignore the advice.

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

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.