‘Fitness for work’ test: government ‘should start again from scratch’


newslatestDisability charities appear to be losing patience with efforts to reform the much-criticised “fitness for work” test, as the government’s new independent reviewer delivered his first report.

The review by Dr Paul Litchfield, chief medical officer for BT Group, was the fourth since the coalition came to power in 2010, and the first since he took over the role from Professor Malcolm Harrington.

It was published only three days after an anonymous disabled campaigner published her own review of the WCA.

The author of the second People’s Review of the WCA says the test continues to cause “stress, anxiety and far worse”, while the accounts of people’s experiences included in the report show the “frightening and inhuman treatment” claimants are having to endure as they try to qualify for the out-of-work disability benefit employment and support allowance.

As well as accounts of deaths connected with the WCA and loss of benefits, the People’s Review also includes criticism of the test by MPs, welfare advisers and doctors, and pages of accounts from disabled people who have experienced anxiety, despair and hardship through their experiences of the assessment.

The author concludes: “The heartrending first-person testimonies, tragic accounts of people who have died before knowing if their appeal was successful and significant concerns expressed by MPs of all parties on behalf of their constituents, together with the length of time for which these issues have caused concern, demonstrate the urgent need for an effective, humane alternative to the current WCA.”

Three days later, Litchfield concluded in his review that only 34 of the 49 recommendations made by Harrington over his three reviews have so far been implemented in full by the government.

Litchfield also appears to suggest that the healthcare professionals employed by Atos Healthcare should be increasingly sidelined, with decision-makers – civil servants – playing an even more central role in the WCA than they do now. He calls on the Department for Work and Pensions to carry out a “full impact assessment” of this alternative process.

Litchfield concludes that the WCA system – which was first piloted under the Labour government in 2008 – was still “enormously complex” and marred by “impenetrable” language”.

He focuses in his review on how claimants are treated, the length and complexity of the process, and the treatment of people with mental health conditions, calling for improved training in mental health for both the civil servants who make the final decisions on eligibility and the healthcare professionals who carry out the assessments.

Among his criticisms, he says claimants must be treated with more “dignity and respect”, while communication with those claiming the benefit must also be improved.

Litchfield also says that the points score used to determine eligibility “gives a false impression of scientific validity” to the test, and he calls for a process that allows more of a “rapport” between the claimant and the assessor, for example by sitting them side-by-side during the assessment.

He also recommends that in most cases at least six months should be left after a successful appeal against a WCA decision before a claimant is recalled for another assessment.

Even before the Litchfield report was published, Liz Sayce, chief executive of Disability Rights UK (DR UK), had suggested in a blog that the government should “start from scratch” on the WCA, which she said was “a scandalous waste of tax payers’ money”.

DR UK was also critical of Litchfield’s report and said there was “little or no recognition by Dr Litchfield of the widespread anger and criticism of the poor standard of medical assessments carried out by Atos Healthcare Professionals”.

DR UK added: “We believe, more fundamentally, that tinkering with the WCA will not make it work and that the Government should start from scratch on the Work Capability Assessment as part of a wider strategy to transform employment support.”

Steve Winyard, chair of the Disability Benefits Consortium’s steering group and head of policy and campaigns at RNIB, said: “After five years, four reviews, millions of pounds in appeals and hundreds of thousands of disabled people let down and made to feel a burden a complete overhaul is still required.

“The assessment remains broken. The WCA wastes millions of pounds denying appropriate benefits or help to find work for disabled people.”

Richard Hawkes, chief executive of Scope, said the WCA was “broken”, a mere “tick-box test of someone’s medical condition”, and that disabled people had “lost all faith” in it.

Paul Farmer, chief executive of Mind, said his charity had been providing evidence to the reviews since they began, and added: “Now after four years, we desperately need to see an overhaul of this broken system which continues to consistently let down thousands of the most vulnerable people in society.”

Mike Penning, the new minister for disabled people, welcomed Litchfield’s report, and said: “The system we inherited wasn’t working properly, and as Dr Litchfield has suggested we will carefully consider his recommendations before responding to make sure we get this right for claimants – and right for taxpayers.”

A formal government response will be published early next year.

Meanwhile, a separate, evidence-based review of the assessment has compared the WCA with a different test drawn up by disability charities – including Mencap, Mind, the MS Society and Forward ME – which was based on the WCA but differed in key areas.

The review, though, concluded that the WCA performed better and produced more “valid and consistent outcomes”, although claimants had a slight preference for the charities’ alternative.

The review was commissioned after the charities called for improvements to the WCA, particularly in assessing fluctuating conditions and learning difficulties. Professor Harrington asked them in his second review to bring forward proposals for how to do this.

12 December 2013