‘Fitness for work’ test ‘needs more than a fundamental redesign’

A new report by MPs that calls for a “fundamental redesign” of the much-criticised process used to determine eligibility for out-of-work disability benefits does not go far enough, say disabled campaigners.

The Commons work and pensions select committee says that the flaws in the employment and support allowance (ESA) system are so deeply ingrained that simply “rebranding” it by appointing a new contractor to replace Atos Healthcare – which tests eligibility through the controversial work capability assessment (WCA) – would not be enough.

The report into ESA and the WCA calls for the system to be redesigned by the time the government tenders for new WCA contractors in 2018.

But it stops short of recommending that the WCA should be scrapped and replaced, although it does suggest the government should consider bringing the assessment process back in-house. The committee also calls for a number of short-term improvements.

The report says the ESA process is “too long and complex”, there are too many unnecessary reassessments which are “distressing for the claimant and a waste of public money”, and that the backlog of 700,000 claimants awaiting assessment is “unacceptable”.

Among other criticisms, it says the work-related activity group – for those claimants who are not fit for work, but who have to carry out activity to help them move towards finding a job in the longer term – covers “too wide a spectrum of claimants with very different prognoses and employment support needs”.

The committee says that the ESA process should identify the barriers that claimants face, and the support they need, through a separate assessment.

Among other changes, they say that many of those claimants who will obviously be placed in the support group should not have to undergo a face-to-face assessment.

And they call on the Department for Work and Pensions to improve the way it communicates with claimants, which is often “unclear and confusing”, and to take more responsibility for decisions made within the ESA process.

The latest government figures show there were 2.46 million claimants of ESA – and its predecessor, incapacity benefit – in November 2013, with about 70,000 new claims every month.

Claimants who gave evidence to the committee’s inquiry reported feeling “dehumanised, ignored or questioned inappropriately” by the ESA process.

Dame Anne Begg, the disabled Labour MP who chairs the committee, said that Atos had become a “lightning rod for all the negativity around the ESA process”, even though it was DWP that makes the decision about a claimant’s eligibility for the benefit.

Dame Anne said: “Just putting a new private provider in place will not address the problems with ESA and the WCA on its own.”

Inclusion London welcomed the call for a major redesign of the ESA process, but said it was “disappointed” that the committee had failed to recommend that the “fatally flawed” WCA should be abolished and replaced by a completely new system “designed and co-produced with disabled people”.

Tracey Lazard, chief executive of Inclusion London, said: “Inclusion London believes the whole assessment process needs to radically change so that a disabled person’s capacity to work is holistically assessed from a social model of disability that takes into account the barriers that the disabled person is likely to face finding, securing and remaining in employment.”

John McArdle, co-founder of the grassroots campaign group Black Triangle, said he was disappointed that the report failed to address the urgent issue of the safety of the WCA.

Thousands of people with mental distress have been found unfairly fit for work following their WCA, and while many go on to win an appeal against this decision, some are unable to cope with an appeal, or experience a relapse in their health as a result of the process.

Many have had relapses, episodes of self-harm and suicide attempts, and have needed higher levels of medication and even hospitalisation.

McArdle said the failure to act was “just allowing the harm to continue unabated”.

Black Triangle (BT) has been campaigning to force the British Medical Association to tell every GP in the country about two vital regulations that BT believes could save lives, if used more often.

The ESA regulations state that a claimant should not be found fit for work (regulation 29), or placed in the ESA work-related activity group (regulation 35), if such a decision would pose “a substantial risk” to their “mental or physical health”.

But the BMA has refused to contact GPs about the regulations, even though doctors at its annual representative meeting were almost unanimous in voting two years ago for the organisation to “demand” that the WCA should end completely.

McArdle said the committee’s report also showed the consensus between the three main parties that the WCA should not be scrapped.

24 July 2014