A report – backed by evidence from more than 1,200 sick and disabled people – tells politicians this week why the system of supporting out-of-work disabled people must be replaced.
The Spartacus online network of disabled campaigners say they want their new report – which is strongly evidence-based – to “kickstart a significant new debate about the failure of sickness and disability support”, and what should be done to improve it.
The first stages of the research, by campaigner and blogger Sue Marsh, began three years ago, while the lead researcher, Stef Benstead, has been working on the Beyond the Barriers report for about 18 months.
That research has concluded that the current eligibility test for the employment and support allowance (ESA) system – the much-criticised work capability assessment (WCA) – is “inaccurate, unreliable and invalid”, as well as being “politically toxic”.
The Spartacus report demands a new system that is “radical and ambitious” and “inspires, enables and encourages” disabled people, rather than the current “punishing, penalty-based system”, which “denies, restricts, judges and harms”.
The researchers say assessments should instead be carried out over several meetings with a single caseworker with experience in the relevant impairment or health condition, so as to reduce the “snapshot effect” of the WCA, and increase the amount of accurate evidence collected.
The report calls for a new “integrated” system, where the caseworker can advise on benefit entitlement, health services and social care, and has access to information on work support, education and training.
The report also examines the failure of the government’s Work Programme, pointing out that the latest figures show that just five per cent of ESA claimants achieved a job outcome within a year, and just 1.8 per cent of those previously claiming the old incapacity benefit.
Claimants should be allowed to control their own back-to-work support budgets, because “they are best placed to assess what help they need, what barriers they face and what interventions might be necessary to return to work”, it says.
These interventions could include aids and adaptations, training, further education and self-employment advice.
The most common recommendation from those who took part in the consultations was the need for more opportunities to work from home, or to be allowed other flexible ways of working, at hours that suited the individual.
In all, the researchers carried out five consultations over two years, and received more than 1,200 responses from disabled and sick people going through the ESA system and Work Programme.
Their report also draws on the best elements of the systems used in Australia, Netherlands, Germany, Iceland, Norway, Denmark and Sweden, and on “the widest evidence considered and presented to date” around sickness and disability support.
Marsh said she believed that scrapping the WCA was now bound to happen. “I think they know it’s inevitable. Atos have [announced they are pulling out of delivering the WCA]. There are so many bits of it falling apart.
“This is the best time for them to sit down and say: ‘This is not working. Let’s just put something in place that works. Why don’t we just get it right?'”
Benstead said she had been determined that the report would be strongly evidence-based.
ESA may have “sounded nice” when it was introduced, she said, but it had not been evidence-based.
She said: “If you want something that works, it cannot just sound nice, it has to be based on the evidence of what works and doesn’t work.
“This is about saying, ‘who are the right people to talk to about this?’ It is the disabled people who are experiencing the system who know what works.”
The report says that the current ESA points system, descriptors and computer system are “incapable of gathering the reality and complexity of people’s conditions”, while “medical evidence from those who have detailed, accurate and relevant knowledge is ignored”.
And it says that healthcare professionals who carry out the WCAs “lack the time, ability and medical knowledge to assess and understand an individual’s condition and how it relates to work”.
It adds: “The assessment is irrelevant to work, as no attempt is made to discover what work an individual is supposed to be capable of doing.”
In one of its most damning conclusions, it says: “Not one of the respondents to our call for evidence felt that their advisor made an attempt to offer a personalised service that genuinely attempted to address their limited capability for work.”
Meanwhile, DWP has told DNS that claims in the Daily Record that the government had decided to scrap face-to-face assessments as part of a revamp of the WCA were “not correct”.
Separately, the Labour MP Sheila Gilmore, a member of Dame Anne’s committee, has told fellow MPs that government statistics are disguising the number of WCAs that are wrongly finding a disabled person “fit for work”, and has called for changes to be made that would “paint a more robust picture of the work capability assessment”.
The figures show about 13 per cent of all decisions to find someone fit for work have been subsequently overturned at an appeal, but Gilmore – who has received backing in her enquiries from the UK Statistics Authority – says these numbers do not take account of informal appeals dealt with by DWP, which take place before any formal tribunals.
She said the current statistics “could understate the total number of overturns and overstate the effectiveness of and improvement in the WCA”, particularly important when Atos has decided to pull out of the contract to provide WCAs.
Penning said he could not order DWP statisticians to present the figures in a different way, but had asked them to “look at this to see whether what she has asked for is possible”.
10 May 2014