Ministers and civil servants were “ruthless” and “reckless” in forcing through their new “fitness for work” test and refusing to abandon it even after they were told of the harm it was causing, according to a former government adviser.
Professor Geoff Shepherd, who was one of nine members of a working group set up by the Department for Work and Pensions (DWP) nearly 10 years ago, said the department could and should have predicted how stressful the test was going to be.
He said the face-to-face assessment at the heart of the process was so “arbitrary” that it was “a bit like Russian roulette”.
And he said it was “reckless” of DWP to continue with the work capability assessment (WCA) once evidence began to emerge of how damaging it was, particularly to people with mental health conditions.
Professor Shepherd is one of three mental health experts who have spoken to Disability News Service (DNS) about their work as members of the mental health technical working group that was used by DWP to help design the WCA in 2006 and 2007.
Their concerns are further evidence that ministers – under both Labour and coalition governments – and senior civil servants were told repeatedly that the WCA was not fit-for-purpose and would damage claimants’ mental health, and that it was vital to obtain a wider range of information about people with mental health problems before deciding on their claims.
Professor Shepherd told DNS that the WCA was a “deeply flawed” and damaging process, something that could and should have been predicted at the time of its introduction under the last Labour government in September 2008.
He said: “Everybody thought that. It was barn door obvious it was never going to work, and it was always going to be very stressful for people.”
He said the working group told DWP that the process – which tests eligibility for employment and support allowance, the new out-of-work disability benefit that began to replace incapacity benefit from 2008 – should include seeking other sources of information in addition to the face-to-face assessment.
Another member of the working group, Sue Godby, said: “What we asked for was getting more information than just relying on that one assessment by someone who was probably not a mental health specialist.
“We were trying to encourage DWP to get information from other sources ie the person themselves but also people who knew them well: key workers, that kind of thing.”
Seven years after the introduction of the WCA, campaigners are still trying to persuade ministers of the importance of securing a range of information about claimants with mental health conditions, rather than focusing on a brief face-to-face assessment.
Professor Shepherd said DWP had been “ruthless” in its introduction of the WCA because it was determined that its approach was the right one.
And he said the department had clearly been far too close to Atos, the company paid until this year to carry out both the predecessor of the WCA – the personal capability assessment – and the WCA itself.
A third member of the group, Dr Jed Boardman, now the lead on social inclusion for the Royal College of Psychiatrists, said suggestions made by the working group for improvements to the assessment were frequently taken away and scrutinised by DWP’s legal team before being rejected.
Godby, who was employed by the insurance giant Unum at the time but had been asked to join the group as an individual because of her mental health expertise and membership of a Royal College of Psychiatrists (RCP) working group, said: “We were asking for a different approach.
“That wasn’t necessarily taken on board, but it was something we were all saying needed to happen: that when assessing people with mental health problems you really do need to get that additional information.”
Even if DWP had not been able to predict the damage the process would cause before its introduction, once the WCA was piloted “the evidence was coming in thick and fast that it was extremely distressing for people”, said Professor Shepherd.
DNS has already revealed how coalition ministers Iain Duncan Smith and Chris Grayling failed in the summer of 2010 to pass on concerns raised by a coroner about the impact of the WCA on claimants with mental health problems – and the need to secure further evidence before deciding on their claims – to the expert they commissioned to review the WCA.
They also decided to go ahead with a roll-out of the WCA to existing claimants of incapacity benefit the following year, despite the coroner’s report.
More than three years after that warning was ignored, another coroner wrote an almost identical report warning of similar concerns about the WCA, this time following the death of a north London father-of-two, Michael O’Sullivan.
Last month, government-funded research by public health experts from the Universities of Liverpool and Oxford concluded that the programme to use the WCA to reassess people on incapacity benefit was linked to 590 suicides in just three years.
Professor Shepherd, a clinical psychologist and expert on mental health and employment, said: “The fact that the process is so bad makes it stressful, because it is a bit like Russian roulette: you don’t know if there is a bullet in the chamber or not.
“That’s hardly going to make you feel comfortable. It’s predictable that it was going to be stressful because of the arbitrary nature of the outcomes, because of the way that it was done itself, because it was so much depending on this single interview on a single day.
“I can very easily believe that it would damage people’s mental health, at least in the short term, and I can believe that it might lead to suicide, but I don’t know enough about the individual cases to know what else might be going on in their lives.
“Obviously there are some tragic stories here about individuals and what happened to them and I have the greatest sympathy for them and their families and I think it is tragic and I think it was reckless the way that DWP continued even in the face of evidence that it was damaging.”
Godby, who is no longer with Unum and now works independently, said: “I feel disappointed that some of the things that we hoped that we had raised have not helped.
“It is obviously awful for the people going through it, that they have had this experience.
“It seems that people have been turned down for benefits and when people appeal and there is all that extra information provided, then very often the appeal is allowed, the payment is made.
“It would have been better if that had happened before people had to appeal.”
She added: “I was there because of my expertise. You give your advice and you hope that they will take it.
“I am very disappointed that people have had to go through this and have such an awful time.”
Boardman said he did not believe the members of the working group could have foreseen all of the problems there had been with the WCA.
Their work was focused quite narrowly on technical aspects of the assessment and drawing up the so-called “descriptors” – which award points according to the difficulty a claimant has in carrying out certain tasks – whereas he saw the WCA as the whole process from the original application to the decision on the claim by a DWP civil servant.
Boardman said: “From the point of view of the descriptors themselves, we weren’t entirely happy with them but we just had to accept that that is what they were going to do.
“The WCA was certainly better than the PCA but most of the members of the group were not entirely happy with what they produced.
“You are an advisory committee and at the end of the day you are not the person who makes the decision.”
As the RCP’s lead on social inclusion, Boardman was responsible for commenting on last month’s research, which found links between the WCA and 590 suicides.
He said the links found by the researchers “do seem to be valid” and were “consistent with several others suggesting a link between the austerity and welfare reform measures on people’s mental health”.
He said: “The findings are reinforced by accounts of clinicians, of people with lived experience of mental health problems and of many disability groups of the adverse effects of the recent welfare benefit changes and the system of assessments for out-of-work and disability benefits.”
He said the research had not come as a surprise to him, as he had listened to mental health charities, and to the difficulties expressed by his own patients.
Boardman said it was now time for DWP to conduct a “rigorous evaluation” of the descriptors and “the process people have to go through”.
He said he believed it was “likely” that the WCA process had led to some suicides, although that would be difficult to prove.
But he said: “What I don’t think you can have any doubts about is that it has been harmful for people.”
Professor Shepherd said he believed the WCA’s introduction had been “highly politically-motivated”.
He said the development of the WCA had been “reckless” because “it wasn’t thought through and then failed to correct itself in the face of increasingly consistent evidence that it was not only ineffective, but also potentially damaging”.
And he said he believed that senior civil servants and ministers “didn’t care” what impact the introduction of the WCA would have.
He said: “The purpose really wasn’t to do an assessment of people with mental health and other problems to see whether they were capable of work or not.
“The purpose was to chase them back into work and save money on the welfare budget.
“You can speculate about what links there were between DWP and Atos that kept this farce going, but the main thing was, ‘Let’s get the scroungers off unemployment benefits and back into work.’”
Professor Shepherd said he regretted not raising concerns strongly enough at the time about the potentially damaging impact of the test on people’s mental health.
He said: “I don’t think that I thought that clearly about it at the time and I regret not doing that.
“I was just so frustrated with them for not listening. I could see that they weren’t going to listen.”
In response to the claims made by the three experts, DWP said the WCA had been subject to five independent reviews, which led to “major changes”, including improvements to the claimant questionnaire, while mental health experts had been introduced to spread best practice and understanding among the healthcare professionals carrying out the assessments.
It said that the healthcare professionals who carry out WCAs were “highly trained to assess people with mental health conditions” and that DWP had “worked closely with medical experts and charities to make significant improvements to the WCA and assessment process”, while the percentage of people with mental health conditions who receive the highest level of support had more than tripled since 2010.
A DWP spokeswoman said in a statement: “It is important we make sure that people are receiving the right support, and they are not simply written off to a life on benefits.
“The work capability assessment has been improved dramatically since 2008 following a number of reviews, including five independent ones.
“Decisions are taken following an independent assessment and after consideration of all the available evidence.
“Guidelines on seeking additional information, particularly in cases where individuals have mental health problems, rightly form an essential part of this process.”
Atos had declined to comment by 9pm this evening (Thursday).