Politics, Policy and Persecution - The People's Review of the WCA - Further Evidence

12/09/2013 09:56:00 am BenefitScroungingScum 1 Comments

It is clear that the Work Capability Assessment (WCA) has been a source of great misery and distress to many sick and disabled people, but there has never been an entirely satisfactory explanation for why this is happening. The finger of blame has been pointed at the outsourcing contractor Atos Healthcare, the influence of the insurance industry on the development of the test, the frontline assessors, the claimants - if you can think of it, at some point someone's blamed it.

Whilst the existence of targets are vehemently denied by politician's, civil servants, the DWP and Atos, the misuse of statistical norms as outlined in my latest report 'Investigating the real reason for the misery of fit for work assessments', published by the Centre for Welfare Reform, means there is a de facto target system in place which limits the overall proportion of successful claims.

Statistical norms are somewhat dry and dull, especially to someone like me who runs out of numbers when they run out of fingers and toes, but I have spent the best part of the last three years obsessed by this misuse of norms, researching and investigating how such a system could operate and why it would be denied by politicians of all parties.

Over that time period I have asked everyone I've met about norms - politicians, private sector employess, Atos assessors, GP's, everyone. I'd ask people I bumped into in corridors at conferences, I'd randomly phone up people I thought might hold other pieces of the puzzle and ask them to talk to me. The more I asked and the more I understood, it became clear that those denying the existence of targets often didn't understand what norms were, didn't know they existed or just didn't understand. There was one consistency though - everytime I explained how I thought the norms were being abused to cap the overall number of claims - the colour would drain from the face of the listener, they'd become very quiet, and some would mumble things like 'oh shit'. Once explained, it was obvious to them how statistical norms were being abused to drive the overall proportion of successful claims.

On paper, this seems quite a simple process, with only one consistent figure involved in the process throughout it's five years - Lord Freud. So determined was he to remove two thirds of incapacity benefit claimants, Lord Freud only needed three weeks to write his report recommending just that. In that time the government has changed, all three political parties have had a taste of power, and the misery caused by the WCA has continued. But only Lord Freud has remained consistent - civil servants have changed, staff at Atos have changed, yet Freud continues, so determined to push through his scheme, and complete the transfer of the human beings he refers to as 'stock', that he even changed political party.

The misuse of statistical norms is dry, technical stuff. It's vital to understand because it acts as the driver of the whole system, the cause of all that human pain and misery. Today, a new report is released by an anonymous author, too sick and too scared of the consequences to be identified. Despite all that, this author has also dedicated years to understanding the misery of the WCA - for them the focus was on the human stories of suffering.

The People's Review of the WCA - Further Evidence gives the people who have suffered as a result of Freud's scheme to cap the overall number of claims the opportunity to speak in their own voices of the damage such a blunt system has done to them and their families.

There are many people I need to thank for their assistance whilst I was researching 'norms', and many of those people cannot be named due to the vulnerable position they put themselves into by whistleblowing. So, this is a mass thank you - to everyone who had to endure my 'norms' related questioning and also to the anonymous author of The People's Review who has been determined to give the voiceless a voice.

The evidence is clear - 'norms' are misused to drive the system to the desired result, ie limiting the overall number of claims. The impact is also clear, the media regularly feature accounts of terrible WCA decisions, and politicians scrabble to justify the worst cases as 'mistakes'.

And there is the true horror of the WCA - none of this was a mistake. All the pain, fear and stress experienced by people like Karen Sherlock, and the many, many examples in The People's Review are written off by polticians as 'mistakes'. But this is no mistake, the contractual terms for the operation of the WCA are clear - all solutions MUST be based around an imposed 'norm' for the Support Group of just 11%, rejecting claims for Employment and Support Allowance was exactly what Freud intended to happen.

All that pain, all that fear, all that waste - not mistakes at all, but the exact result desired by Freud and achieved by the artificial imposition of 'norms'.

Leaked Evidence Shows DWP Set Quotas For 'Fit For Work' Assessments

12/03/2013 02:59:00 pm BenefitScroungingScum 7 Comments

Why are so many sick and disabled people being failed by the Work Capability Assessment and who is to blame?

1. The contract between DWP and Atos Healthcare specifies all costs and solutions MUST be based around an artificially imposed ‘statistical norm’ for the Support Group of 11% (which has since been allowed to rise slightly). This ‘gears’ the whole WCA system to deliver that ‘desired result’.
2. The manner in which the audit system is used within Atos Healthcare, including whistle-blower evidence of ‘punitive auditing’, means there is insufficient latitude for assessors to freely use their professional judgement about an individual’s true fitness for work.

The Work Capability Assessment (WCA), used to determine eligibility for Employment and Support Allowance (ESA), which replaces Incapacity Benefit, has been dogged with problems since its inception. Department for Work and Pensions (DWP) ministers and Atos have always denied the existence of ‘targets’ for the WCA. Now, for the first time, evidence is presented that the WCA operates to a norm-referenced system. This is a de facto target system, since when ‘statistical norms’ are applied to a process such as the WCA they deliver the same outcome as targets. As Lord Boswell predicted in 2007, this use of statistical norms means "the test will, in effect, be geared to deliver that [desired] result”. Being able to consistently deny the existence of any targets has been crucial both for the Labour government who introduced the WCA, and the Conservative/Liberal Democrat Coalition government who have continued with its use despite evidence of significant faults in the process.

The media regularly feature stories of people even the Daily Mail would consider deserving of ESA who have been refused the benefit – people with sickness or disabilities as diverse as Huntington’s Disease, uncontrolled epilepsy, kidney failure or brittle bone disease - but until now there has been no completely satisfactory explanation for this misery and hardship.

Ministers, MPs, the DWP and campaigners point the finger at Atos, the company contracted to carry out these tests on behalf of the DWP. The DWP say Atos are at fault and that they will improve the system by breaking their monopoly and allowing other companies to bid for the contract.  Labour have also announced that they will “sack Atos”. DWP ministers blame the civil servants and the civil servants seethe. It is a classic case of political, “it wasn’t me Miss, it was them”.

To explain what all this really means education analogies are helpful. Exams can be either ‘norm-referenced’, ‘criterion-referenced’ or a mix of both. A criterion-referenced exam system means students receive an objective grade based on their performance against a pre-defined marking scheme. A norm-referenced exam system sets ‘quotas’ which limit the overall proportion of students able to achieve each grade.

Originally ‘A’ levels were simply pass or fail, but in 1963 guidance was issued which limited the overall proportion of students allowed to receive each grade. This was a norm-referenced system which ensured that only a small proportion of students could achieve ‘A’ grades. This was widely perceived as unfair to students and during the 1980’s ‘A’ level marking systems were changed to remove quotas.

The audit system as controlled by the DWP can be seen as a teacher, and Atos the poorly performing pupil. The teacher punishes the pupil, focusing on reprimanding him when he smudges his ink (deviates from the ‘norms’ imposed in the contract) whilst ignoring the content of his answers or his behaviour. The teacher blames the pupil for not learning and the pupil blames the teacher for everything. Before anyone should feel too sorry for the pupil, it’s important to note, this pupil is more Harry Flashman than Harry Potter; the real victims are those affected by their combined bad behaviour.

The test for the old Incapacity Benefit - the Personal Capability Assessment - was a criterion-based system. People were awarded points based upon how they scored against certain criteria – for example, those who could walk less than 50 metres were awarded more points than those who could walk less than 200 metres. If the person scored the number of points, across all the criteria, necessary for benefit receipt, they would be entitled to the benefit.

However, the WCA is a norm-referenced system. People must both score the number of points required for benefit receipt and fall within the proportion of people the norms system will allow to receive the benefit. In practice this means there is a finite number of claimants the assessment system will allow to be awarded the benefit, regardless of the number of people who objectively meet the criteria for benefit eligibility.

New evidence gleaned from the original contract between Atos and DWP, testimony from Atos employees and Freedom of Information requests, clearly indicates that the outcomes for individual sick and disabled ESA claimants are not driven solely by the severity of their condition or the nature of their disability. On the contrary, as Lord Boswell warned in 2007, the imposition of statistical norms onto the WCA gears the outcome of the whole system to achieve the desired result: in effect a cap on the overall number of people the system will permit to be granted eligibility for ESA.

Evidence shows that Atos uses a ‘management information tool’,  based on the ‘statistical norms’, to ‘manage’  the behaviour of individual assessors. Although officially the audit of assessments is not supposed to be punitive, it’s clear from whistle-blowers that in many regions there are negative consequences for assessors if they do not restrict the number of points they award to claimants to comply with the norms. This makes it difficult, for example, for them to award a high point score to every claimant who, in their clinical judgement, has a serious condition affecting their ability to work.
 
There is therefore a serious risk that the overall outcome for the claimant  – whether they are placed in the Support Group and given unconditional support because they are unable to work, placed in the Work Related Activity Group on the basis that they are likely to be able to return to work in the future, or denied ESA altogether and expected to actively seek employment – may be driven as much by the severity of other claimants’ conditions as their own, particularly those claimants assessed on the same day by the same assessor!

So is removing Atos actually a solution to the problems with the WCA? The answer is no. As long as the WCA remains a norm-referenced system of assessment, removing Atos is the political equivalent of fiddling while Rome burns.

It is clear, and in the light of this evidence totally unsurprising, that this iniquitous system is causing immense distress, hardship and increased ill-health for the very people who most need support, whilst at the same time costing the taxpayer many millions of pounds in unnecessary assessments and appeals.

This evidence and analysis must be understood by politicians of all parties, since only a cross party solution can fix this cruel, wasteful, immoral system and prevent more unnecessary suffering. If sick and disabled people are to receive the support they need - and which a civilised, compassionate Western society is expected to provide - this new report, published by The Centre for Welfare Reform, "Investigating the real reason for the misery of 'fit for work' assessments", is essential reading for both Parliamentarians and the public alike.