Listening and Learning? Is Chris Grayling capable of that?

It's been a tough old week for the welfare industry and DWP, in particular Chris Grayling who seems a wee bit cross. Cross that he's not getting his own way with naughty documentary makers who refuse to film what he tells them to, despite also being given a significant proportion of the same documentary to put across his own arguments. Naughty BBC not doing what a minister says. To be fair that must have come as quite the shock to the current incumbents at the DWP who've become far too relaxed about briefing the press with misleading statistics, being rapped on the knuckles for it, then doing it again and again and again.

The key moment in Spartacus report was when the DWP took to twitter to try and argue their case. This week has been equally explosive and equally telling as late last night Chris Grayling penned a Comment is Free piece, insisting despite overwhelming evidence to the contrary that Work Capability Assessments can improve lives.

Unlike the DWP I'm not a fan of misinformation so it's time to put some facts straight. The DWP have been naughty enough to rack up a whole series of spankings from Nanny, but they did NOT decide to time yesterday's announcement that Atos had won the lion's share of the new PIP contracts in order to divert from information about the Evidence Based Review of the Work Capability Assessment that was announced by charities and campaigners yesterday morning. The timing of the EBR announcement was decided by myself and Sue Marsh in consultation with the charitable sector. I initially received the information about EBR several weeks ago, but neither Sue or I were comfortable breaking the news until we'd checked as many facts as we could. That took a while...bizarrely for a pair of sick and disabled people who rarely get out of our pyjamas we work at a speed the DWP and charitable sector find challenging to keep up with. Fact checking and getting people's agreement took days, so eventually we settled upon this monday to make the announcement. But, then realising both Panorama and Dispatches were scheduled for that day, we felt the news would be better later in the week. Also originally the PIP contractors were due to be announced earlier this week, that changed, presumably because G4S had been one of the preferred bidders and were so busy failing to 'secure our world' that the DWP had a bit of a wibble and wanted more time. They changed dates, we changed dates and the eventual announcements coincided. So, if we're sticking to conspiracy or cock up themes it was a cock up. Given that between us Sue and I take enough medication to sedate a shiny pink elephant, and often don't know what day it is...we make lots of these kinds of mistakes.

Having cleared that up, lets look at the other biggest rumour - financial targets. Financial targets remain just a rumour; though there may well be bonus clauses in the commercially confidential sections of the contract between DWP and Atos no-one knows if this is the case because no-one is allowed to see those sections of the contract. So, there is absolutely no proof that financial targets exist. There's also no proof that there's anything called targets in the contract, because Atos use a system of statistical norms, based on averages, based on forecasts. Regardless of intention using such a system will create targets and a target based culture, particularly for frontline workers fearing a punitive audit process every time they make a decision about whether someone can be defined as fit for work, fit for some form of future work or in need of unconditional support using the deliberately tight parameters set by the DWP. These are NOT financial targets, they are norms based on averages based on forecasts that have never been called targets but do exactly the same thing in practice.
Atos are an eagerly litigious company; I've written two articles within the last week about these norms that create targets, one on this blog and one for the Independent. Atos follow all the work campaigners do, so we can be confident making the assumption that their legal teams have scrutinised my work in detail, and of course the article for the Independent had to be cleared through their legal team. What does this mean? It means that if there was anything factually incorrect in my theory about targets that are really called norms it would have been picked up by two sets of lawyers and either I would have received a stroppy letter threatening legal action if I didn't correct the record....or has been the case, I would have heard nothing. Which means those two sets of legal teams couldn't find anything that was incorrect so we can safely presume that although there don't appear to be any financial targets there is a target system in operation which does not take account of any of the different disabilities or health conditions of those it assesses.

Where does that leave us? Well, it means that the Minister isn't technically lying when he swears there are no financial targets. But it also means that either he's as stupid as Atos and couldn't work out how statistics work* or he knows full well that these statistical norms lead to an effective target culture but isn't technically lying about it, just being even more flexible with how he presents the facts than my bendy joints are. I very much doubt Nanny would be happy with either, thus earning Grayling another spanking.

But, as is often the case with governments, the real issues are in what they are not saying. Chris Grayling uses his Guardian piece to talk about a woman he met with depression who despite being 'almost hysterical' was grateful for his work programme tough love, a common problem with politicians of all parties who are forever bumping into just one person whose life circumstances can be used to support the argument being made. This latest case doesn't feature a black Royal Navy sailor cited by David Cameron who would have had to have been about 12 when he joined up if Cameron's facts were correct, thus proving that his parents could have saved £30 grand a year on his private education as he can't add up any better than I can. Nor was it Ed Miliband's man on the doorstep who had a bad back but who Ed confidently declared as being able to work if he tried harder, showing that everyone's an amatuer disability analyst when they feel like it and about as good at making accurate judgements as Atos are. These three examples are all about reinforcing negative stereotypes with anecdotal stories people can easily relate to.

Are there people claiming sickness and disability benefits who could work with the right support? Of course there are, I am one of them, despite having significant disability and health problems. Would going on a work programme help me? Of course it wouldn't. As a writer I can probably manage to put together my own CV, search the internet for jobs and put in applications without going to a work provider to sit in their office doing exactly that. Of course, that presumes that anyone would let me in their office as part of the reason I lost my part time public sector admin job almost a decade ago was that I was a considered a health and safety risk. That's somewhat discriminatory, but to be fair to my employers...they had a point. Someone regularly dislocating and collapsing in work tends to be a bit stressful for all concerned, and we'll gloss over the time I had to be carried out of the hospital I worked in by paramedics to another hospital to be treated after having spent an indeterminable amount of time unconscious on the floor alone in an isolated office. But I'm sure now I've added in lots of morphine and some complex and at times life threatening breathing issues that the work programme providers and any employer will welcome me in with open arms as will their insurance providers.

What would help me and many other thousands of highly skilled sick and disabled people is for politicians to look at the situation more constructively. Work programmes are based on the assumption people need to be forced into work, and set to the lowest common denominator. Forcing highly skilled and often seriously disabled or ill people through this process is not just degrading and dehumanising it's also utterly pointless. There is currently no set up for people like me to be able to apply to have that work programme funding transferred to an employer to reduce some of their financial and commercial risks in employing me. I can't access funding to provide better equipment to enable me to work from home, or ask a work provider for a list of employers who'd like to hire a more diverse workforce and are willing to be flexible about how that operates in practice in order to benefit from the vast pool of untapped skill out there.

What would also help is a bit of common sense (yes, I know that is banned in Westminster) and acceptance that the current system is not working. It is demonising and devastating those the public perceive as deserving of support and proving so traumatic to go through that it is likely to move people further from the workplace not closer. There's also the fairly major not enough jobs to go around the not yet,  disabled healthy workforce, but like all good politicians I'm going to gloss over that trivial obstacle.

Over the past two years sick and disabled people have tried desperately to expose the reality of our daily lives to an incredulous public. We've reported wheelchair users, including two gold medal winning paralympians being forced to crawl off trains, young disabled people unable to access workplaces or leisure spaces, not because they were unskilled or unqualified but because they couldn't access the social care and accessible housing they needed to be able to work. I've personally experienced a 4* central London hotel who's idea of access was to put wheelchair users on a pallet lift in the kitchen, been hit on the head by faulty equipment on a train, shut in a tradesman's cupboard and left there when asking for assistance at a major London station...oh and accidentally tipped out of my wheelchair in a spectacular enough fashion to stop central London traffic. And they are just the incidents I can immediately recall before the morning painkillers kick in. And I don't exactly get out alot. Tell me, would you feel confident about accessing the world on a daily basis if incidents like that were common place? No fibs now...Nanny is watching...

The answer is, no you wouldn't. But like me, you might still dream of and hope to work. You might as I do dream that employers would be encouraged to employ disabled people to work from home, using technology to empower our skills and be able to ascertain that work is actually being done. You might carry on hoping that you'll be able to fundraise and save for the vital mobility equipment the NHS can't afford to provide, you might dream of a social care package that actually supported your needs, or long term physiotherapy, counselling or whatever it is that you currently can't access that you know having would make the idea of working seem much more achieveable.

But you'd have to carry on dreaming, because all those things were scarce before the Coalition came to power, and are fast becoming almost mythical. You might dream about politicians who tackle these challenges and barriers head on, who ask sick and disabled people to advise them on how this might be possible. You might hope that politicians would understand forcing people down a pathway to full time work is foolish and preventative when instead they could value contribution and recognise that part time paid or self directed voluntary work is a much more sensible aim.

But you'll just have to carry on dreaming, while the Minister carries on repeating himself. Work is good. Benefits claimants are lazy. Jobs are plentiful. And perhaps, if you had the chance, if you dared to ask these politicians how you are supposed to fit within this rigid failing system you'd see and hear their damning response.

A confused look and the assurance that they really, really don't mean people like you.

But they really do mean people just like me, and although they don't mean it, its people just like me who are absorbing the negative and prejudicial attitudes emerging from politicians through the media. I doubt they mean it to frighten us or to increase the barriers to wider society or the workplace, but that's what happens when you base policy on "I don't mean people like you".

So to the Minister, I am exactly one of those people and like many campaigners I'm full of positive ideas to improve disabled people's career prospects. If that is actually the aim of the government, to Chris Grayling and Iain Duncan Smith I say, pick up the phone, have the grace to do as Ed Miliband did when challenged over the issue, close your mouths and open your ears. You might be awfully surprised and pleased by what you hear...




*which lets face it, given that I start crying if numbers over 100 are introduced means you have to be pretty seriously stupid to not understand this.


Breaking News - Possible New #WCA Descriptors!


As most of you probably know, the big problem with Work Capability Assessments are the descriptors.

However bad Atos might be at customer service, they did not write the 17 descriptors that decide whether or not you will be found eligible for Employment and Support Allowance, the replacement for Incapacity Benefit.

The DWP did.

Atos might have designed a computer programme as a framework for these descriptors, but they didn't write them.

The DWP did.

Atos might be asked to carry out an assessment, but they don't decide if you are fit for work or not.

The DWP do.

What does this mean? Well, it means that the Government wrote criteria that were so tough, so detached from reality, so blatantly designed to ensure that seriously ill or disabled people failed, it didn't matter who did the assessments - Atos or Coco the Clown - the results would be the same. (Some might argue the two examples are the same....)

The descriptors we use today,http://www.tameside.gov.uk/esa/wca mean that those with fluctuating conditions, mental health or learning disabilities find it almost impossible to be accurately assessed. As these are the conditions increasing around the world, a cynic might argue that it was entirely intentional. Please do take a moment to look at the descriptors used currently.

A week or so ago, we were sent a new set of descriptors anonymously that seemed to be significant improvement. We didn't know who had written them or whether there was any realistic chance that they would ever be used.

As you can see from the guest post on out blogs, It turns out that these were the descriptors suggested by the mental health charities, learning disabilites charities and charities representing those with fluctuating conditions.

We felt that it was only fair that you be given the chance to decide for yourselves what you think of the new descriptors. We are told that they may have changed over the last few weeks but that broadly, these are the descriptors that the DWP now say that they will test independently and fairly.

We also felt, once we had seen them, that Mind and other charities had made the correct decision to work with the DWP rather than walking way and leaving the testing to be done by the DWP alone, without any input from sick or disabled people.

We can only hope that these descriptors ARE closer to a model that will be used in the future as any improvement can only mean that millions of people currently undergoing an unfair and distressing process are more fairly treated.

As Mind have pointed out, these new descriptors are far from perfect, but those currently used are unfit for purpose and will never provide a fair and balanced outcome. 

From Sue and Kaliya 


PART 1

1. Mobilising
a. The claimant cannot reliably, repeatedly and safely, within a reasonable amount of time mobilise:
             Over at least 100m [or suitable alternative distances to attract lower points]
             On a variety of terrains, including steps and uneven as well as level ground
             Through a variety of working spaces, including negotiating doors and other entrances and exits
             To and from the workplace, and relevant work-related commitments, with some prior planning and adjustments
             Without significant discomfort, breathlessness or fatigue

b. This is the case:
i. More than 75% of the time

ii. Between 50% and 75% of the time

iii. Between 20% and 50% of the time


2. Standing and sitting
a. Cannot reliably, repeatedly and safely, using any aid that it is reasonable to expect them to use:
i. Move between one seated position and another seated position located next to one another without receiving physical assistance from another person.

ii. Remain at a work station, either:
a. Standing unassisted by another person (even if free to move around) or;
b. Sitting (even in an adjustable chair) for more than 30 minutes without significant discomfort, loss of balance or exhaustion

iii. Remain at a work station; either:
a. Standing unassisted by another person (even if free to move around) or;
b. Sitting (even in an adjustable chair) for more than an hour without significant discomfort, loss of balance or exhaustion.

b. This is the case            
i. More than 75% of the time

ii. Between 50% and 75% of the time

iii. Between 20% and 50% of the time


3. Reaching, picking up and moving
a. Due to difficulties with or restricted movement of upper body (arms, shoulders, back, neck) and/or lower body (hips, knees, ankles), cannot repeatedly, reliably and safely, without significant discomfort or exhaustion, from standing or sitting:
i. Reach up, down (i.e. through bending, kneeling or squatting) and sideways a reasonable distance

ii. Pick up and move a range of differently-sized objects up to 0.5kg

iii. Either reach up, down or sideways a reasonable distance; or reach and pick up and move a range of differently-sized objects up to 0.5kg

b.
i. with either hand

ii. with dominant hand

iii. with both hands


c. This is the case;                           
i. More than 75% of the time

ii. Between 50% and 75% of the time

iii. Between 20% and 50% of the time


4. Manual dexterity/ hand movement
a. Cannot reliably, repeatedly and safely, within a reasonable amount of time and without significant discomfort:
i. Grip and turn a door handle, tap and/or piece of equipment (such as a dial on a radio)

ii. Create a legible message or draw a diagram through the use of a pen or pencil

iii. Use a suitable keyboard or mouse

iv. Turn the pages of a book

v. Pick up and move a £1 coin (so as to put it into a slot in a machine/ box)

vi. Repeatedly press buttons, such as to dial a number on a telephone keypad

vii. Twist a lid or cap so as to open a jar or bottle.

viii. Carry out fine motor/ finger movement, such as to do up a button or tie a knot

b. To the extent that this is, without significant discomfort;
i. Impossible

ii. Very difficult

iii. Difficult

c. This is the case:
i. More than 75% of the time

ii. between 50% and 75% of the time

iii. between 25% and 50% of the time


5. Bladder/ bowel continence
a. Experiences unpredictable or recurrent loss of control leading to voiding of the bladder, extensive evacuation of the bowel or substantial leakage of the contents of a collecting device sufficient to require cleaning and a change of clothing and/or incontinence pads            Or

b. Without immediate access  to a toilet, suitably modified where appropriate, would experience loss of control leading to voiding of the bladder, extensive evacuation of the bowel or substantial leakage of a collecting device sufficient to require cleaning and a change of clothing and/or incontinence pads;

c. Experiences significant discomfort due to the need to evacuate the bladder or bowel or risks losing control if not able quickly to reach a toilet, suitably modified where appropriate

                And

                c. This is the case:
                                i. Most of the time (more than 75%)

                                ii. Some of the time (between 50% and 75%)

                                iii. Occasionally (between 20% and 50%)
PART 2

6. Learning Tasks
a. Is able to learn processes necessary to get a job and undertake tasks within it

b. Can learn tasks relevant to getting a job and to working;
i. with verbal or written instructions

ii. with guided practice

iii. Cannot even learn all necessary tasks

c. No longer requires support to repeat the task after;
i. one day

ii. one week

iii. one month

iv. Three months or more

7. Awareness of Hazards
a. Is fully aware of potential hazards

b. Without help and/or adjustments, risk(s) of injury to self or others, or of damage to property or possessions is likely to be;
i. Moderate

ii. Substantial

iii. Very substantial

c. The risks above are likely to arise;
i. Occasionally

ii. Frequently

iii. More often than not


8. Maintaining Focus
a. Is able to maintain focus without difficulty

b. Due to poor memory or concentration, needs help and/or adjustments in
maintaining focus on;
i. Some tasks

ii. Most tasks

iii. All tasks

c. When working on the tasks concerned for;
i. Most of the day

ii. A few hours

iii. An hour or less

d. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently    

iii. More often than not

9. Executing Tasks
a. Has no difficulty executing even complex tasks

b. Needs additional time to complete;
i. Some tasks

ii. Most tasks

iii. All tasks

c. Such that the task would take;
i. A little longer

ii. Substantially longer

iii. Much longer

d. This is an issue;
i. Occasionally

ii. Frequently

iii. More often than not

10. Managing Self and Schedule
a. Has no difficulties managing him/herself and his/her schedule

b. Because of difficulties in motivation or organisation, or distress, can only manage self and schedule to an acceptable standard with;
i. Some help and/or        adjustments

ii. Substantial help and/or adjustments

iii. Cannot manage at all

c. For;
i. Short periods

ii. Much of the day

iii. All day

d. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently

iii. More often than not

11. Coping with Change
a. Able to cope with minor planned changes to daily routine

b. Can only cope with minor planned changes to daily routine with;
i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Cannot cope at all

or

Can only cope with minor unplanned changes to daily routine with;
i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Cannot cope at all

c. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently

iii. More often than not

12. Getting About
a. Able to get to familiar places

b. Because of distress or disorientation, can only get to familiar places with;
i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Cannot make journeys at all

or

Because of distress or disorientation, can only get to unfamiliar places with;
i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Cannot make journeys at all

c. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently

iii. More often than not

13. Social Engagement
a. Is able to interact with people and engage socially

b. Because of difficulties interacting with others, anxiety, distress or other emotions, can only engage socially with;
i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Cannot engage socially at all

c. Difficulties in interaction and engagement occur with people
i. Unknown to the person

ii. Known to the person

iii. Familiar to the person

d. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently

iii. More often than not

14. Appropriateness of Behaviour
a. Does not display behaviour which work colleagues would consider inappropriate

b. May display physically aggressive, verbally aggressive or socially inappropriate behaviour unless he/she has;
                i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Behaviour not amenable to help or support

c. The nature of this behaviour tends to be;
i. Mild

ii. Moderate

iii. Severe

d. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently

iii. More often than not

15. Communicating with Others
a. Has no difficulties with communication or social understanding

b. In order to communicate and to show social understanding, needs;
i. Some help and/or adjustments

ii. Substantial help and/or adjustments

iii. Communication is not amenable to help or support

c. Needs help and/or adjustments during;
i. Some communication

ii. Most communication

iii. All communication

d. Needs help and/or adjustments for this;
i. Occasionally

ii. Frequently

iii. More often than not

Guest Post From MIND #WCA


Sue and Kaliya have kindly agreed to host this blog on their sites, as I was keen to communicate with as wide an audience as possible about the work Mind is currently involved in around the Work Capability Assessment (WCA). I’m sorry about the length of the blog, but there’s lots of background to cover!

18 months ago, Mind, working with Mencap and the National Autistic Society, submitted a report to Professor Harrington, the independent reviewer of the WCA, about changes we wanted to see to the criteria used in the WCA. Harrington had asked us to produce this report after recognising that the assessment was not working well enough for people these organisations represent.

Translating our concerns with the system into specific proposals was not an easy task. Based on what we had been told by the people we represent, we identified two key aspects of the ‘descriptors’, used to score applicants, that we believed needed changing:
·         We didn’t feel the descriptors really took account of the fluctuation and variability inherent to many of these conditions and we wanted to make sure that our descriptors could collect this information.
·         We wanted assessors to be able to ask applicants directly about the areas covered in the assessment rather than trying to select the appropriate descriptor based on tangential questions.

We made an attempt to address these issues in the proposals we produced, looking at models of fluctuation used in the equivalent Australian assessment. But we recognised that our descriptors were not perfect and didn’t address some of the fundamental issues with the WCA, such as what ‘work’ and ‘fitness for work’ actually mean.

After refining our proposals through consultation with other groups and collaboration with a ‘scrutiny panel’ of health experts convened by Harrington, they were submitted to the DWP. The Department responded that the proposals were too radical and not backed up with sufficient evidence.

Meanwhile, at Harrington’s request, another group of charities (MS Society, National AIDS Trust, Parkinsons UK, Forward ME, Arthritis Care, and Crohn’s and Colitis UK) were submitting proposals for how the descriptors could better address the type of fluctuating conditions they focus on. This report built on our descriptor proposals and made more general recommendations for improving the assessment.

They received a similar response to us from the DWP and the whole endeavour might have been dead in the water at that point, were it not for Harrington arguing that the DWP should carry out some testing on the proposals. This suggestion was accepted in principle but in the ensuing months there was no real activity.

Then, about six weeks ago, the charities involved were invited to the DWP to discuss how the testing would proceed. We were told there was Ministerial commitment to the project, resources allocated to make it happen, and a tight timetable to work to.

This turn of events provoked mixed feelings: it would be the first time that the current descriptors had been properly tested, with the outcomes they suggest compared to the view of an expert panel on whether the applicant was actually fit for work. It would also be a good opportunity to test out some of our ideas for improving the descriptors. But we were wary of the project being driven by the DWP, with Mind’s name attached to it, and the possibility that we wouldn’t be comfortable with how the testing was designed or carried out.

Overall though, we felt it was too good an opportunity to turn down and since then we have been involved in intense and long meetings with the DWP and the other charities involved to try and finalise a common set of proposals that can be tested.

Mind knows this is fairly unique opportunity and we are acutely aware that the circumstances aren’t ideal: our proposals were suggested reforms to problems with the current assessment, not a perfect alternative; we are not experts in producing assessments; we are not in control of the design and timeline of the project; and there are many people not round the table who could make important contributions. However, it is clear that the DWP will go ahead with or without us and so we feel that it is important to try and make the process as rigorous and constructive as possible.

It’s been a hectic few weeks, but we want to make sure we find the time to keep the process as open as possible to disabled people and the disability sector. We’re pushing to relax the timetable to make more time for consultation but we’d welcome any comments or questions that people have at any point in the process.

Tom Pollard – Senior Policy & Campaigns Officer, Mind
This blog represents the views and experience of Mind, not necessarily those of other charities involved in this process

Benefits Targets - Sickness & Disability Are Not The Same

I've written my first blog for the Indy ;

"The shiny pink elephant in the room of policy makers and certain sectors of the disability lobby is the complete exclusion of sick people from this group. Sickness and disability are not the same issue, but for benefits purposes we are all lumped in together and labelled as ‘disabled’ regardless of condition. Whilst it’s important that young people growing up with disabilties be educated, skilled, prepared for a competitive labour market, and taught that they are just as valuable as any other employee, it’s also equally important to recognise the vast difference between those needs and those of someone in their early 50’s, who has worked all their adult life, and now become too ill to work with conditions as diverse as breast cancer, Parkinsons, or Huntington’s Chorea."

Panorama - disabled or faking it? BBC2 8.30pm tonight

Panorama has revealed evidence of disabled or sick people being cleared as fit to work by the Government’s Work Capability Assessment in spite of medical advice given by their own GPs.

Professor Harrington, the man appointed by the Government to review the assessment, told the programme that the success of the test is ‘patchy’ and that as a result, people who are genuinely unable to work will suffer. He says:
“There are certainly areas where it’s still not working and I am sorry there are people going through a system which I think still needs improvement.”

Over two and a half million people in the UK are required to take the test because they are too ill to work. The contract between the Department of Work and Pensions and Atos Healthcare, who conduct the Work Capability Assessments, is worth a billion pounds and runs to 2015. However, more than 176,000 cases go to appeal tribunals each year, costing the taxpayer an additional £50 million. Almost a third of these cases are overturned.

Neil Bateman, a Welfare Rights Advisor says that his success rate for appeals is much higher and that the system is badly flawed:
“I think I’ve won all of the appeals so far. 80-90% with experienced advisers is quite common, which is ridiculous that we’re getting such a fantastic success rate. The way they gather the evidence and the quality of the decision-making is badly wrong.”
Stephen Hill was sent to his first Work Capability Assessment in 2010 when he gave up his job as a sandwich delivery man after being referred for tests on his heart. His wife Denise was with him at the assessment. She says:
“She checked him out. She did his blood pressure and his heart and said to see a doctor as soon as possible.”
Steve did and was immediately referred to a consultant.
However, when the ESA results came in, despite the fact the assessor had recommended he urgently see a doctor, Stephen had been given no points in the assessment, and subsequently found fit for work.  In the meantime, medical consultants had diagnosed him with heart failure.
Steve won his appeal but this was followed up with a demand to return for another assessment.
“He got a letter for another medical and I couldn’t believe it,” says Denise. “He’d got to go for a medical when he was waiting for a heart operation.”
According to Denise, the second assessor was more interested in a problem with Steve’s knee than his heart. Once again he was awarded zero points and the assessor wrote in Steve’s report that “…significant disability due to cardiovascular problems seems unlikely.”
Steve’s family say that the second assessment decision started to affect him in an unexpected way. His son Shane says:
“He started doing more. He started thinking, well I must be ok now, I must be fit for work if they’re telling me I am. On Boxing Day he hoovered the car out and as he was taking it back into the house, that’s when he collapsed and had his heart attack and died.”
Stephen Hill died 39 days after being found fit for work. Shane Hill says: “You believe doctors are right so it doesn’t matter who’s doing the assessments.”
However, Steve Hill may not be a one-off. Between January and August last year, an average of 32 people who the department of work and pensions thought could be helped back to work died every week.

Panorama spoke to an Atos Healthcare professional who carries out the test. They are afraid to be named because of a confidentiality agreement with Atos but told Panorama that the Work Capability Assessment is too rigid.
“There are people who you would like to be able to award ESA [Employment and Support Allowance] to but you can’t. If you are doing it absolutely honestly, they just don’t get the points you know, that’s it, they’re stuffed.”
Atos insiders say that they’re also under pressure to see eight patients a day and with the paperwork around each examination, it could impact on the Work Capability Assessments.  “We’re under pressure to see eight patients a day, even if it’s impossible to do. I’d like to think that the quality of my work is consistent but time pressure doesn’t help.”
In a statement to Panorama, Atos said that their staff “carry out thousands of assessments every month in accordance with detailed guidelines as set by the Department of Work and Pensions… Any serious suggestion that our work has fallen short of the high standards we set ourselves… is investigated as a matter of course.”
However, local GPs like Chris Johnstone believe that they’re left to pick up the pieces when patients fail assessments. He says that the test - far from saving the Government money – is adding to NHS costs in poor areas.
“We are busy at the best of times and we are now having to fit in more people whose appointments are more for their benefits than they are for their health.”
Staff at the Maudsley Hospital in South London feel that they’re picking up the tab for a system that has gone badly wrong.
Andy King has bi-polar disorder and had already been feeling unwell when he was told he would have to be reassessed for ESA.
“That was quite a blow. I thought I might lose a big part of my benefit… and that’s what resulted partially in me being admitted to the Maudsley in mid November.”
Andy had been sectioned under the Mental Health Act and spent time in the hospital catatonic and unable to speak. The decision about his claim was made without him being seen – he was put into the Work Related Activity Group, which means that he was to be supported back into work.
The dedicated welfare team at the hospital appealed the result of the assessment and won.
Shelley Leckey from the Maudsley Welfare Team says they’re now overwhelmed with helping people like Andy appeal wrong decisions.
“We’re having to call upon the resources of the doctors and nurses, and social workers, to put everything together to send off to the Department of Work and Pensions.”
The government says that the system is being improved and assessors are getting new training in working with vulnerable people.
But according to Professor Malcolm Harrington, who recommended that training, there is some way to go.
Panorama: Disabled or Faking It? will be shown
on Monday at 8.30pm on BBC One.
Ends
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