Scotsman interview with Black Triangle – ‘Just not working: Why government fit-to-work tests are failing’

 

Saturday 23rd January 2012

Tests introduced by the government two years ago in a bid to cut benefit fraud are not fit for purpose,say organisers of a campaign, based in Edinburgh, formed to fight them. Here, Jane Bradley talks to the campaign leaders, including a Leith GP who has many cases where he believes the assessments got it badly wrong

IT was a badge used by the SS guards to mark prisoners as “asocial” or “workshy” in Nazi concentration camps. Now the “black triangle” symbol has been adopted by a group of campaigners fighting the so-called “fit-to-work” assessments implemented by the Department of Work and Pensions (DWP) in a bid to stamp out benefit fraud.

Set up by John McArdle and a group of like-minded Edinburgh campaigners 18 months ago, the Black Triangle Campaign was launched in memory of Edinburgh writer Paul Reekie, who took his own life – allegedly after having his benefits cut during a bout of serious depression. Reekie did not leave a suicide note, but he laid out two letters on his table, found after his death. One was notifying him that his housing benefit had been stopped. The other was informing him that his incapacity benefit had been stopped.

McArdle – who himself was forced to fight an appeal that he won to continue to retain his own benefits after a severe period of clinical depression – heard about the circumstances surrounding Reekie’s death and decided to take action. “Paul Reekie was an acquaintance, but when I heard about what had happened to him, I decided to do something about it,” says McArdle. “I set up the Black Triangle campaign. It began as a Facebook page, but it just snowballed from there. The frustration is that the issues haven’t really got any better.

“Disabled people are incredibly vulnerable and it is devastating when someone has their benefits cut, but it is incredibly difficult to change.” Under the official title, the Work Capability Assessment (WCA), the test was introduced by the DWP two years ago to assess whether people should be entitled to employment and support allowance.

It has since been the subject of much debate from both sides of the argument: some believe it is a much-needed crackdown on benefit cheats; others say the system used by the private company, Atos, which carries out the interviews, is not fit for purpose.

Also leading the campaign is Leith GP Dr Stephen Carty, who broke ranks with his profession to stand up for his patients when he discovered many were being told they were fit for work after passing a number of tests that did not involve consulting medical experts.

“I have grave concerns about the harm that is being done to patients who are being put through this Work Capability Assessment processes,” he says. “It is essentially a computer system used by Atos to assess patients. What is happening is that people are being seen by individuals with very little occupational health training – and they don’t request any meaningful information from a GP who has been treating the patient.”

He added: “I think there are a variety of reasons why there has been silence from the medical perspective on this issue. One is that if changes are brought in, they would have to act as gatekeepers for patients. We have been staggered by the harm and the lack of regard to safety that has been applied here through these assessments.”

Carty’s list of people deemed fit to work, whom he insists are not capable of normal employment, is almost endless. Right he lists four case studies, including one man who had his benefits axed after being told he had to go out to work shortly after being sectioned in a mental hospital.

The campaigners are now focusing on lobbying the government and organising demonstrations – the next is due to take place at Westminster later this month over the proposed Welfare Reform Bill, which would see a shake- up of how disability benefits are paid – and is trying to build a database of legal experts willing to donate their time to people trying to fight their corner.

A spokeswoman for Atos said the results of all Work Capability Assessment interviews are passed onto the DWP for a decision. The DWP says its system works. Reforms to the system, brought in after an independent review carried out by Professor Malcolm Harrington, were welcomed by the government when the review was published in November.

“It is in everyone’s interest to get the WCA right, which is why has been greatly improved over the last two years,” said a DWP spokeswoman. “The system is far better than it was but we will continue to keep it under review and refine it further.

“We are committed to helping thousands of people move from benefits and back into work. Those found too sick or disabled to work won’t be expected to and will continue to receive the help and support they need.”

Case 1.

Mr O is a 57 yr old man who has limited intellect with an IQ between 50 and 70. He spent many years of adulthood in Gogarburn hospital but now lives independently with carer support. He is unable to read or write. He has a number of other health problems including severe arthritis which has required recent surgery.

He was assessed on the basis of “infomation that your patient gave us”.

The DWP did not request any information from the GP and the ATOS assessor found him capable of work based on the LIMA assessment.

In one stroke his entitlement to benefits, including housing benefit, were stopped.

This decision caused him a lot of avoidable distress which he is intellectually ill equipped to cope with. Thankfully his benefits were re-instated ten months later after a successful tribunal.

The LIMA assessment completely ingnored his complex needs and failed to gather any information from the GP.

A completely avoidable situation.

Case 2

Mr B is a 37 year old man who was claiming ESA.He attended an ATOS assessment and on the basis of physical discriminators (e.g. the ability to pick a pen up of the ground or move a pint of milk across the
table) was deemed fit for work. 

It was 15 months since any medical information had been sought about this man. In the intervening period he had been detained on a locked ward under the Mental Health Act with a new diagnosis of schizophrenia.

In addition to this he had complex drug problems which have since required long term residential rehabilitation. 

When he attended the ATOS assessment he was still seeing a psychiatric nurse frequently and was heavily medicated while still experiencing auditory and visual hallucinations. He was also firmly of the opinion that he had special powers – He believed he was the Son of God.

The ATOS assessor considered him to be fit for work. All his benefits were stopped immediately. 

This sudden stressor brought about a significant worsening of his mental health.

If the assessor had any competence whatsoever as a medical health professional they ought to have identified how ill this man was and made every effort to request further information from the GP or
psychiatrist.

It is well known that ATOS staff are actively discouraged from requesting further information and indeed I have never as a GP been asked for further information other that from a patient who is appealing an adverse decision.

This was a very ill and vulnerable man with complex problems and I hold that the process he was put through and the adverse decision reached was potentially harmful and avoidable.

I spoke to the benefit centre on the 22nd July 2011 to express my concern and wrote to them on the 19th August 2011. I never received a reply.

Case 3

Miss G is a 29 year old woman with severe and treatment resistant depression and suicidal ideation. She also suffers severe anxiety and is unable most days to go out with out company of a friend or family
member. She has required continuous support from a Consultant  Psychiatrist and CPN (Community Psychiatric Nurse).

She attended an ESA assessment and was found fit for work.

No information was requested at all from her GP.

She was awarded zero points based on physical discriminators and there was no assessment whatsoever of her mental health problems.

The adverse decision meant that her ESA, housing benfit and council tax benefits were all stopped immediately. This adverse decision seemed to cause a rapid deterioration in her condition requiring urgent involvement of a Psychiatrist.

Although I wrote to the Benefits centre in October to express my concern I have yet to receive a reply.

Stopping the only means of financial support of a vulnerable adult with a severe mental health problems with no risk assessment of the possible consequences is potentially harmful.

Case 4

Mr L is an eldery man with severe peripheral vascular disease. 

He walks slowly with 2 sticks and has to stop after 20 yards due to severe pain in his calves which is the result of very poor circulation. 

He is considered to be in too poor health to be operated on so there is no prospect of any improvement.

He also has a severe degenerative problem in his lower spine proven on MRI scan which again cannot be operated on. 

He cannot sit for more than a few minutes without having to move due to severe pain. This is despite him being on strong pain killers around the clock.

He was assessed by ATOS and deemed to be “fit for work.” 

In their paperwork the assessor stated that he could walk 200 yards without difficulty. This is not true. The information his GP provided was completely overlooked. 

He will appeal and I have no doubt his appeal will be upheld. 

The success rate at appeal is between 40% and in some cases 70%. 

Why do ATOS and the DWP get it wrong so often?

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