Edinburgh, Thursday 27th March 2014
By Alan Wylie
Arguably the most hated company in Britain, Atos Healthcare is the multinational corporation that carries out the Tory Government’s ‘Work Capability Assessments’ (WCA) on behalf of the Department of Work and Pensions. This computer-based, tick-box ‘functional assessment’ is supposed to determine if a sick and disabled person is ‘fit for work’ or if they meet the criteria for any sickness benefit.
The assessments are so inadequate that, according to the mental health charity Mind, in Oxford 90% of those who have been found ‘fit for work’ have had their decisions overturned when they have appealed with the help of an advocate. This figure is replicated throughout the UK. Even when unrepresented decisions are overturned in 40% of cases.
The DWP’s own statistics reveal that in 2011 alone 10,600 people died within six weeks of being found fit for work by Atos and another 2,200 died before their assessment was complete. 1300 of these were classified as having had limited capability for work and had been placed in the ‘Work Related Activity Group’ (WRAG).
The Government has since refused to publish statistics for 2012/13 having rejected a Freedom of Information request submitted by Mike Sivier of the Vox Political blog on the grounds that is was ‘vexatious‘.
Mr. Sivier has since lodged an appeal with the Information Commissioner with the help of a solicitor specialising in human rights: What we should be clear on is that this Government has a lot to hide.
Atos Healthcare’s reputation now stands in ruins. The company is completely discredited and it’s name now so toxic that earlier this month they rebranded themselves under the new name of “OHAssist”.
This reminds me of a phrase my mother used to say: “You can polish a turd but it will always be a turd.”
The company is now attempting to run away with its tail between its legs, confirming in February that it is seeking to end its contract to assess whether benefits claimants are fit to work, citing unsubstantiated ‘death threats‘ to its staff. They can run, they may rebrand – but their infamy will plague them for as long as our collective memories last in this country.
Perversely, the company was awarded the tender to act as assessors for the new Personal Independence Payment (the replacement of the now abolished Disability Living Allowance) under the OHAssist name and only last week they were directly accused by members of the Commons public accounts committee of lying in their bid to secure the contract.
Already it has been widely reported that terminally ill people are now going for months without the benefit they are entitled to owing to ‘delays’ in getting an assessment and the charity Scope estimates that up to 600,000 disabled people are set to lose their entitlement to disability living allowance, owing to the new, much harsher criteria.
The word “henchmen” is the word which immediately comes to mind when thinking about Atos, If you’ve ever wondered where Osborne’s “savings” are coming from, look no further: Atos cuts – disabled people bleed.
In June 2012 Britain’s Doctors overwhelmingly backed a motion at the BMA’s annual conference submitted by the Scottish-based Black Triangle Campaign through their Medical Advisor Dr Stephen Carty stating that Atos’s assessments were “inadequate” and had “little regard to the nature or complexity of the needs of long-term sick and disabled persons”. The motion went on to demand that the tests be ‘scrapped with immediate effect to be replaced by a rigorous and safe system that does not cause avoidable harm’ to sick and/or disabled people.
The vote was a huge victory for the Black Triangle Campaign’s activists and gave hope to hundreds of thousands of people at the brutal receiving end of this fascist-like disability assessment regime.
Regrettably since then, sick and/or disabled people have felt badly let down by the inaction of the BMA’s leadership who they say have in reality done little to give effect to the wishes of the union’s membership.
Granted, they have tussled with intransigent DWP ministers and officials who clearly have no intention of doing anything that might jeopardise their primary aim of kicking as many people off benefit and into destitution as necessary in order to “pay down the deficit” as sacrificial lambs on the altar of austerity, but nothing more.
Worse still, many Local Medical Committees (LMCs) – local associations of GPs – have appallingly mounted a ‘Just Say No‘ campaign instructing GP surgeries all over the UK to refuse patients further medical evidence in support of their benefit applications and appeals to the Tribunal Service.
The two main reasons given justify their unconscionable stance is that such work is outwith the duties doctors are required to perform as part of their contract with the DWP and that they are swamped with so many requests that they interfere with the core work of doctoring.
One of the functions of the doctors’ regulatory and disciplinary body, the General Medical Council (GMC), is to set the standards of professional and ethical conduct that all practising doctors in the UK must abide by. The chief guidance is contained in a document entitled ‘Good Medical Practice‘ which clearly states that :
‘… a doctor must (overriding duty or principle) take prompt action if he feels that patient safety is or may be seriously compromised by inadequate … policies or systems.’
Consistent with this and the fact that the WCA incontrovertibly compromises patient safety Black Triangle argues that doctors have an overriding duty in these cases to intervene to prevent catastrophic harm to their patients and to do so independently of any government interference or agreement, if required.
They have furthermore pioneered a simple and effective way for doctors to fulfil their duty of care which has been adopted by dozens of practices belonging to the Deprivation Interest Group in Scotland, the Lothian Area Health Board and the Glasgow Local Medical Committee district.
Dr Carty, who practises in Leith on the north side of Edinburgh has helped over thirty of his patients to gain exemption under the “exceptional circumstances” rule ESA regulations 29 and 35. In these cases, he has effectively informed the DWP that in his clinical judgment he believes that were his patient to be found ‘fit for work’ or to have ‘limited capability for work’ (i.e. placed in the WRAG) there would be a ‘substantial risk of harm to the physical or mental health of either the patient or to others around them’. He does this using one side of an A4 sheet of paper justifiying his declaration by stating clearly his clinical reasoning based on his patients’ diagnoses. He has said that in almost every case the DWP have not resisted his evidence and a great deal of suffering and tragedy has thereby been avoided.
The Black Triangle Campaign has one simple demand.
It isn’t the world that they are asking for.
They are not asking GPs to act as gatekeepers to the benefits system.
They stress that the judgment call as to whether or not to invoke these regulations must be left entirely at the professional discretion of the clinical practitioner.
They fully recognise that a GP may not feel qualified in every case to decide upon a person’s suitability for work as they are not trained Occupational Health experts.
Their simple demand is that the BMA issues an advisory to their members informing them of the existence of these regulations and how to apply them in cases where a GP has a grave concern for the safety and well-being of their patient facing the Atos assessment regime in order to prevent avoidable harm from the outset. They argue that in most cases where the regulations are invoked the clinical condition of the patient in question will be so severe that the judgment call will be an absolute ‘no-brainer’.
The method they have pioneered for making it takes up little more time for the doctor than it would to write out a prescription and in the end will result in fewer acute admissions to hospital and generally dealing with the adverse impact on the patient’s health with the fallout that inevitably follows as the knock-on effect of a wrongful decision by DWP-Atos.
On the 10th December last year, after two solid years of lobbying, Black Triangle led a meeting with Dr John Canning of the BMA’s General Practice Committee who travelled up from London and Dr. Dean Marshall of BMA Scotland at BMA House in Edinburgh. Also in attendance was Bill Scott, Manager of Inclusion Scotland and representatives of the PCS Union from London and Glasgow who are desperate to find a moral and ethical solution to prevent the catastrophic consequences of wrongful decisions their members witness every day as administrators of the system.
They say that at that meeting it was agreed that the campaign would submit their materials to the BMA delegation which would then be discussed at BMA Council with a view to issuing a cascading advisory to all 55,000 GPs in the UK.
That was nearly four months ago and Black Triangle now believes that they have been stonewalled and strongly suspect that they have met with stubborn resistance within the ranks of the BMA’s hierarchy in London.
“In advance of the historic Commons debate – the first one in history ever to be secured by disabled people themselves after raising over 104,000 signatures on the War on Welfare Petition (The ‘WoWpetition’) on 27th February, the BMA put out a briefing document that merely recognised what we all know and stated that they look forward to working with the DWP to address the issues giving better feedback to the department at the outset of the process on the ESA113 (the so-called ‘fit note’ – actually the old sick note). This does not adequately address the issue of flagging up substantial risk because the ESA113 is only rarely requested by the DWP and is returned on time in less than 37% of cases.”
An article in GP Online published the day before the WoWpetition debate reports the BMA as warning that ‘GPs are not occupational health specialists and are unable to make the judgments required’ to provide appropriate medical evidence.
The article reported that ‘Although GPs are not under a contractual obligation to provide this evidence directly to patients, these requests (for evidence) place GPs in a difficult position that can potentially compromise the doctor-patient relationship,’ warning that the requests were taking up limited GP appointment time ‘inappropriately’.
“Recently we witnessed the case of Mark Wood, a man with severe and enduring psychiatric illness starve himself to death following a fit for work decision by DWP-Atos in Oxford. We have no doubt in our minds whatsoever that had Mark’s GP been given the necessary information and tools with which to effectively flag up risk in this case by the BMA this appalling tragedy could have been averted. We are now in close contact with Mark’s sister who has joined together with us in campaigning to see to it this this never happens again.”
“We are sincerely grateful to the grassroots support of the BMA’s membership who have supported us from the outset in demanding an immediate end to this cruel and barbaric disability assessment regime with immediate effect.
“However, the members and steering group of the Black Triangle Campaign and allies in our sister organisation Disabled People Against Cuts together with Mark’s sister stand united in protest and condemnation of the unacceptable quiescence on the part of BMA Council in continuing to fail to address this issue robustly.
“We have done all we can as disabled people. We have mobilised and galvanised opinion among grassroots GPs, Consultants, trade unions and campaigners from across civil society.
“It is now time for the BMA to stand up and show true leadership in defence of sick and/or disabled people. In our view the leadership is acting completely out of step with the clearly stated wishes of their membership who support us in bringing down this whole putrid edifice.
“As sure as night follows day, many more tragedies such as that of Mark Wood will continue to occur as a result of this inaction.
“We call upon them now to issue, with immediate effect, a substantial risk advisory to all their members to equip them with the tools to ensure that such barbarity is stopped and that there will be no more deaths such as Mark’s on their watch.
“Not to do so is in our view to be complicit in the deaths of innocent people whose only crime is to have the misfortune to be sick and/or disabled.
“History will not hold them guiltless.”
McArdle finishes by quoting the holocaust scholar, Yehuda Bauer who said:
“I come from a people who gave the Ten Commandments to the world. Time has come to strengthen them by three additional ones, which we ought to adopt and commit ourselves to: thou shall not be a perpetrator; thou shall not be a victim; and thou shall never, but never, be a bystander.”
“The BMA cannot wash its hands and abdicate from their moral responsibilities. It must act now without any further delay.”
Of all the professions, British society places the medical profession upon the commanding heights of moral authority. Standing by and allowing patients’ health to be damaged risks a severe fracturing the public’s high esteem for our Doctors.
They must take action now.
Their position as passive bystanders witnessing this carnage at the hands of an inhumane and outright nasty Government is no longer tenable.
Black Triangle’s demand is not only a simple one and easy to achieve: It is an astoundingly reasonable one.
For the sake of us all, I hope and pray along with Black Triangle that just for this once, power listens to reason in this case and that the BMA leadership’s inaction does not translate to infamy when in future people ask “what did the British medical profession do to put a stop to it?”
Alan Wyllie is the Creator of PoliticsUK, a founding member of the No2BedroomTax Campaign and is an ‘Ambassador’ for the Labour for Independence Campaign
Woman killed herself over benefits cut, says mental health watchdog: Mental Welfare Commission for Scotland finds that woman took her own life after assessor docked benefits by 30% 26 March 2014
The Mental Welfare Commission for Scotland has recently conducted an investigation around the new benefits system.
‘We investigated the case of a woman who tragically took her own life in December 2011. She had recently had a work capability assessment following which the Department for Work and Pensions (DWP) decided her benefits were going to be reduced. She was on incapacity benefit and was told she would not be able to be transferred to Employment and Support Allowance so would receive Jobseekers allowance …’
Mental Welfare Commission for Scotland Investigation Report: ‘Who benefits? The benefits assessment and death of Ms DE‘
We have received a response from the DWP in relation to our recommendations and we have made comments on their response:
Social security: a cap designed to confuse ~ Policy lazily lumps all benefit costs together, irrespective of whether they reflect mismanagement or answer genuine need