Prospect believes criticism by disabled benefits claimants and in the media of healthcare professionals who carry out the controversial tests for the company Atos Healthcare is “grossly unfair”.
Geraldine O’Connell, Prospect’s national secretary, says union colleagues have become “increasingly frustrated” by reports of the “alleged poor standard of medical assessments” carried out by her members who work for Atos.
Atos doctors, nurses and physiotherapists have faced fierce criticism from many disabled people who have been tested using the discredited work capability assessment (WCA).
Campaigners have pointed to success rates that have been as high as 40 per cent – and much higher for those with expert representation – for disabled people appealing against the result of their WCA.
In his first annual review of the assessment for the government, Professor Malcolm Harrington said widespread complaints about Atos staff “must be taken seriously”.
The General Medical Council is investigating complaints about seven Atos doctors.
But in a letter written to Harrington as evidence for his second review, O’Connell blames appeal tribunals for overturning “carefully considered” reports prepared by Atos staff.
She claims the tribunals are failing to “follow the same stringent criteria” as Atos staff, and that all Atos healthcare professionals “take considerable pride” in their work and are “very sensitive to the needs of all claimants”.
She adds: “All staff receive training in good customer service and communication skills and are caring individuals who do not wish the claimant to have a bad experience.”
O’Connell says in her letter that Atos staff have to apply the government’s own WCA guidelines “regardless of their personal opinions” but are facing regular complaints and “vilification” in the press.
She says their jobs have been made “almost impossible”, while Atos is facing “huge” problems in retaining assessors, mainly because of the extra time pressures imposed by improvements to the WCA recommended by Harrington.
But a spokesman for Black Triangle, which campaigns against the unfair use of the WCA, described the union’s claims as “nonsense”.
He said that “most genuine healthcare professionals” would refuse to carry out the “profoundly flawed” assessments, whereas tribunals “take the time to carefully consider all the reports and written evidence and closely question the appellant before rigorously considering all the evidence presented, before coming to their conclusion”.
He added: “Prospect should be fighting against this, not coming out with excuses for their members, or at the very least advising them to demand that all WCAs are recorded, then the professionalism of their members could not be questioned as the evidence would be there on record.”
Disabled activist Mo Stewart, who has carried out extensive research into Atos Healthcare, said: “I would recommend that whoever wrote the Prospect letter should access the comments by former Atos staff whose comments cannot be misinterpreted and expose that the only priority when working for Atos is to get through as many cases as possible so Atos can reach their daily targets.
“Atos, like all corporate giants, are about profits and not people and their staff clearly know that when they agree to be employed by them.”
O’Connell told Disability News Service she did not accept that her members had been “insensitive to the needs of ESA claimants, nor that their reports have been inaccurate, their behaviour or attitude poor, or that they have shown poor knowledge and understanding of the relevant impairments and disability”.
She insisted that “any complaint made by any claimant is fully investigated by independent complaints officers from within Atos Healthcare”.
The original letter to Prof Harrington from Prospect –
Professor Harrington, Work Capability Assessment WCA Independent Review Team Floor2, Section B Caxton House Tothill Street London SW1H 9NA
17 October 2011
Dear Professor Harrington,
Prospect union represents members employed by Atos Healthcare in support of the Department for Work and Pensions contract, covering disability analysis. We did submit evidence to the consultation exercise undertaken last year into the Work Capability Assessments and it had not been our intention to submit further evidence under the ‘2nd call for evidence’ which closed on 16 September. However, there is one issue that we would like to raise, even though we recognise that the deadline for comments has now passed, but we would like to bring this to your attention. Prospect has become increasingly frustrated by the representation in the Press regarding the alleged poor standard of medical assessments covering WCA as supported by the high number of assessments that overturned at the Appeals Board. Appeal Board members are not Decision Makers. Equally, no Appeal Board member, with perhaps the odd exception of the medic on the Appeals Board, will have conducted an ESA Assessment. No Health Care Professional or Appeals Board member has any direct control over the decisions made affecting benefit; that is an issue for DWP alone.
Prospect welcomed your observations last year, that the WCA was too reliant upon on a ‘tick box’ system and was far too impersonal in the assessment of the individual’s capability. This was particularly the case at times, in both the understanding and the subtlety of some mental health issues. As you aware, Atos Healthcare has embraced your recommendations by introducing the Personalised Summary Statements and also by appointing Mental Function Champions throughout the country to give advice on difficult Mental Health Cases. All of these initiatives have been welcomed by Prospect and we believe that these revisions have resulted in a direct improvement to the quality of the reports produced by HCPs.
All Health Care professionals, whether they are Doctors, Nurses or Physiotherapists, take considerable pride in the work that they are do and they are very sensitive to the needs of all claimants in what, at times, can be very difficult circumstances. All staff receive training in good customer service and communication skills and are caring individuals who do not wish the claimant to have a bad experience. Understandably with more than 700 HCPs undertaking a variety of assessments at any one time, it is perhaps inevitable, that some claimants feel that they have not been treated in the consistently high standard that we would all expect.
However, it is important to emphasise that the criteria for the WCA assessment has also been revised. In effect it is now a little easier to meet the threshold for those with mental health conditions but much harder for those with physical disability. It remains the task of the HCP to apply these criteria regardless of their personal opinions on the matter.
The main problem reported from our members is that the medical standard time involved in preparing a Personalised Summary Statement has increased significantly, which means that the number of claimants that HCPs can assess during the working day has gone down from an average of 9 per day to 7 per day. Ideally, Atos Healthcare would like HCPs to see an average of 8 per day but this is unrealistic given the amount of ‘free text’ required. Producing a good quality report with a Personalised Summary Statement takes at least an hour in most cases, more time than then HCPs are allowed. This has resulted in a drop in morale and is very stressful for the Healthcare Practitioners who work on the DWP contract for Atos Healthcare. It is made much more unpleasant by regular vilification of their role in the press and on certain websites, not to mention the receipt of complaints when claimants do not qualify for benefit or are disqualified for benefit.
The great majority of Atos practitioners wish to do a good job under very difficult circumstances, but this has become almost impossible. The attrition rate of new entrants is huge which gives Atos Healthcare a continuous problem, not in recruiting or training staff but in retaining new staff.
However, the main cause of dissatisfaction is that HCPs regularly see that their carefully considered reports being overturned at Tribunal. Sometimes this may be due to extra evidence presented, but this is a minority of cases. HCPs are doing a functional assessment as trained Disability Analysts. HCPs perceive the main problem being that the Appeals Board does not follow the same stringent criteria that they do, as laid down by the Government. HCPs have to apply rigorous thinking according to these criteria and the Tribunals do not, hence there are a number of occasions where appeals have been upheld for no relevant medical/disability issue.
It is grossly unfair to question their professionalism merely because their reports are overturned at Tribunal. Successive Governments (regardless of political persuasion) have all been in broad support of a new look at benefit entitlement. The purpose of this letter is not to question Government policy in this respect, only to point that HCPs adhere to the criteria laid down in defining the levels of disability.
Prospect believes that it is now important to focus on the reasons why so many assessments are being overturned at Tribunal and if there is a genuine conflict then this needs to be addressed. However, it is important that the assessment criteria laid down by Government is consistently applied both by HCPs working for Atos Healthcare and the Decision Makers and Appeals Tribunals working for DWP. Only then will claimants receive a truly fair assessment.