How many hundreds has Atos Healthcare killed so far?
September 20th, 2012
This is far from an isolated case.
After my speech in the House I received several other similar heart-rending accounts by email.
I quote from two:
“I was sent to an Atos fit-for-work assessment medical. I was unwell at the medical and pointed out I have had 7 heart attacks, 2 of which were within the prior 18 months. At the medical the doctor took my blood pressure with a machine and it read 174 over 145. She said That’s high, so took it on the othjer arm, and it read 172 over 142. Then the doctor said: “The machine must be broken, you look fine to me.”
“That is the first time I have known a doctor to see visually that a person’s blood pressure is fine. As I walked out, I asked for my taxi fares, and was told I am not entitled any. As I walked to get a taxi, I got about 50 feet from the medical centre door and had a heart attack…..10 days after the medical I was allowed home (from Hospital), only to find that I was found fit for work in a letter and all my benefits were stopped
“I have been fighting for 18 months now for DWP to accept that my clinical depression rules out my capacity to work for the foreseeable future………How many people who have been mentally ill for 15 years or more have found lasting jobs after being forced onto JSA? The real purpose of this process is to force mentally ill people to live on less money and ‘look for work’. In my opinion every Conservative and Liberal Democrat minister is guilty of murder. I am 52, and have never been so terrified (literally terrified) of what this government will do next”.
(The Record of Adjournment Debate from The Parliamentary Hansard)
Thursday 13th September 2012
House of Commons
Mr Michael Meacher (Oldham West and Royton) (Lab): Speaking in the House of Commons is rather like the apocryphal story of waiting for the 77 bus: you wait a very long time, and then two or three opportunities come along almost immediately.
I sought this debate in order to raise the case of one of my constituents, Colin Traynor, who was epileptic. He was assessed as fit for work, yet died less than four months later. I raise the issue knowing that, tragically, this is far from a unique case, but I believe that there are some particularly disturbing aspects of Colin’s treatment at the hands of Atos Healthcare and the Department for Work and Pensions that deserve official attention and reform.
Here are the facts of Colin’s brief life. He suffered from grand mal epilepsy from the age of 14 months. Although he was prescribed medication, his condition was never controlled. According to the detailed letter written by his parents a few months ago, which I have with me,
“he was unable to do normal things that some of us take for granted such as go out to work, drive a car and even socialising with friends.”
“found it very difficult to communicate verbally with others; it could take him a while to process a question that was put to him”.
“find out whether Colin would be willing to find employment.”
Colin welcomed the interview because it gave him hope that he might actually find an employer who would be willing to take him on, which he very much wanted. However, according to his parents’ letter:
“After doing everything possible to try and find employment for Colin, Remploy informed him that his condition was so severe that he was deemed unemployable. After 9 years of trying to find employment in the hope of living a little bit of normality in his life, Colin eventually came to terms with the fact that he would never be able to work.”
“Colin was confused as to why when 3 years before that he was deemed unemployable”.
“The medical assessment works on a point scoring system. Colin was only given 6 points in total; he would need 18. On 19/12/11 Colin received a letter stating that because Colin had not scored enough points in the medical assessment, he would have his incapacity benefit cut by £70 a week. This caused Colin a lot of stress and anxiety. He was worried about losing his home, not being able to pay his bills and even worried about not being able to afford good food to eat. He was informed that the decision would have to go to an appeal and could take as long as 9 months. He was told there was nothing more they could do, and he would just wait for the outcome of the decision. From the period of December 2011 to April 2012 Colin’s health deteriorated, his seizures increased due to the stress and he also lost a lot of weight. On the 3rd of April 2012 the stress and anxiety that Colin
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was suffering from resulted in Colin having a massive seizure and it took his life. Colin died at home on his own and he was only 29 years of age.”
“the same condition that DWP were expecting him to work with”.
On or around 19 April, a fortnight later, Colin’s mother contacted the DWP again to ask for a decision on Colin’s appeal. She was told that Colin’s file was at the bottom of the pile. On being told that he was dead, the DWP official, very shocked, said that she would find the file and bring it to the adjudicating officer’s attention immediately. The following day, Colin’s mother received a telephone call from the DWP saying that it had overturned the decision in Colin’s favour, and that he should never have been assessed in the first place.
Many people, including me, would conclude on hearing that story that this young man died at least in part owing to the procedural rigidity and heartlessness of a Government Department and its agents. That is certainly the view of Colin’s parents, and I want finally to quote the end of their letter. It ends with just one sentence:
“We as a family”
“hold the Government, David Cameron, Iain Duncan Smith personally responsible for the death of our son… and brother.”
Nothing is going to bring Colin Traynor back to life, but I believe that the Government owe it to his memory, and that of hundreds of others who have lost their lives in similar circumstances, to make fundamental changes to the work capability assessment procedures which are taking such a terrible administrative toll in fear, intimidation, distress and death.
First, the mechanistic nature of computer points-based assessment should be ended. It is reaching obviously wrong conclusions in a vast number of cases. The Conservative hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart), to whom I pay tribute, has established that 29,000 claimants who originally scored zero in the test were later granted the benefit on appeal. In his words:
“it seems that some people are not failing by a couple of points. They are failing completely—then going to a tribunal—then passing completely.”
Secondly, a revised and new system should be able to distinguish at the outset, by means of a much more personal and sensitive interview, those who, by any standard, cannot possibly be fit for work. It is highly significant that in Colin Traynor’s case the DWP finally admitted that he should never have been assessed as being able to work in the first place. The tragedy, which is unforgivable, is that that happened only after he had been dead for a fortnight. That alone ought to compel a fundamental rethink of the procedures, so that this never happens again.
Thirdly, that so many Atos assessments are overturned at tribunal appeals shows that these procedures are deeply flawed. We know the statistics: 40% of people appeal against the decisions, and 38% of those appeals are successful. That means that more than one in seven
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of all the original decisions are reversed on further systematic examination at tribunals. Last year, some 1,100 claimants died under compulsory work-related activity for benefit, and a number of those found fit for work and left without income have committed, or attempted, suicide. I simply say that a record of failure of that magnitude clearly indicates that the system is so faulty that it needs wholesale replacement.
Fourthly, it is unacceptable that those who are deprived of benefit, thus putting their life and well-being at risk, should have to wait six months or more for their appeal to be heard. If Colin Traynor’s appeal had been heard promptly, he would almost certainly be alive today.
The least the Minister should confirm today is that the Atos medical testing contract should be suspended—as the National Audit Office demanded last month—until new and more sensitive and discerning procedures are put in place that end this dreadful catalogue of distress and death, which shames the Government. I hope the Minister will respond positively on each of these heartfelt points.
The Minister of State, Department for Work and Pensions (Mr Mark Hoban): I thank the right hon. Member for Oldham West and Royton (Mr Meacher) for raising these important points on the handling of this case, and I assure him that we are committed to improving the work capability assessment, the incapacity benefit reassessment and the appeals processes.
I would like to start by restating our sincere condolences to Mr Traynor’s family. The right hon. Gentleman will be aware from his previous correspondence with the Secretary of State on this case of our plans to undertake a full internal review. This review has now been completed, and it confirms that we have correctly applied the procedures for incapacity benefit reassessment in this case. The work services director for Jobcentre Plus North West and representatives from the Oldham benefit centre have arranged to meet the right hon. Gentleman and members of Mr Traynor’s family to discuss the case on 28 September. Let me deal with a few points in respect of Mr Traynor’s case before dealing with the broader issues.
Following a WCA, it was decided that Mr Traynor did not have limited capability for work, and he was found fit for work with effect from 4 January. Prior to this decision, Mr Traynor had been contacted by the decision maker to establish whether there was any further evidence that should be taken into account. No further information was provided at that stage, and we wrote to Mr Traynor confirming our decision. Mr Traynor submitted an appeal against the decision on 12 January and continued to receive benefit throughout this period—albeit at a basic rate—while his appeal was considered.
Following the consideration of new information, in the form of evidence from Mr Traynor’s GP and an epilepsy specialist nurse, the original decision was changed by a Department for Work and Pensions decision maker and Mr Traynor was placed in the work-related activity group. The right hon. Gentleman quoted from the letter from Mr Traynor’s parents and solicitor, which I have read, and he suggested Mr Traynor was facing increased stress. That was not communicated to DWP during that period.
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Mr Meacher: Irrespective of whether the distress, of which the parents were aware, was made known to the authorities, the crucial point in this case is: how can a 29-year-old who had been subject to grand mal seizures since he was 14 months old, and for whom Remploy had desperately tried for three years to get a job and could not do so, have been regarded as employable?
Mr Hoban: I do not want to get into the details of Mr Traynor’s case, because there is an opportunity for the right hon. Gentleman and Mr Traynor’s family to go through those with the regional director. I will come on to deal with the process in a bit more detail. Mr Traynor was asked questions during the course of his assessment by an Atos employee, which led to that conclusion. As I said a few moments ago, it was not until Mr Traynor submitted an appeal that he provided us with further evidence. The Department had asked for that evidence earlier and it had not been supplied.
I wish to make a broader point that comes out of this and other cases, which is that it is important that claimants provide information to support their claim at the earliest opportunity, so that we make the right decision first time around. I am sorry to say that we often find that evidence to support an application is provided only at the appeal stage. Not only is it the responsibility of all of us, as Members of Parliament, to help our constituents, but it is the responsibility of groups advising people with complex conditions, be they disability awareness groups or Citizens Advice, to ensure that when they work with people they encourage them to submit the evidence at the outset, so that we get these decisions right first time.
The right hon. Gentleman asked why Mr Traynor was referred for a work capability assessment. The reassessment of claimants entitled to the old-style incapacity benefit is a key part of our reform agenda to create and deliver a 21st-century welfare system by ensuring that those people who can work are given the correct help and support to do so. We do not believe that it is acceptable to write people off to a lifetime on benefits because they have a health condition or impairment. A claimant on incapacity benefit may not have had to speak to anyone in the Department about their health condition or work options for as long as five years. People are left on their own with no support or sense of how and when they may return to work.
The employment and support allowance regime recognises the importance of work and is designed to help claimants move towards employment with the right help and support. We therefore need to ensure that people currently receiving incapacity benefits are supported in preparing for a return to work where some form of employment is a possibility. The reassessment of 1.5 million existing incapacity benefits claimants started nationally in April 2011 and is expected to take three years to complete. Claimants are being reassessed using the work capability assessment process. Claimants who are assessed as having limited capability for work will be moved to ESA and will be placed in either the support group or the work-related activity group. The Department does not aim to reduce the levels of support for the most severely ill or disabled people, so claimants in the support group will be paid a higher rate of benefit. Claimants in the work-related activity group will be expected to undertake activity to support their return to the labour market.
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That process is based on the Government’s fundamental belief that many people with health conditions are able to sustain and progress in employment. Indeed, evidence points to the negative impacts of being without work and suggests that appropriate work is generally good for people, regardless of whether they are disabled or have a health condition. In the context of Mr Traynor’s condition, the respected book “Fitness for Work”, published by the Faculty of Occupational Medicine, clearly sets out that
“most people with epilepsy are capable of normal employment without need for supervision or major restriction”.
That is supported by Epilepsy Action, which states on its website that many people with epilepsy do go out to work, that their epilepsy does not disrupt their work in any way and that nearly all jobs are open to people with epilepsy. I pay tribute to the hard work of organisations such as Epilepsy Action, which work not only to support their members but, crucially, to inform employers and tackle misconceptions about epilepsy.
Of course, no two individuals are the same and it is essential that the work capability assessment is capable of looking at individual circumstances and dealing with the wide variety of health conditions that individuals may have. That is why the work capability assessment was developed in consultation with medical and other experts, alongside representative groups. The working group, and that of a subsequent internal review carried out by the Department, includes an expert in neurological disability and rehabilitation to ensure that it deals effectively with conditions such as epilepsy.
The right hon. Gentleman commented that Colin was confused as to why he had been called back for reassessment. I will set out why we are going through the reassessment process and say a little about the process that happens when someone is called for assessment. Guidance to staff refers to the fact that claimants are not already identified as vulnerable but might become so at any point during their IB reassessment process. Following the letter to the claimant advising them that incapacity benefit is changing and that we will be assessing their entitlement to ESA, we call them to ensure that they understand the process and provide them with the opportunity to ask about anything about the process that might concern them. The ESA50 and the accompanying letter encourage claimants to provide full details about their conditions and offer face-to-face help to complete the form if they feel they need it. Once returned by the claimant, the content of the ESA50 is scrutinised by Atos, which can refer to a claimant’s GP for more information or advise departmental staff about any vulnerability if it believes it is necessary to do so.
The right hon. Gentleman suggested that the points were awarded by a computer, but the medical assessment conducted by an Atos Healthcare professional is a confidential, face-to-face discussion about the claimant’s condition that affords both parties the opportunity to identify and respond to any vulnerability that might prevent the claimant participating effectively in the IB reassessment process. Prior to making a decision about a claimant’s entitlement to ESA, the decision maker calls the claimant to provide them with an opportunity to offer any additional evidence. We recognise the concerns that people called for reassessment might have, which is why we have tried to ensure that there are steps in the
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process to explain to them what is happening, reassure them and give them the opportunity to make their points and express their concerns about the process.
Although we believe that the need for, and the principles of, the work capability assessment are right, the system we inherited from the previous Government contained flaws that undermined its effectiveness. We have therefore moved swiftly to put things right and are committed to improving the work capability assessment continually to ensure that it is as fair, accurate and efficient as possible.
We recognise that many people with a health condition want to work and can do so with the right support. In June 2010 we appointed Professor Malcolm Harrington, a highly respected occupational physician, to undertake independent reviews of the assessment. He has completed two reviews and is currently undertaking the third. His reviews set out a series of recommendations for improving the assessment. We fully endorsed the recommendations and are committed to making the changes as quickly as possible. For example, we have: improved the standards and consistency of decision making through additional training and better use of evidence; improved the way we communicate with claimants by providing personalised statements, summarising key advice clearly and implementing the customer charter; and made changes to the claims process to better support the claimant at each step of the process and ensure that they understand what is required of them.
Professor Harrington has also worked with charities to propose alternatives for the majority of work capability assessment activities, although I understand that, in relation to epilepsy, nothing has been received in relation to consciousness. We are confident that the improvements we are making to the assessment following these reviews will ensure that we increase the number of decisions that are right first time and improve the service provided to claimants.
It is important to state that Atos does not make the decisions on benefit entitlement; decision makers in the Department make the decisions after considering the advice Atos provides and any other appropriate evidence, including information from GPs, consultants and so on. The Department makes millions of such social security benefit decisions each year, the majority of which are not appealed. In fact, between October 2008 and May 2011 the Department made more than 1 million decisions following receipt of a work capability assessment from Atos. Only 9% of those decisions were overturned.
Let me talk about what we are trying to do to improve the appeals process. We want to encourage claimants to provide all the evidence to support their claim at the earliest opportunity. The Department for Work and Pensions now interacts more with claimants at an early stage to ensure that decision makers get more decisions right first time. We are also introducing a mandatory reconsideration process for benefits, so that when a claimant queries a DWP decision, they will be given an explanation by telephone and helped to identify any additional evidence that could change it. Claimants will still be able to appeal after the reconsideration if they wish.
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the additional stage in the process where a decision maker contacts the claimant to seek additional evidence before they make a final decision. The introduction of mandatory reconsideration will build on that. We will continue our programme of reassessing existing incapacity benefit claimants over the coming years.
Mr Meacher: I am grateful to the Minister for giving way. He has largely been talking about process. Clearly, the Government are trying to improve the process. However, the fact that there have been three reviews by Professor Harrington suggests that the process is pretty flawed.
May I return to my original question? Whatever improvement there has been in the process, how can someone subject to grand mal epilepsy seizures virtually from birth have been construed, at any stage in his 29 years of life, as able to work? He wanted to work; he probably came to the original work capability assessment eager to work. But how could he be accepted for working when Remploy and others considered that he was unemployable?
My last point is that Mr Traynor probably would not have died if he had not received the deduction of £70 a week in his incapacity benefit. How would that get someone into work? It simply produces extreme stress and anxiety.
Mr Hoban: Let me deal with those points. The right hon. Gentleman asked why Professor Harrington had done three reviews. The legislation, passed when his party was in government, actually required five independent reviews to be carried out. Professor Harrington is now conducting the third of those reviews. That is why it is happening. The reviews also demonstrate a commitment to learn, develop and listen to the experiences of claimants and the groups that represent them.
I will try not to go through the fine detail of Mr Traynor’s case; I am not sure that Parliament is the right place for that. However, having looked at the assessment form that was completed through a conversation with Mr Traynor, I should say that it was clear that the number of fits that he had during the day were relatively few across the course of the year. That was the information used to determine whether he was capable of working; it was then superseded by the letter from his GP and the epilepsy specialist nurse. Based on the original information supplied, the conclusion appeared to be right. Later information led to the reassessment of the conclusions made at that original assessment. I am sure that the north-west director will go through that in more detail with the right hon. Gentleman and Mr Traynor’s family.
We will continue to learn lessons from employment and support allowance, incapacity benefit reassessment and the work capability assessment. We are applying those lessons to the introduction of the personal independence payment, particularly around appeals and reconsiderations, to encourage claimants to provide all evidence to support their claim at the earliest opportunity. I reiterate that point. It would improve the whole process if we encouraged claimants to provide as much information
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as possible at the start of their application rather than leaving that to the appeal process. That is one of the learning points to come out of the debate this evening.
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