The House of Commons Public Accounts Committee just published a report identifying serious shortfalls in the Department of Work and Pensions’ management of its contract with Atos, provider of the widely criticised Work Capability Assessment (WCA).
The Rt Hon Margaret Hodge MP, Chair of the Committee of Public Accounts, today said:
“The Department for Work and Pensions is getting far too many decisions wrong on claimants’ ability to work. This is at considerable cost to the taxpayer and can create misery and hardship to the claimants themselves.
This poor decision-making is damaging public confidence and generating a lot of criticism of the Department’s contractor for medical assessments, Atos Healthcare – but most of the problems lie firmly within the DWP.
The Department’s view that appeals against decisions are an inherent part of the process is unduly complacent. Nearly 40 per cent of appeals are successful, with a third of those successful appeals involving no new evidence.
The Work Capability Assessment process hits the most vulnerable claimants hardest. The one size fits all approach fails to account adequately for mental health conditions or those which are rare or fluctuating. While the Department has started to improve, the process is still too inflexible and too often is so stressful for applicants that their health simply gets worse.
A key problem is that the Department has been unable to create a competitive market for medical assessment providers, leaving Atos in the position of being a near monopoly supplier.
The Department is too often just accepting what Atos tells it. It seems reluctant to challenge the contractor. It has failed to withhold payment for poor performance and rarely checked that it is being correctly charged. The Department also cannot explain how the profits being made by Atos reflect the limited risk that it bears.
There needs to be a substantial shake-up in how the Department manages this contract and in its processes for improving the quality of decision making.”
Margaret Hodge was speaking as the Committee published its 23rd Report of this Session which, on the basis of evidence from Citizens Advice, Disability UK and the Department for Work and Pensions, examined the contract management of medical services.
The Department for Work and Pensions (the Department) relies on medical assessments to help its decision makers reach an appropriate decision on a claimant’s entitlement to a range of benefits. Work Capability Assessments are used to assess new applications for Employment and Support Allowance and to reassess existing recipients of Incapacity Benefit. This is damaging public confidence and generating much criticism of ATOS, but most of the problems lie firmly within the DWP. The Department has outsourced this work since 1998 and in 2011-12 paid its contractor, Atos Healthcare, £112.4 million to carry out 738,000 assessments. From April 2013, a new medical assessment will be introduced for the Personal Independence Payment.
The Work Capability Assessment process is designed to support a fair and objective decision by the Department about whether a claimant is fit for work, but in far too many cases the Department is getting these decisions wrong at considerable cost to both the taxpayer and the claimant. The Department’s decisions were overturned in 38% of appeals, casting doubt on the accuracy of its decision-making.
Poor decision-making causes claimants considerable distress, and the position appears to be getting worse, with Citizens Advice reporting an 83% increase in the number of people asking for support on appeals in the last year alone. The committee found the Department to be unduly complacent about the number of decisions upheld by the tribunal and believe that the Department should ensure that its processes are delivering accurate decision-making and minimising distress to claimants.