From Sue Marsh, Stef Benstead and Sam Barnett-Cormack
So, yesterday, as most of you will know by now, representatives from Spartacus finally got to meet with Mark Hoban to discuss Employment and Support Allowance and Work Capability Assessments after almost a year of trying.
Other online groups representing sick and disabled people had felt very strongly before the meeting that it should be made explicitly clear that WCAs should be scrapped. They are unfit for purpose and no amount of tinkering with descriptors or processes will change that.
We agreed, but felt that for that approach to be credible, there had to be alternative suggestions in place. Happily, in just 24 hours, all of the online groups representing sick and disabled people were able to agree to this solution in time, meaning that we could go into the meeting with the whole weight of the online campaigning community behind us.
We agreed that we would raise the issues people had agreed in extensive consultations on my blog to be the most important and “listen” to what the minister said on these issues, suggesting things that could at least make the process safer in the meantime until we were able to put together an alternative proposal.
With this in mind, here is a summary of the issues we raised and Mr Hoban’s responses. We feel that the meeting was remarkably productive in this sense.
“Before any further discussions took place, Sam explained that there was widespread support for abolishing WCAs. The system causes stress, fear and anxiety, it is not trusted and we doubt that any amount of “reform” would now be able to change that.
Sue opened the meeting by saying that we hoped we could break down the oppositional, partisan and confrontational stance that has often blighted discussions over ESA. She asked for genuine engagement. She pointed out that we had only ever tried to present helpful, evidence based research, aimed at showing how WCAs affect real people. She suggested that we all had experts and networks that could be valuable in re-designing a new system.
Mr Hoban appeared to listen carefully. He and three civil servants all took notes during the meeting. They did seem to genuinely want to discuss issues openly with us. We’re delighted to say that the meeting had none of the frustrating stonewalling or fudging of some parliamentary debates.
45 minutes passed in the blink of an eye and sadly, though we did ask the questions, there was no time to pin down answers on where things stand on mental health assessments/champions and the decision to divide physical and cognitive conditions when it comes to scoring points during an assessment. However, the Chief Medical Officer gave us his card at the end of the meeting and we agreed to chase up or define any issues that we weren’t clear on, so this will be an opportunity to clarify.
Mr Hoban appeared to particularly agree on gathering medical evidence earlier in ALL claims. Civil servants confirmed that an ESA113 was only sent to GPs in limited circumstances. Mr Hoban agreed that medical evidence was crucial at the earliest stage andaccepted that sending an ESA113 in ALL cases as soon as the claim is received might be a solution. They accepted that GPs don’t always return this evidence and agreed to do more to make sure that they do.
Sue suggested that explaining and suggesting the use of “Reliably Repeatedly and Safely” on the ESA50 form more often would be very helpful and Mr Hoban appeared to agree that this would be a helpful change. He particularly agreed that there is a need for more guidance to help people complete their forms in a way that would ensure they give the information needed to make decisions. He told a story of one of his own constituents who had filled in the form particularly badly. He said he thought he could have done a better job himself after just 5 minutes with the constituent and that it was clear much more guidance could be included to help with the process. They committed to looking again at what could be done with some urgency.
We asked about universal audio recording of assessments and urged that this was the only way to truly know that assessments had been conducted fairly and accurately. Mr Hoban was not entirely convinced that this was the case and cited examples of HMRC losing audio files, which had created even more suspicion. He didn’t rule it out however, and did say that letters would be amended to say that the option was available to all claimants.
We asked about the Evidence Based Review (EBR) and trials of new descriptors for Mental Health and Fluctuating conditions. It was clear from the civil servants that this was taking longer than they had originally envisioned. It had proved harder than anticipated to develop robust descriptors that claimants could
be compared against and which could be tested; some of the original submissions had been too vague to be of practical use. They did agree that so far it is clear that lessons can be learned from this alternative assessment. Sue asked what would happen if the new descriptors were more generous to claimants and would cost more to implement. Would they say it was just too expensive or would the Treasury veto any changes? Mr Hoban confirmed that they would do what was right. There was no financial limit on how generous a new set of descriptors might be and these will be based on evidence not cost. He cited examples of more people going into the Support Group and how that had cost over a billion pounds extra in the first year, but that it had been accepted financially.
Mr Hoban was particularly concerned by how long it was taking to assess people. He said that he was concerned about what is right even when improvements are difficult to implement and is keen to learn what works and doesn’t work so that the process can be improved. He wants to see a test that is robust, is the right test and has credibility. If changes are identified that would improve the system, then the DWP accepts that. He said that the EBR is a good example of that, as it has proved harder to run than originally anticipated but the DWP will use the evidence from the EBR to improve ESA. There are no financial limits from the Treasury, and no consideration of cost will be used to decide which descriptors are the best to use.
Sue mentioned concern about targets. Mr Hoban said DWP set no targets. He said they are only concerned about quality. If an assessor was an outlier (ie putting more claimants into the Support Group or WRAG than colleagues) then it is not that the assessor is an “outlier” that matters but that a need to check his or her assessments are right was all that mattered; if the assessments were correct then it doesn’t matter that the assessor was an outlier. Mr Hoban was very clear that targets are the wrong thing, and that they have no place in a credible system. We suggested that Atos are using “norms” either way, even if not part of DWP guidance and it might be worth re-iterating with Atos that this shouldn’t be the case.
Sam mentioned concern that assessors are saying they are told to presume zero points and award points grudgingly. We want to see an inquisitorial approach, not adversarial. Sue said that the balance of comments from claimants is that the HCPs are trying to trip people up. but maybe all that is needed is to remind Atos that their role is not to be denying people points or benefits.
Mr Hoban agreed with this and said that this is what DWP guidance to HCPs recommends; the HCPs are to gather the evidence as it is. Sue pointed out that whilst this is indeed the written DWP guidance, anecdotal evidence from HCPs suggests that this is not the case during in-house training. Again, taking this issue up with Atos may be helpful. Mr Hoban appeared to agree to this. Mr Hoban mentioned that WCA is just one part of the information that decision makers use; this is why Decision Makers do increasingly disagree with HCPs based on other evidence although we don’t know what the ‘right’ number would be given that high levels of disagreement would also be concerning.
Sue said how pleased we were to discover that such a high proportion of claims were successful based on paper assessments alone, with no need for a stressful and costly WCA. She suggested this should be even more widespread and almost certainly could be if more GPs returned evidence in time. Mr Hoban appeared to agree that this was the best way of conducting assessments where possible.
On Mandatory Reconsideration, leaving people without income we pushed very hard, coming back at Mr Hoban several times to try to get some kind of compromise. We argued that it isn’t consistent to give claimants 4 weeks to get evidence in when the DWP has as long as they want for reconsideration. Mr Hoban indicated some agreement and agreed to review this 6 months He said they need to see how it works in practice. We argued that in the meantime people are going without money, and would it not be better to give them this money during those first 6 months, and then review it. However Mr Hoban felt that as it was appropriate for these people to sign on for JSA, then there is no poverty issue. Sue pointed out that many would not be able to do that – herself included as her husband works. They would simply lose nearly £500 a month while they waited indefinitely.
Stef pointed out concerns over the appropriateness of Jobcentre Plus conditionality agreements, and the concerns over the high percentage of successful appeals that were not borderline but instead had been severely under-awarded points initially when they should have very easily got over the 15 points mark. Sue pointed out that a very high % (16%) of Fit for Work decisions are inaccurate and that few disagreed that the system is flawed as it stands.
Unfortunately, Mr Hoban still insisted that these people had been found fit for work and it was reasonable to expect them to make other arrangements, time was running out and we had to leave the issue.
We devoted the final part of the meeting to arguing very robustly that Mr Hoban consider an alternative to WCAs that would be developed by all online groups in unity. We requested a follow-up meeting to present this alternative to ESA/WCA designed by the online disabled community. Mr Hoban agreed that he is very willing to listen to constructive and fully-worked out proposals. He was concerned that given the difficulties that large charities experienced in designing workable descriptors, that we need to be aware of the challenge we have set ourselves. He did however say that if someone has an alterative that works, that is fully worked out and includes an indication of why it would be effective, then that alternative should be presented. Michael Meacher pushed him on a follow up meeting. Mr Hoban concluded that if an alternative could be put together, they are always willing – including this meeting – to listen to ideas that are constructive.”
So, we did our very best for you all. We felt quite pleased that the meeting had been so constructive and we had managed to cover so much in the short time available. If nothing else, some of the clarifications make it easier to know where things stand and what changes the government are considering in the short term to make the system safer and fairer.
Everyone now has the chance to design a better system that is robust and which works and the knowledge that the minister will at least consider our approach.