Jenny Willott MP writes: Harrington – better assessments, better outcomes

At our Conference in September, the Liberal Democrats unanimously supported a motion calling for changes to Employment and Support Allowance (ESA) and the Work Capability Assessment (WCA) which accompanies it.

Speaker after speaker stood up to condemn the system left by Labour which subjected sick and disabled people to an ineffective, demeaning assessment process that was not fit for purpose. Many will remember the powerful speech by Shana Pezaro who condemned the WCA process as ‘utterly failing many people’.

The motion welcomed the first annual review of the WCA by Professor Malcolm Harrington, and the progress the Coalition Government has already made by adopting his proposals. Thanks to these changes, more power is now given to DWP decision-makers, who are encouraged to look at other evidence on a claim, such as notes from a consultant, rather than simply rubber stamping the tick-box assessment performed by Atos Healthcare.

Today sees the announcement of the second review by Professor Harrington. It looks at progress made by the Government in implementing the changes recommended last year, and examines how the WCA can be further improved so that the decision is right first time, particularly for those with hidden or fluctuating conditions, just as we called for at Conference.

I’m glad that Professor Harrington is pleased by the progress that has been made since his first review. He states that the WCA has ‘noticeably changed for the better’, and that the work done by DWP to give more power to decision-makers has had ‘undoubted effectiveness’ on the process and the decision-makers themselves. It is clear that we are starting to see improvements to the WCA now Lib Dems are in Government.

But as well as assessing progress, Professor Harrington also looks at ways to improve the WCA for the future. I’m really pleased that he has recommended developing new, evidence-based descriptors on the impact of generalised pain and fatigue. Fatigue is one of the most debilitating aspects of many conditions so it is absolutely right we should be looking to assess its impact properly. He also suggests developing evidence to change those parts of the assessment that focus on mental and cognitive disabilities. I’m glad that the DWP has accepted in principle these recommendations and is already working with charities on putting together this evidence. This needs to be done quickly so we can soon see further improvements to the WCA process.

One of the most important suggestions by Professor Harrington is that changes be made to ensure that people who are receiving oral chemotherapy for cancer be treated the same as those undergoing other types of chemotherapy. At the moment those on oral treatment are far less likely to be put in the Support Group of ESA, despite often having similar reactions to treatment as those on intravenous treatment. The Government is now going to consult on this proposed change, and if it then goes ahead many more people who are fighting cancer will be eligible for much needed extra support. As we said in our Conference motion, it is the duty of a compassionate society to support those who need it, and fair treatment for all cancer patients would do exactly that.

Finally, Harrington calls for assessors to be less bound by tick boxes, and instead make much more use of “free text” boxes, where they can give individual, specific information about the claimant. One of the major criticisms we made of the WCA at Conference was that the day-to-day impact of a disability or illness can’t be summed up by ticking a box on a form. By encouraging assessors to write more individual notes, the process should become more humane, more individual and most importantly more accurate.

These changes, and the plans for Professor Harrington’s third assessment, are a clear sign that the Coalition is working hard to make the WCA fit for purpose, just as we called for in our motion in September. Fully implementing the recommendations will, of course, take time. Sadly nothing in Government happens overnight! But I and all Lib Dem MPs and Peers remain committed to making sure that Professor Harrington’s work makes a difference, so that in future we see better assessments and better outcomes for all sick and disabled people.

Jenny Willott is the MP for Cardiff Central and the Co-Chair of the Lib Dem Parliamentary Party Committee on Work and Pensions.

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This entry was posted in Op-eds.


  • Tony Dawson 24th Nov '11 - 4:02pm

    Very good feedback on an important issue for many.

  • Good news all round, but clearly still some substantial progress to be made. Not least on communicating the positives to the wider community. There is still a great deal of fear and distrust out there (sadly stirred up by a number of hyperbolic and ill-informed bloggers) which you need to allay.

  • These are indeed very welcome changes to the WCA. The fact that issues such as pain & fatigue and “hidden” or fluctuating illnesses were not considered for some time was a disgrace and has caused pain, fear and worry among people with such illnesses. Let’s hope these changes do a bit to help those disabled like myself who suffer mainly from pain, or are ok one day but need to stay in bed another.

    One thing, though, that still needs to be addressed ASAP is ATOS themselves. There have been many, many reports of coldness and impersonality in the WCA, as well as “health professionals”, as they are called, who have little to no knowledge of disability. Many sick and disabled people have complained that many of these “health professionals” never make eye contact at all, ask claimants to do things they simply cannot, as well as being rude. Going to the centre to take a WCA is stressful and scary enough for those of us who have to go through them. Many reports have been filed where the claimant’s only issue with the whole process is ATOS themselves. To illustrate this report, a man was once asked at a WCA “how long have you had Cerebal Palsy”, when they should know it is an affliction one is born with! There have been people who went through the WCA, received their report and felt the entire write-up by ATOS was fantasy. There are many such examples of the same behaviour from ATOS.

    So I really feel that is something that also needs to be looked at. Sick and disabled people do not mind having to be assessed, but it is the way we are being assessed and the breathtaking incompetence and coldness shown by ATOS that scares us.

  • James Sandbach 24th Nov '11 - 6:43pm

    Are the Government also taking note of the Conference motion’s call to look again at access to advocacy services in welfare rights which empower people to challenge bad assessments? – obviously in an ideal world assessors and decision-makers would get their decisions right first time, but we don’t live in an ideal world, so review and appeals processes provide a much needed corrective – but these only work if claimants have access to appropriate expert advice for example from welfare benefits caseworkers at Citizens Advice Bureaux who are currently provided for by the legal aid system, but will no longer be funded if the Legal Aid Bill currently in the Lords passes without revision.

  • paul barker 24th Nov '11 - 7:54pm

    I have had years of experience of the current system, having been through the rejection-appeal-reinstatement cycle several times & I would like to know if the new approach takes any more account of my age. I am getting close to Retirement age now & I wonder if there comes a point when the system recognises that I am not going to make a miraculous recovery.
    We are all supposed to be focused on saving The Taxpayers money & the Appeal process in particular looks very expensive to me.

  • What puzzles me is how Professor Harrington, a World renowned expert on psychometric testing, can think the 10 minute computerised “work capability assessment” is in any way fit for purpose.
    To assess what work, (if any), a physically/mentally disabled person is capable of, what education/training, they would need to be able to do that work, and what workplace modifications would be needed to for them to be able to work, takes eight hours of psychometric testing, not 10 minutes.
    Such assessments are carried out on batches of up to 30 people at a time, overseen by a handful of occupational experts.
    There is also a history of expertise going back to 1916 when the tests were first used on wounded soldiers. They tests have been continually modified to keep them up to date.

  • @Paul Barker

    The simple answer to your question in “None”

    A friend of my mother has suffered for a number of years from Emphysema, like anyone with this condition she has good days and bad days, ask anyone who suffers from any form of Chronic obstructive pulmonary disease and they will all say the same.

    In her particular case, she has more worse days then she does good, and on really bad day’s she can not be to far away from her oxygen support.

    She is approaching her 60th Birthday next year, and not only was her recent WCA an absolute farce which wrongly found her capable of some work, She was told she would need to claim JSA.

    Even though she reaches retirement age in a couple of months, DWP does not recognize your “payable” pension age until your 61st Birthday.

    The absolute ludicrous point to all this is however, She was in receipt of “Higher” rate care component of DLA which means she “should” have been exempt from a WCA assessment, but because she received a letter from ATOS telling her she had to attend an appointment with only 10 days notice, When she contacted them to tell them of their mistake, she was informed that she should contact DWP but she would still need to attend the appointment if not her benefit could be stopped.

    She did attend and was found fit to work, Disability alliance has helped her ask DWP to reconsider her case and point out there clear failings.

    So in other words, don’t think for one moment that the DWP will regard you as medically retired if approaching pension age. The only time the DWP does that, is when your a DWP employee and they want you off their books.

  • @George W. Potter:
    What we’re talking about here are the lives and welfare of 2 million sick and disabled people, many of whom are terrified by the assessment system and some of whom are suicidal. Let’s not forget that the government’s proposed changes are predicted to put 200,000 sick and disabled people into poverty.

    Thank you for saying that. The very fact that we have a government which is pushing vulnerable members of society to the brink of, and actual, suicide should be a national scandal. The cynic in me says the fact that this is not a scandal shows how successful government & press efforts to brand sick and disabled people as “scroungers” and “workshy” are.

    Disabled “suicidal” over welfare reform:

    Coalition ministers accused of causing fear for disabled people:

    One thing I find particularly interesting is the language used:
    She said such articles were having an effect and pointed to research by the Glasgow Media Group which claimed there had been a significant increase in the use of pejorative language to describe disabled people in the media.

    The use of terms such as “scrounger”, “cheat”‘ and “skiver” was found in 18% of articles in 2010/11 compared with 12% in 2004/5.

    Now, @Jenny Willott MP, no self-respecting news outlet would use ANY pejorative words to describe ethnic minorities in such a casual manner. Why is it acceptable for the press to describe sick people as “scroungers”? Why have LibDems in government (I stress government, as many rank-and-file members are just as horrified as the disabled community & charities) been mostly silent about this up until now?

    Or is the basic dignity and respect of sick and disabled people another “compromise” signed away by your MPs in the coalition agreement?

  • After reading Professor Harrington’s second review, I am deeply disappointed.

    In several parts of the review he mentions that recommendations from the “first” years review has still not been totally implemented and claimants are being asked to trust that important changes have been made to the way DWP/Atos work –they just haven’t filtered through yet.
    Harrington is looking more increasingly like a DWP/Atos apologist rather than a claimant’s champion.

    The Government accepted all of Harrington’s recommendations in Year 1 and yet here we are in year 2 and they have still not been implemented.
    It is a disgrace that the Government acknowledges problems with the WCA and yet are still using the same system, it is even more disgusting when on top of all this, the Government and certain ministers are party to constantly benefit bashing claimants labeling them as feckless and scroungers through the media when they are testing these people with a not for purpose system.

    I would have though that professor Harrington should have also prioritized the second year review to deal with LIMA (Logic Integrated Medical Assessment) the Software that ATOS healthcare professionals use to determine someones ability to work or not. Since it is this highly contested mechanical process which makes these “supposed” medical assessments and decisions.

  • Ms Willott seems to have read a very different Review to the one I read!!!

    The review states –

    “A number of organisations, including the National AIDS Trust, Arthritis Care, the National Rheumatoid Arthritis Society, Asthma UK, the Stroke Association and RSI Action, have identified inaccuracies and out-of-date information in the medical guidance provided to Atos assessors on certain conditions”

    The Call for Evidence issued in July 2011 specifically asked respondents for robust evidence about whether some or all the year one recommendations were in place at that time.
    Whilst recognising that it is probably too early to be able to provide robust evidence about implementation at this stage, the vast majority of respondents reported that the process had broadly stayed the same or that they had not noticed any changes, primarily due to time.

    Some respondents did report negatively on the implementation of the recommendations, noting particularly the increase in time taken for claims to be processed and the remaining lack of clarity in the process.

    In August 2011, a series of seminars was convened with the major representative groups, patient support groups and the Work Programme providers. The outcome of these discussions reflected responses to the Call for Evidence and suggested that although few organisations had seen any change some positive messages were starting to get back to them. Most saw little change yet, but the more circumspect thought this would come soon. Some, disappointingly, saw no change for the better and did not expect to see any.

    The Disability Benefits Consortium’s response to the Call for Evidence included the results of a survey of 439 welfare rights advisors during the period 19 July 2011 to 16 August 2011. Reviewing evidence for improvements in the claimants’ experience of the ESA process from the beginning of 2011, less than 4% saw improvements, whilst 75% reported no change. Less than 2% of respondents reported any increased empowerment by Decision Makers.

    How, after findings such as these, he can possibly come to the conclusion that “Evidence collected at first hand by the Review and from numerous meetings with DWP staff proved conclusively that the recommendations are being enacted.” is beyond me!!!

    He then goes on to say – “Inevitably, the whole process has been time consuming but the Review believes that positive changes are in the pipeline. A little patience would be valuable here from the critics.”

    “Recommendations are being enacted”
    “It is hoped that fewer negative experiences will be reported overall next year as the recommendations from this year and last are fully implemented and begin to have a real impact.”
    “Positive changes are in the pipeline”
    “Once all of the recommendations have been implemented for every claimant going through the WCA noticeable improvement in the process can be expected to be seen.”

    Confusing? Contradictory??

    “The Review recognises that there are still a considerable number of negative comments about the face-to-face assessment and the HCPs carrying out those assessments…The vast majority of respondents had concerns with the HCPs approach, their understanding of conditions and the IT supporting the assessment; or with the HCP’s approach and knowledge. It is worrying that these negative experiences of the face-to-face assessment, and the WCA process as a whole, are still being reported to the Review. Of particular concerns are – Reports that supporting evidence from a chosen healthcare adviser is not being asked for or taken into consideration in the decision making process. The continuing questioning of Atos HCP’s professional skills. Inaccurate reports being generated at the face-to-face assessment.

    “The stakeholder seminars identified several anomalies in the language used in LiMA (computer system) which could have a negative impact on the quality of reports generated during the face-to-face assessment.”

    “It is unclear to the Review which accreditation/appraisal schemes are the most suitable for the medically qualified personnel employed by Atos and the First-tier Tribunal. It is also worth noting that practitioners who merely wish to remain registered with the GMC can still practice in certain contexts.”

    “The increased workload caused by Incapacity Benefit migration will, inevitably, put strains on Atos… Tthe onus for the delivery of sound, accurate and effective assessments which the Decision Makers can use to make reasoned and evidence based decisions on rests heavily on Atos. To do this they need to maintain a body of first class HCP’s. A high turnover of staff will place undue demands on the training programme that Atos have put in place, which in turn could have a negative impact on the assessment process as a whole.”

    He says “it seems sensible… to allow the Review access to more Benefit Delivery Centres and to Atos Assessment Centres. Great you may think. But then he qualifies it with “This would not constitute a formal audit of the Centres and the people carrying out the WCAs…”

    In January 2011 a group led by the MS Society and also containing Arthritis Care, Crohn’s and Colitis UK, Forward ME, the National AIDS Trust and Parkinson’s UK were asked to provide recommendations on refining the approach used to assess fluctuating conditions in the WCA. They presented initial recommendations to an independent Scrutiny Group in April 2011. In November 2011 the Scrutiny Group and representative groups made joint recommendations to the Review.

    In response to the Review, Sir Peter Spencer, Chief Executive, Action for M.E. (M.E. being one of the fluctuating conditions) said:

    “Whilst I acknowledge that it will take time for improvements to take effect throughout the UK, I am disappointed that there is no specific recommendation in the Review to improve the assessment procedure for people with fluctuating conditions such as M.E. This is despite Harrington passing on suggested changes made concerning fluctuating conditions to the Department for Work and Pensions (DWP). The DWP claims it has ‘not yet had time to consider’ these changes.

    “However, if only recommendations included are those that have already been approved by the DWP, it raises a question as to whether the Review is as independent as it appears to be.

    “The Government cannot in all conscience continue to put people through this very stressful assessment process which is so clearly unfit for purpose. Senior consultants have provided compelling evidence to the DWP of the harm this does to vulnerable patients. Once again Action for M.E. calls on the Government to suspend Work Capability Assessments for those with fluctuating conditions until the DWP has established criteria that are demonstrably fair.”

    “This report paints a picture of improvement in many areas but unfortunately these have yet to benefit people with M.E. We continue to receive feedback about inaccurate medical reports, rushed assessments and claimants being wrongly told that their condition is psychosomatic.”

    I could go on… and on… but you get the picture. This Review actually shows that not much has been done and precious little is going to be done SOON ENOUGH and people who are suffering serious illnesses and having to wait for up to a year for their appeals to be heard etc etc are now being told to just “be patient” for another few years. It is a joke.

    I endorse what Sir Peter Spencer said – it raises a question as to whether the Review is as independent as it appears to be.

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