Welfare Reform Bill

Indeed, the purpose of the process is to identify and bag up these issues right at the start of the process of an ESA claim. Clearly issues might arise and mistakes might be made. Notwithstanding recognition of the fluctuating nature of the condition, a direction may be made that somebody thought was consistent with that, and it proves not to be. These things will happen. I am conscious that I am talking for too long, as noble Lords have indicated, but I want to make sure that I get something on the record in relation to this about the evidence-gathering procedure. When an individual makes a claim for ESA, this is supported by medical certification from their GP to confirm that the individual has a health condition or disability. That is the starting point. Individuals are provided with a questionnaire in which they detail their functional capability. If this indicates that an individual is likely to be in the support group or to be treated as having limited capability for work—for example, as a hospital inpatient or currently receiving a course of treatment—then Atos will procure evidence either from the individual’s GP or the relevant healthcare provider to confirm this, and the evidence is treated as a medical fact. If an individual is called to a face-to-face assessment then they are able to bring with them any relevant evidence to support their claim for benefit. That may include a report from their GP or specialist. They are also encouraged to bring a companion if they want to. I say to the noble Baroness, Lady Murphy, that the role of Atos doctors is not meant to be as keepers of the gateway to funds. That is not their role and I hope that it is not in practice. The WCA assesses an individual’s functional capability as a result of their condition. The healthcare professionals carrying out the assessments are therefore trained in disability medicine in order to access that capability. They also receive ongoing medical education in order to remain up to speed with developments in the field of disability medicine. This includes training on the need to inquire about variability in an individual’s capability, both day to day and in the longer term. The criteria by which an individual is assessed require that they be able to carry out an activity reliably and repeatedly for the majority of the time. If they are unable to do so, they are considered unable to carry it out at all. So fluctuations, irrespective of their frequency and duration, are therefore reflected by the practitioner providing an opinion based on the individual’s capability for the majority of the time. Each practitioner employed by Atos Healthcare to carry out work-capability assessments is approved by the chief medical adviser to the department. Their continued approval is dependent upon ongoing demonstration that the work being carried out meets a satisfactory standard. This is done through regular monitoring prior to approval for new entrants, and continuing random audits by the medical services quality monitoring and auditing system. Approval to do these examinations could be removed if their work does not continue to be of the required standard.