Welfare Reform Bill

My Lords, I strongly support this amendment in the hope that it will go someway to meeting the fears of the thousands of disabled people facing their work capacity assessment, especially those who have a fluctuating condition such as multiple sclerosis or an ill understood condition such as ME. Members of the Committee will have been inundated with letters from people who have been given every reason to mistrust the assessment process as carried out by Atos, and I know that the Minister has been made very aware of the stress and anxiety this is causing. Broadly, this amendment sets out that, in order to be deemed capable of work, the claimant should be able to work for at least 16 hours each week in meaningful work that pays the national minimum wage or above and, most importantly, that they can reliably perform their work on a sustainable basis of at least 26 weeks without requiring excessive leave or absences. This would do much to rectify the current situation. What happens now is that at the end of an Atos report on a claimant, which goes to DWP decision makers following the completion of the work capability assessment, there is usually a prognosis which says ““this claimant should be able to return to work within x months””. However, the WCA is not currently designed to offer any concrete evidence of a person’s realistic capability to find employment. The content of the WCA is designed purely to assess a person’s physical and mental functionality, not their ability to find employment, how long this may take or what support an individual may need to do so in the light of the barriers to work that their condition presents. The WCA test focuses largely on a claimant’s typical day. Yet there is no such thing as a typical day for someone with a fluctuating condition. For example, a woman with MS in her early 30s told the MS Society that on one day she may feel well enough to participate in voluntary work and have a busy and active lifestyle, yet during a recent lapse she was rendered completely blind for a period of weeks and found that on many days she was unable to get out of bed due to disabling fatigue. The typical-day history taken in the WCA refers to a typical day out of work. However, a typical day out of work for someone with a long-term condition could be very different from a typical day if they had to travel and complete a full day’s work. One person with multiple sclerosis told the society, ““Nothing done in the interview related to my ability or my lack of ability to work. I answered the questions as honestly as I was able, but was not able to stress the fluctuating nature of the symptoms, i.e. yes, I can read, but not for more than a few minutes and then I have to rest””. Another person said, ““They have no idea what day with MS is like. They do not know how work would go if one day you can walk but the next you cannot, if one day you pee yourself continually and the next you are okay. Who would employ me? I am constantly fatigued, yet of course the WCA found me fit for work.”” I do not doubt the Minister’s sincerity when he says that his whole motivation is to support and enable people to take their place in the world of work, but how can he hope for this to succeed when the assessment for determining eligibility for universal credit is based on such a flawed, unjust and mistrusted system? As we have heard too many times, 40 per cent of those wrongly found fit for work win on appeal of the decision, and in some areas I am told that the figure increases to 90 per cent if people are represented at tribunal. This amendment gives us an opportunity to look at the Atos Healthcare assessment. We have heard that there is considerable concern and complaint about how it is carried out. We have received many letters from claimants who feel that they have been abused by their treatment, and medical professionals have provided further evidence. In an article in the British Medical Journal this year, reference BMJ 2011 342:d599, Margaret McCartney, a GP, questioned the ethics of doctors performing assessments without access to patients’ medical records. She also questioned the lack of specialist knowledge among the physiotherapists and general nurses employed by Atos. She described her experience of a recruitment evening at Atos Healthcare in Glasgow, and from what is a long and critical article, I shall quote briefly: "““At the meeting, I asked how it was possible to know the variation in symptoms that a patient may have during a one-off assessment. I was told that this could be ‘difficult’ but this ‘wasn’t an occupational health service’. Instead, it was a ‘functional assessment’… One nurse in the audience asked about training in mental health, as she had had little training in this area and would not feel competent to assess it in a fitness for work setting. The reply was that health professionals were ‘very thoroughly assessed’ at interview for their abilities; however, general nurses were often taken on and given training … One assessment, which initially reported a woman was fit to work, reported as evidence that her mental health was reasonable that she ‘did not appear to be trembling … sweating … or make rocking movements’ ””." I will not go on with the plethora of complaints about Atos, but I should like to ask the Minister three questions. First, what part does medical evidence supplied by a claimant’s specialist doctor or GP play in the decision arrived at by the Atos Healthcare medical assessor? Is the medical assessor bound to refer to this evidence or is it discretionary? Secondly, are there specific conditions in the Atos Healthcare/DWP contract that require medical assessors to seek a specialist medical opinion, and is there any monitoring evidence that such a contractual requirement is observed? Lastly, is Atos Healthcare subject to regulation by the General Medical Council or the Care Quality Commission? If not, to which regulatory body are the decisions of its medical assessors accountable? Finally, in earlier sessions of this Committee we have talked about the appalling language used about benefit claimants, with press headlines of ““scroungers”” and ““benefit cheats””, which it seems that the Government have taken no action to modify. Indeed, there is a suspicion among claimants that the Government have stoked the headlines. These headlines have a particularly negative effect on people with fluctuating or misunderstood conditions such as ME and MS. Neighbours will see them in the street being perfectly active and untroubled on one day, but are totally unaware that those people are not even able to get to the door the next day; they may be in bed for weeks. Does the Minister’s department have any action planned to educate the press and the public in order to counteract these damaging press reports that are bringing so much misery to disabled people’s lives? In the mean time, I hope that the Minister will accept this amendment, as it would go some way to allaying claimants’ fears.