‘Flawed fit-to-work tests pile work on social workers and harm clients’

The disturbing realities of the work capability assessment are at odds with government rhetoric about helping people back to work, argues Mathew Little – who has been through the process.

“Politics as currently practised,” says the French journalist Christian Salmon, “is no longer the art of the possible, but the art of the fictive. Its aim is not to change the world as it exists, but to affect the way it is perceived.”

In British politics, nowhere is this gap between perception and reality more yawning than in the government’s treatment of sick and disabled people.

The iniquities of the work capability assessment (WCA), which disabled people have to pass in order to continue to receive benefit, have been well recorded. Decisions are overturned in 38% of appeals heard and 14% of GPs say they have patients who have self-harmed as a result of fear of the assessment or actually going through it.

A further 6% of GPs say they have patients who have attempted or committed suicide.

The Care Quality Commission has recently found that the workload of many social workers has increased because their clients are going through the assessments.

The art of the fictive

What is less noted, though, is the role of the “art of the fictive”. The fictional character of the government’s claims about what the tests involve and are intended to do.

When challenged after revelations of the deaths and suffering the tests help to bring about, the government resorts to, in my view, deception.

When, in November 2012, it was revealed that a half-blind, paralysed stroke victim who couldn’t speak had died following a decision he was fit for work, the Department for Work and Pensions (DWP) suspected a regrettable error in the flow of information.

“We encourage people to provide as much medical evidence as possible,” said a DWP spokeswoman “Often people found fit for work only provide the necessary evidence when they ask for an appeal.”

The response was identical to the explanation given two months earlier when an epileptic man died following a work capability assessment that found him fit for work.

Claims that don’t stack up

There’s one slight problem with this excuse. Far from sick people not providing the correct medical information, the government’s work capability tests specifically do not ask for medical evidence.

Claimants are required to fill in a 20 page questionnaire, which asks about their ability to perform “tasks”. They are then compelled to attend a face to face “medical” during which their ability to perform day to day activities like walking and shopping is interrogated. At no stage in the process is medical information ever requested.

“The assessors do not ask GPs like me to provide any medical information about patients to help them make their decisions”, said one doctor writing about the experience of one of her patients, “a woman in her 20s who is slowly dementing and will eventually die at a young age”, and who became homeless after she was found fit for work in a WCA.

Now, as the government never tires of saying, officially, decisions about whether a claimant is fit for work or not, are not based solely on the WCA, conducted by the French company Atos.

Medical information, given to the DWP by the claimant’s GP or specialist when the claimant first applies for Employment and Support Allowance (ESA), is also supposed to be taken into account.

Theoretically, the DWP, based on this medical evidence, can overrule the decision made by the work capability assessment. But, to my knowledge, this never happens.

So the excuse of a lack of medical evidence is a complete fiction. But if it fails to convince, there is a back up.

Are the tests really “tough love”?

“It’s not a financial exercise,” protested then employment minister Chris Grayling when defending the WCA on the BBC’s Panorama investigation, Disabled or Faking It.

“It’s about saying it’s a huge waste of life for some many people to be left at home on benefits, doing nothing.”

The tests are an example of “tough love”, Grayling said.

There is one small flaw in this justification. People on Employment and Support Allowance are very definitely not “left at home on benefits, doing nothing”.

A work capability test classifies claimants into three groups, based on a points system. If they score below 15 points, the claimant is chucked off benefit altogether.

If they score between 15 and 24 they are placed in the Work Related Activity Group (WRAG), for people who may be able to do some work or work at some point in the future. Above 24 points, claimants are placed in the Support group and it is accepted their medical condition means they will never work.

Far from being ignored, people in the WRAG group, which includes people with terminal illnesses, are required to attend six work-focused interviews, take training courses and very possibly, join the Work Programme and work for nothing.

They are compelled to undertake “work-related activity”. Last September, it was revealed that the government wants to dock £71 a week from these sick and disabled claimants who don’t adhere to their “back to work agreements”.

Many appeals (and there are thousands of them) against incorrect WCA decisions are because people have been placed in WRAG group when they should have been placed in the Support group.

But the majority of appeals against WCA decisions are because people are simply denied all support. They score 0 points and are informed they are ‘fit for work’ and can apply for Jobseekers Allowance if they wish.

Disabilities, which claimants know better than anybody, severely restrict their ability to perform paid work, are deliberately minimised and misunderstood.

This happened, for example, to a man waiting for heart transplant, kept alive by a portable machine, a man with terminal brain cancer, someone with brain damage and no short-term memory, a woman with the mental age of seven, a woman with 90% burns, people with MS, an incontinent man who is both blind and deaf, and a semi-paralysed woman.

Sick people are being put in an impossible position

The decision they are fit for work puts sick and disabled people in an impossible position. Their only source of income is removed, whilst they know, even though the DWP pretends not to, that they are unemployable, and so can’t replace the income that is being taken way.

A 2011 DWP report, surveying people found fit for work in WCAs in 2009 (under the last government it should be noted), discovered that over half of them were living without jobs or benefit. It seems a racing certainty that the number of people made destitute by the work capability test has increased exponentially since then.

It is no surprise that social workers are reporting an increase in their workload. They can see at first hand the disturbing realities of the work capability assessment which are completely at odds with the government’s reassuring fictions of “tough love” and helping people back to work.

Mathew Little is a freelance journalist. He has previously written in the New Statesman about his own experience of appealing a work capability assessment ruling.

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