Is the WCA fit for work?
by Claudia Wood
The fact that the Work Capability Assessment, the test by which nearly 2 million IB claimants are being reassessed for their eligibility for Employment and Support Allowance, is fundamentally flawed is common knowledge among disability campaigners and charities.
But yesterday, this revelation made it into the mainstream media. Thanks to a double whammy of investigative reporting in Dispatches and Panorama, the bureaucratic incompetence, use of unofficial targets to reduce claimant numbers and sheer inhumanity of the WCA in dealing with very ill people was displayed for all to see with undercover recordings and first-hand accounts.
And it was clear that at the heart of these problems is the DWP’s belief that people’s health can be assessed as objectively as a means test. As a result, the WCA strives for such fool-proof standardisation through tick-boxes that it leaves no room for professional discretion, and becomes so inflexible that it is fundamentally incompatible with the messy, subjective, fluctuating world of ill health and disability.
Such simplification and inflexibility means it also has no bearing on the reality of the labour market. For example, guidance states that being able to lift a 1 litre carton of liquid counts towards fitness to work – but a person doesn’t have to be able to pour it. It states being able to raise one hand to their head counts towards fitness to work – they don’t have to be able to move their hand when it’s there. And points are only scored if a person can’t lift both arms – bilateral immobility is the only thing that counts. One wonders, when someone is deemed 'fit for work' by such a test, whether anyone has considered fit for what work. Telling the JobCentre you can stand for 30 minutes and lift one arm certainly doesn’t give them much to work with.
The DWP might argue that breaking down the concept of 'fitness to work' into such unfathomable components is necessary in order to make the test consistent across the country. Subjectivity has no place when it comes to gatekeeping benefits. But it isn’t beyond the wit of man to marry the flexibility of professional discretion with a point-based assessment in an accurate way – social care has managed it, where people are assessed and funding is allocated according to a point score, which reflects a person’s need for support. These assessments are coproduced with the person applying, set around goals they want to achieve, and usually carried out face to face with a social worker informed by professional opinion. Whilst not perfect, they certainly enjoy far greater support and perceived fairness from those being assessed.
Yet the DWP fails to grasp that people’s health and their ability to join the labour market is a complex issue, requiring professional judgement and an understanding of the realities of the demands of work. It cannot be distilled into a series of functional tests devoid of all context. The WCA’s attempts to do so have created a system littered with error (52,500 appeals, with a 40 per cent success rate in the first quarter of this year), Atos staff frustrated by the constraints of the automated test, and – from what we saw last night – the NHS mopping up the fall out by helping to overturn medically inappropriate decisions.
The human cost of this also cannot be overstated. The distress of repeated assessments and appeals has a very real health impact, which was played out on our screens last night. Audiences were no doubt aghast hearing from the man was found fit to work whilst sectioned under the Mental Health Act and living as an inpatient at a mental hospital. Another man was sent for a WCA while waiting for heart surgery – and tragically died shortly after being deemed fit for work.
But these are not anomalies. Thousands of such cases have come to light, and still the DWP press on with the WCA, convinced that the assessments are – as Chris Grayling disturbingly described it – 'tough love' for people he believes have become accustomed to a life on benefits.
So it is unlikely that these human stories, while shocking for the public, will move the DWP to rethink their strategy.
But something else might. Both Dispatches and Panorama made a point of the fact that the WCA contract is administered by Atos, an outsourcing company not unlike G4S. Following the criticism around Olympic security arrangements, the government now has questions to answer regarding the efficiency of such contracts, and the level of accountability achieved. Under this renewed scrutiny, the fact that Atos are not accountable for the high level of successful appeals against their decisions– and the costs associated with this – becomes more important. The fact that the administrative behemoth of the WCA is generating costs for the NHS also gains new relevance.
By focusing on bureaucratic ineptitude and wasted resources, what Dispatches and Panorama may do is turn a human tragedy into a political embarrassment. The question is, is this enough to prompt the DWP to rethink?