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Peverley’s attack on benefit claimants was wrong-headed - and having worked for Atos, I should know

The latest piece from Pulse’s GP columnist showed far too much faith in the work capability assessment, writes Dr Greg Wood

In his column in the August issue of Pulse, Dr Phil Peverley let out a howl of pain on behalf of his readers - fellow GPs who feel ‘caught in the middle’ between their patients on Employment and Support Allowance (ESA) and the Department for Work and Pensions (DWP)’ proxy, the global outsourcing firm Atos.

But it was a cry from the heart, not from the head. He began by referring to a DWP press release, put out on 22 July (the day of the royal birth) about a hypothetical new contractor that might be invited to work alongside Atos on work capability assessments (WCA) some time next year.¹

In it, the Government also slipped the news that it has told Atos to improve the quality of its reports (a quality drive already underway on the day the royal baby was born).

The DWP also admitted that all Atos disability assessors were undergoing retraining. As if that wasn’t enough of a mea culpa, the DWP has called in external auditors, PricewaterhouseCoopers, to ‘strengthen quality assurance processes’ across its disability assessments.

Dr Peverley claimed that Atos ‘nearly always gets it right’ as far as so-called fitness-to-work assessments are concerned, but even the DWP admits that at least 15% of cases are appealed successfully.²

Furthermore, if you look at the findings of the tribunals that hear appeals against WCA decisions, the rate at which these decisions are successfully appealed is now running at 42%.3 Many would argue that the tribunals provide the clearest window into the accuracy of the WCAs, because an independent doctor and lawyer sit on them and because they are funded by the Ministry of Justice, not the DWP, and are thus free from the constraints written into the DWP-Atos contract.

Stephen Hawking’s WCA

Dr Peverley claims that ‘nearly everyone is capable of some form of work’. He’s right, in the sense that nearly all small boys are capable of going up chimneys. It is a common misconception that the WCA is a fitness-for-work test, a mistake encouraged by those with an anti-welfare agenda. In fact the test only sets out to establish whether a claimant has limited capability for work, and if so, whether they have limited capability for work-related activity.4 In this way, someone can be awarded ESA yet still apply for jobs: if they get one, great. No one would consider them a cheat for doing so.

As for using Stephen Hawking as an example: what was Dr Peverley thinking? Professor Hawking is of retirement age and way too rich to qualify for ESA, but if he wasn’t, he would obviously be eligible for the highest level of medical benefits. As Dr Peverley must know, motor neurone disease doesn’t affect cognitive function, which is why Stephen Hawking has been able to use his unique intellect to such good effect despite his physical impairments, which are of the utmost severity. Would Dr Peverley issue him with a sick-note if he were a postman, not a physicist?

Regarding letters of support, claimants are in a genuine Catch-22 situation. The DWP says that ultimately claimants - not the DWP or Atos - are legally responsible for providing any documents to be used in support of their claim, yet LMCs like Bro Taf have decreed that their GPs will only provide reports if asked to by Atos.5,6

Doing things differently

Atos has a £110 million-a-year deal with the DWP to conduct Work Capability Assessments, and the appeals process is costing half as much again.7 I would favour channelling some of that money towards GPs, in return for a willingness to write helpful reports which describe their patients’ functional limitations during activities of daily living, and which comment on any risks associated with them being found fit for work.

I propose we develop two kinds of sick-note: one for people in work, to give an indication to the employer of how long the employee is likely to be off sick; and another using a low standard of proof, simply recommending to the Jobcentre that the DWP pay the ESA, until a truly fair and truly independent assessment can be carried out.

Dr Greg Wood is a former GP and disability analyst for Atos, now a campaigner for WCA reform

References

1 Department for Work and Pensions (DWP). Hoban - taking action to improve the Work Capability Assessment. 22 July 2013.
2 Hansard. Work and Pensions Committee; Supplementary written evidence submitted by the Department for Work and Pensions. 29 January 2013.
3 GOV.UK. Tribunals statistics (quarterly) earlier editions. 27 September 2012.
4 DWP. A guide to Employment and Support Allowance - The Work Capability Assessment (ESA 214). January 2013.
5 DWP. Employment and Support Allowance claimant journey Stakeholder information pack. November 2012.
6 Pulse. GP support for benefit claimants is an ‘abuse of NHS resources’, LMC claims. 18 July 2013.
7 Hansard. Written answers. 17 July 2013.

Readers' comments (11)

  • When I am in doubt I will mark the fitness note as maybe fit to work and then write in the box I do not feel in a position to make an assessment and advise the job centre to arrange OH assessment. The end date is then set to "after the OH assessment". This means I don't have to think it all through again in two weeks. As there is no need for further notes until they have had a proper assessment.

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  • Thank you for responding to the nonsense written by the "good" doctor. As you are aware WOWpetition calls for an immediate end to the Work Capability Assessment, it can't come soon enough!!

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  • Gosh, there is staggering lack of intelligence here.

    Granted, some may find Dr Peverley's article distasteful and may not find it humorous. But surely you can understand it was written in his sense of humour and not meant as a serious opinion or serious attempt to discriminate. It was published on web site intended for professionals (that's what the web site says!).

    Personally, the worst GPs are the serious politically correct morally righteous ones who are incapable of changing due to their inflexible fixation on their agenda. I much rather work with wheeler dealer who is able to analyse and adapt.

    Remember we are not here to enforce our moral principles, even when it's a politically correct ones!

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  • There's many a true word spoken in jest, Dr Anon!
    Dr P's column was picked up by the national press and not taken as being tongue in cheek, if that's what it was.
    Not many people would want a GP who was a wheeler dealer - look it up...

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  • Joint Response by DPAC and Black Triangle on Dr Phil Peverley’s Shameful Comments published in Pulse Magazine, The Daily Mail and The Daily Telegraph
    Posted on August 5, 2013

    http://blacktrianglecampaign.org/2013/08/05/joint-response-by-dpac-and-black-triangle-on-dr-phil-peverleys-shameful-comments-published-in-pulse-magazine-the-daily-mail-and-the-daily-telegraph/

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  • The Atos WCA was designed in consultation with Unum Insurance, an American corporate giant with a disturbing reputation and identified by the American Association of Justice as the 2nd worst insurance company in America. The question remains as to why the British national press refuse to expose the links between the WCA and corporate America, as described in research evidence published by the Centre for Disability Studies:
    http://disability-studies.leeds.ac.uk/files/library/THE%20HIDDEN%20AGENDA-a-research-summary-March-2013-FINAL.pdf

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  • http://www.actionforme.org.uk/Resources/Action%20for%20ME/Documents/get-informed/supporting-medical-evidence-factsheet.pdf

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  • Sorry Dr Wood cant agree fully.
    I too used to work for Atos.
    I generally found 8/10 claimants to be exaggerators or outright fakers, the ATOS assessment was painful for the doctor too, having to go over every tick on the claim form that was done deliberately by the claimant with little to no true justification, let alone a reason to be truly work incapable.

    The downside I agree is the 2/10 who can be easily missed off being recognised as disabled by the assessment process.

    However, We shouldn't forget the 8/10 though. They need to be weeded out and there is no easy way to do it for GP or disability assessor.

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  • Peverley's column would be more at home in Country Life or The Lady.
    The methods employed by ATOS are scandalous. They contravene practically all of the NICE Guidelines for Clinical Excellence.

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