Benefit assessment system undermined by culture of mistrust, say MPs

The disability benefit assessment system is being undermined by a “pervasive culture of mistrust”, fuelled by widespread claims that assessors are deliberately trying to prevent disabled people receiving the support they are entitled to, according to a committee of MPs.

The long-awaited report by the Commons work and pensions committee describes how many claimants of personal independence payment (PIP) and employment and support allowance (ESA) have reported dishonesty by the healthcare professionals who have carried out their face-to-face assessments.

The report says the culture of mistrust this has produced means that assessors “risk being viewed as, at best lacking in competence and at worst, actively deceitful”.

The committee’s report substantiates evidence provided by hundreds of disabled people who have contacted Disability News Service (DNS) over the last 15 months to describe the dishonesty of the healthcare professionals who assessed them.

A separate report published earlier in the week includes examples from the “unprecedented” response from claimants who had submitted evidence to the committee, with nearly 4,000 submissions.

The committee says this response was “remarkable” in the “consistency of the themes that emerged”, including claims that assessment reports “bore little or no relation to their circumstances or what had occurred during the assessment”.

Claimants, said the committee, “do not believe assessors can be trusted to record what took place during the assessment accurately”.

One example quoted by the committee comes from Mary, a PIP claimant who first told her story last year to DNS (she was named ‘Elizabeth’ by DNS).

She told the committee how the assessor wrote in her report that she “arose from the chair without any difficulty” when in fact she “was in bed the whole time (she let herself in) and I only have the one chair in the room and she was sitting in it”.

Another who submitted evidence said: “I did most of the talking as my partner was drowsy with his medication, but in the statement with the PIP decision [it said that] my partner was chatty. Completely untrue.”

A third claimant told the committee: “I was attacked with a deadly weapon only a short time before my assessment.

“The man threatened my life, on a walk with my dog. So the assessor wrote that I like to talk to people on my walk.”

A fourth claimant said: “The assessor claimed in the report to have completed an extensive examination of me during the assessment.

“She listed a breakdown of her observations regarding the movement of all my limbs and joints.

“In reality though my assessment was only fifteen minutes long and the assessor didn’t examine me at all.”

The committee calls in its report for the Department for Work and Pensions (DWP) to improve trust in the system by offering the opportunity for all face-to-face assessments to be audio recorded, and by providing a copy of the written assessment report to all claimants.

The evidence provided to DNS helped persuade the committee last year to investigate what Frank Field, the committee’s chair, described as “concerning reports about the operation of the PIP assessment process”.

He later said that DNS had “provided us with a useful series of case studies that acted as a further catalyst” for calling an emergency evidence session last March, which subsequently led to the launch of the inquiry.

The committee had appeared last year to be trying to avoid discussing allegations of dishonesty that had been raised by DNS, refusing to ask welfare rights experts about such claims in the urgent evidence session, and then neglecting to raise the issue of dishonesty in a letter seeking further evidence about the PIP assessment process.

But the sheer weight of the allegations submitted by PIP claimants appears to have convinced the committee that these claims were valid, even if there was no explicit statement in this week’s report that the MPs believed there was dishonesty in the assessment process.

Despite the role played by DNS in persuading the committee to investigate the PIP assessment process, neither Field, nor Heidi Allen, the senior Conservative member of the committee – the two MPs who were said to be available for interviews – agreed to talk to DNS this week.

A spokeswoman for the committee declined to say if the refusal to be interviewed was connected with DNS reports that have criticised Field and his colleagues.

Those reports questioned why they failed to ask the minister for disabled people about figures suggesting attempted suicides among people claiming out-of-work disability benefits may have doubled between 2007 and 2014, following the introduction of the work capability assessment, which tests eligibility for ESA.

In response to the committee’s report, a DWP spokeswoman said: “As the [committee] highlights, assessments work for the majority of people, with 83 per cent of ESA claimants and 76 per cent of PIP claimants telling us that they’re happy with their overall experience.

“However, our aim has to be that every person feels they are treated fairly, with respect and dignity.

“We are committed to continuously improving the experience of our claimants; that is why we’ve commissioned five independent reviews of the work capability assessment – accepting over 100 recommendations – and two independent reviews of PIP assessments.

“We continue to work closely with our providers to ensure people receive high quality assessments, and are exploring options around recordings to promote greater transparency and trust.”

15 February 2018

 

 

Benefit assessment report welcomed, but concern over ‘preventable harm’ failings

Disabled campaigners have welcomed a report by MPs on disability benefit assessments, which they say highlights “serious multiple failures”, but many believe it should have done more to highlight the serious “preventable harm” caused by the system.

The report by the Commons work and pensions committee concludes that there is a “pervasive culture of mistrust” around the personal independence payment (PIP) and employment and support allowance (ESA) assessment processes.

It calls for “urgent change” in the system, including the introduction of routine recording of face-to-face assessments, and says that the government’s contractors, Atos, Capita and Maximus, “have consistently failed to meet basic performance standards”.

It also says the government should send every claimant a copy of the assessment report prepared by the healthcare professional who assessed them, which it says would “introduce essential transparency into decision-making”.

And it calls for improved accessibility of the system “at every stage” and pays tribute to the thousands of claimants who shared evidence with the committee, a response which it says was “unprecedented” for a select committee inquiry.

The committee concludes that the Department for Work and Pensions (DWP) should consider ending the outsourcing of the assessment contracts and bringing the assessment processes back in-house.

Tracey Lazard, chief executive of Inclusion London, welcomed the report on behalf of the Reclaiming Our Futures Alliance, and said it highlighted “the serious multiple failures of the ESA and PIP assessment process”.

She said: “The report findings reflect what we hear every day from disabled people, that the assessment process is not fit for purpose, with poorly trained assessors and staggering levels of inaccuracy and dishonesty in the assessment reports.

“This not only results in a vast waste of taxpayers’ money, it also subjects disabled people to unacceptable levels of distress, placing considerable strain on our communities and on already over-stretched support services left trying to assist individuals through a process that is difficult to navigate and too often produces wrong and unfair decisions.

“This is yet further evidence that outsourcing to private providers is not only inefficient but that it’s the poorest people who are hit the worst by failings.”

Sue Bott, deputy chief executive of Disability Rights UK, said the “pervasive distrust in the system blights the claims process and creates misery for disabled people when they are in need of support.”

She said the committee’s calls to record face-to-face assessments and provide assessment reports to all claimants “would go some way to improving matters and we would strongly recommend the government implement those ideas as soon as possible”.

She said: “It’s ironic that so many disabled people are sanctioned within our benefits system when the assessment companies in the shape of Atos and Capita are making such a poor fist of doing what they are paid for – hundreds of millions of pounds of taxpayers’ money for a very poor service indeed.

“The government should, as the committee says, look closely at whether the assessment process should be brought in-house.

“Ultimately the government needs to completely overhaul what is a flawed system and replace it with one that identifies the true extra costs of living with disability, and is based on what disabled people can do with support rather than on what they can’t.”

But John McArdle, co-founder of Black Triangle, said he was “deeply dismayed” that Frank Field, the committee’s chair, had concluded that assessments “work adequately” for “the majority of claimants”.

McArdle said he believed that most claimants are harmed by the assessment process.

He also said the report had “not gone far enough” on the frequent failure of assessors and DWP decision-makers to collect further medical evidence (FME) about claimants.

Black Triangle is campaigning for a new legal duty on assessors and DWP decision-makers to seek FME for all ESA claimants with significant mental health conditions, including those with a history of suicidal thoughts and suicide attempts.

Last week, McArdle and fellow Black Triangle activist Maggie Zolobajluk met shadow chancellor John McDonnell to discuss what they hope will be a cross-party campaign.

McArdle said he was “shocked” that the report had ignored official government figures – passed to the committee by Disability News Service (DNS) – that suggest that the rate of lifetime attempted suicides among people claiming out-of-work disability benefits doubled between 2007 and 2014, following the introduction of the work capability assessment (WCA) in 2008.

He said: “We are flabbergasted that the committee has not confronted this reality and has not proposed concrete solutions on how to address it, in order to prevent further catastrophic avoidable harm as a result of this profoundly flawed disability assessment regime.”

DNS has reported previously how the committee failed to ask the minister for disabled people about the figures when she gave evidence to the inquiry in December.

McArdle is also frustrated that the report fails to mention evidence submitted to the committee that highlighted how the “biopsychosocial (BPS) model of disability”, which underpins the PIP assessment and the WCA, was “scientifically invalid”.

McArdle said the “ill-conceived” BPS model “has not even been touched upon by the committee”.

Mo Stewart, the disabled campaigner who spent years researching the “totally bogus” WCA for her book Cash Not Care: The Planned Demolition Of The UK Welfare State, was also highly critical of the committee for concluding that it was only a “minority of claimants who directly experience poor decision making”.

She said: “Following nine years of independent research on this subject, I have no idea how the work and pensions committee concluded that the identified preventable harm created by the WCA and PIP assessments only negatively impacts on a ‘minority of claimants’.”

She said the committee had “disregarded” the ongoing preventable harm caused by “the fatally flawed WCA”, particularly to people with mental health problems, some of which had been reported by the national media.

And she said: “Nowhere in the report does the work and pensions committee acknowledge the detailed evidence that the WCA and PIP assessments are based on the BPS model, as influenced by corporate American advisers, has no credibility, was designed to limit access to benefit and was totally discredited by independent research.”

Stewart added: “Whilst no doubt the recommended recording of assessments may help, the fact is that the use of the BPS model of assessment as used for both the WCA and PIP assessments was based on discredited DWP commissioned research, and its use should be abolished not amended.

“Trust in the assessments will not be returned so long as assessments which are fatally flawed by design continue to be used.”

Debbie Abrahams, Labour’s shadow work and pensions secretary, said the report “provides yet more damning evidence that these assessment processes are not fit for purpose and that trust in the system has been completely undermined under this government”.

She said: “Instead of supporting people, the process is often dehumanising, inaccurate and worsens existing health conditions.

“The widespread distrust of the assessment process by sick and disabled people is no surprise, with a record 68 per cent of decisions taken to tribunal being overturned by judges.

“Under private contractors the assessment process is getting worse, not better, yet the government refuses to act.”

She said Labour would scrap the current system, replacing it with “personalised, holistic support which provides each individual with a tailored plan, building on their strengths and addressing barriers, whether health, care, finance, skills, transport, or housing related”.

Stephen Lloyd, the Liberal Democrats’ spokesman on work and pensions, said the report was “utterly damning”.

He said: “It’s clear far too many assessments are inadequate for this system to continue in its current form.

“This is proof that the Liberal Democrat position of stripping the assessment contract from corporate behemoths such as Atos and Capita and bringing them in-house as a public service, is the only practical and humane way forward.”

A DWP spokeswoman said: “As the [committee] highlights, assessments work for the majority of people, with 83 per cent of ESA claimants and 76 per cent of PIP claimants telling us that they’re happy with their overall experience.

“However, our aim has to be that every person feels they are treated fairly, with respect and dignity.

“We are committed to continuously improving the experience of our claimants; that is why we’ve commissioned five independent reviews of the work capability assessment – accepting over 100 recommendations – and two independent reviews of PIP assessments.

“We continue to work closely with our providers to ensure people receive high quality assessments, and are exploring options around recordings to promote greater transparency and trust.”

15 February 2018

 

 

DWP quietly dumps plan to trial softer sanctions regime

Ministers have quietly dumped their promise to test a gentler approach to dealing with claimants who breach strict benefit conditions for the first time.

The Department for Work and Pensions (DWP) agreed in October to trial handing out warnings instead of benefit sanctions when claimants breach the conditions imposed on them for the first time.

It was one of five recommendations made in a report on benefit sanctions by the Commons public accounts committee (PAC) in February 2017.

But DWP has now said that it will not carry out the trial after all, because of “competing priorities in the Parliamentary timetable”.

There was no public announcement, but the decision was included on page 139 of the latest Treasury Minutes Progress Report, which describes progress on implementing those PAC recommendations that have been accepted by the government.

It was spotted by welfare rights advisers on the rightsnet online forum, and from Buckinghamshire Disability Service.

Although the progress report is dated 25 January, a DWP spokeswoman insisted that the decision to dump the sanctions trial had been taken before the appointment of Esther McVey as the new work and pensions secretary on 8 January.

She said: “The decision not to undertake a trial was taken at the end of 2017 – before Esther McVey took up her position as secretary of state.

“As you have read, introducing the trial through legislative change cannot be secured within a reasonable timescale.

“But we are keeping the spirit of the recommendation in mind in our thinking around future sanctions policy.

“To keep the sanctions system clear, fair and effective we keep the policies and processes under continuous review.”

Last October’s decision to trial handing out warnings had been seen as a sign that years of campaigning by disabled activists and anti-austerity protesters aimed at raising awareness of the harshness of the sanctions regime might finally be paying off.

It had come only weeks after the UN’s committee on the rights of persons with disabilities made sweeping criticisms of the UK government’s welfare reforms.

The UN committee had called on the government to review “the conditionality and sanction regimes” linked to employment and support allowance, the out-of-work disability benefit, and “tackle the negative consequences on the mental health and situation” of disabled people.

David Gauke, at the time the work and pensions secretary, admitted at his party’s annual conference last October that sanctions often fail to work and can instead cause harm to claimants, particularly those with mental health conditions.

He promised then to try to find a way to make the sanctions system less damaging to people with mental health conditions, and the announcement of the trial soon afterwards appeared to demonstrate his department’s commitment.

But that commitment is now being questioned, following McVey’s appointment as his successor.

Among the victims of the sanctions regime was David Clapson, who had diabetes, and died in July 2013 as a result of an acute lack of insulin, three weeks after having his jobseeker’s allowance sanctioned.

Because he had no money, he couldn’t afford to pay for electricity that would have kept the fridge where he kept his insulin working, in the height of summer, and he had also run out of food.

An autopsy held after his death found his stomach was empty, and the only food left in his flat in Stevenage was six tea bags, a tin of soup and an out-of-date can of sardines. He had just £3.44 left in his bank account.

But despite the circumstances of his death, and clear links with the sanctions system, no inquest was ever held, even though DWP admitted that it knew he was insulin-dependent.

The DWP spokeswoman said: “It’s right that we encourage claimants to do everything they can to prepare for, or find, work in return for benefits.

“We are committed to tailoring the support that we give and any conditionality requirements to the specific circumstances of individual.

“Sanctions are only ever used in a small minority of cases, and people are given every opportunity to explain why they haven’t met a requirement before a decision is made.”

Linda Burnip, a co-founder of Disabled People Against Cuts, said: “It comes as little surprise to us that DWP has used the feeblist of excuses not to trial a gentler approach to imposing sanctions on disabled people.

“How anyone can describe this abominable system as ‘clear and fair’ is beyond my comprehension.

“To say that ‘sanctions are only ever used in a small minority of cases, and people are given every opportunity to explain why they haven’t met a requirement before a decision is made’ can hardly explain the 600 per cent rise in sanctions handed out to people with mental health conditions in 2015, and is a blatant lie.

“Given Gauke’s acceptance that sanctions are harmful it is unproven, but seems likely, that this change is directly linked to the return of Esther McVey as a DWP minister.”

A PAC spokesman said: “The committee has not yet considered its course of action.”

15 February 2018

 

 

The PIP Files: Senior MP to write to minister over ‘devastating’ revelations

A senior opposition MP is to write to the minister for disabled people to ask how she plans to penalise government contractors Atos and Capita, following last week’s “devastating” revelations about their “shocking” failings in delivering disability benefit assessments.

Stephen Lloyd, the work and pensions spokesman for the Liberal Democrats, said last week’s revelations by Disability News Service (DNS) were “utterly devastating” and raised “serious questions” over the performance of the two outsourcing giants.

Last week, DNS ran three stories revealing fresh evidence of failings by Atos and Capita in how they deliver assessments for personal independence payment (PIP) across England, Wales and Scotland.

The reports were based on data released to campaigner John Slater by the Department for Work and Pensions (DWP) under freedom of information laws, as well as analysis by Disabled People Against Cuts researcher Anita Bellows and DNS.

The data included management information (MI) provided by Capita and Atos, showing how they had performed in meeting certain contractual requirements set by DWP while delivering PIP assessments during 2016.

One story revealed how Atos and Capita had been failing to request the vital “further medical evidence” (FME) from GPs, consultants and social workers that would help disabled people secure the PIP they were entitled to.

Another described how up to 180 PIP assessors – mostly from Atos – were the subject of at least four complaints each from PIP claimants in three-month periods in 2016.

And the third story showed how nearly one in three PIP assessment reports completed by Capita between April and December 2016 were significantly flawed.

Lloyd highlighted the “shocking failure in not securing medical evidence from claimants’ GPs, which they’re supposed to do under the terms of their DWP contract”.

He said: “The scale of failures on all these are frankly unbelievable, proof, were it needed, that my call to strip the assessment contracts from both Atos and Capita and bring the whole regime in-house as a public service needs to happen sooner rather than later, before even more damage is done to disabled people’s lives.

“Why should tax-payers continue to enrich these two companies on the backs of disabled people?”

He said the DNS reports showed that the service disabled people were receiving was “simply sub-standard if not actually downright illegal”.

He added: “I will be writing to the disabilities minister, Sarah Newton, to ask how the DWP proposes to penalise both Atos and Capita in the light of these clear contractual breaches.”

Labour’s shadow minister for disabled people, Marsha de Cordova, said the issues raised in the three stories last week were “very consistent” with her own concerns.

She said: “Poor contract management feeds poor practice, as the contracted assessors draw the lesson that poor performance will not too greatly trouble the client (the DWP).

“This in turn leads to poor decisions, as assessments are generally rubber-stamped by DWP decision-makers and then, if challenged by the claimant, rubber-stamped again at ‘mandatory reconsideration’ stage.”

Although decisions can be corrected at appeal tribunals, she said, many claimants will not appeal because they “do not realise there is a problem or they cannot face the struggle”.

She said the DNS reports, together with this week’s damning report by the Commons work and pensions committee (see separate stories), criticisms made by the senior president of tribunals and “the stream of complaints from disabled people and disability organisations”, should mean the government finally “admits that the game is up and ‘business as usual’ (when the fuss dies down) is not an option”.

She added: “We must make sure that the fuss doesn’t die down and insist on detailed plans for change – plans that centrally involve disabled people.”

Slater has this week sent a link to the data to the work and pensions committee, as it was preparing to publish its report into the PIP and employment and support allowance (ESA) assessment systems.

The committee has promised to continue to investigate flaws in the PIP and ESA systems.

Meanwhile, neither Capita nor DWP has been willing to comment on figures which appear to show that Capita’s failings on FME became even more serious last year.

The figures, released to the SNP’s Drew Hendry by Newton earlier this month, showed the number of individual requests for FME by Capita fell from about 94,000 in 2015, to 48,000 in 2016 and then dropped below 21,000 last year.

Asked why FME requests had fallen so drastically between 2015 and 2017, a Capita spokeswoman said: “Each case is considered on an individual basis and we will request further evidence where it is necessary and appropriate, taking into account the information that has already been provided.”

Asked if this showed that Capita had been cutting corners in fulfilling the PIP assessment contract, she said: “No. We are fully committed to delivering a high quality service for people applying for PIP.”

Last week, Capita said: “Individuals are encouraged to provide further evidence to the Department for Work and Pensions when starting their PIP claim and this, along with our assessment report, is taken into consideration alongside all other evidence when the DWP, not Capita, makes the decision about the level and length of award.”

But Bellows said: “Capita’s response does not make sense. How does that explain the huge drop in FME requests, from over 6​0 per cent to two per cent within a few months?

“Did all claimants, in all regions, and in the same proportion decide at the same time to produce the medical evidence necessary for Capita to give an opinion and for DWP to decide on a PIP claim?

“The likelihood of this happening is close to zero.”

She said the downward trend was confirmed by the 2017 figures released by Newton to Drew Hendry.

DWP declined to say why the Capita numbers had continued to fall and were so low last year; whether this showed Capita had been cutting corners; and whether it was concerned by the figures.

But a DWP spokeswoman said in a statement: “As we explained last week, it is not always necessary to seek further medical evidence to assess an individual’s eligibility for PIP.

“In the vast majority of cases, the evidence provided by the claimant on their PIP application form, the evidence claimants send in to support their claim and the evidence provided during their assessment is sufficient for DWP to make a decision.

“As Paul Gray pointed out, primary onus of responsibility for providing functional evidence should lie with the claimant.

“They are in the best position to supply what evidence is available.”

But Gray, DWP’s own independent reviewer of PIP, also said that DWP and its providers “should also be proactive in gathering Further Evidence where they identify sources that are relevant and reliable”.

And this week’s work and pensions committee’s report reveals that Maximus – which carries out ESA assessments – requests FME in up to 46 per cent of cases each year.

DWP documents drawn up in May 2012, before the award of the PIP contracts, show the department expected its contractors would need to request FME in about half of all PIP cases.

In DWP’s own PIP handbook, it says: “The face-to-face consultation will be conducted by a health professional who considers the evidence provided by the claimant, along with any further evidence they think is needed.”

And in DWP’s PIP Assessment Guide, it makes clear that, in order for a report to be graded as “acceptable”, the assessor must ensure that “sufficient further evidence” has been “appropriately sought and referenced”.

Slater said: “I’m delighted that the previous stories have generated so much interest and that people can now start to have discussions about what’s actually going on with PIP.

“I hope the MI data will help organisations like the work and pensions committee to hold the DWP to account.”

He added: “I’m very disappointed that the DWP hasn’t responded to me about what appears to be incomplete disclosure of the PIP MI data and I am pursuing the matter via the information commissioner.”

15 February 2018

 

 

Watchdog begins probe into failure of regulators to punish lying PIP assessors

A watchdog is examining the failure of two healthcare regulators to punish nurses, paramedics and physiotherapists who write dishonest benefit assessment reports.

The Professional Standards Authority (PSA) is looking at concerns about the way regulators deal with complaints about nurses, physiotherapists and paramedics who carry out personal independence payment (PIP) assessments on behalf of the outsourcing giants Capita and Atos.

About 300 disabled people have come forward over the last year to tell Disability News Service (DNS) how assessors working for Atos and Capita wrote dishonest PIP assessment reports, on behalf of the Department for Work and Pensions (DWP).

Many raised concerns about the apparent refusal of the Health and Care Professions Council (HCPC) and the Nursing and Midwifery Council (NMC) to take their complaints seriously.

Now PSA has told DNS that it has begun to examine how the regulators deal with those complaints.

Among the evidence it will be considering are last week’s DNS reports on data released by DWP to campaigner John Slater under freedom of information laws, which included figures that showed that up to 180 PIP assessors had been the subject of at least four complaints each in three-month periods in 2016.

It comes as the Commons work and pensions select committee published its findings into the assessment processes for both PIP and employment and support allowance, the out-of-work disability benefit.

But the committee’s report failed to address the issue of regulators who neglect to hold dishonest assessors to account.

David Martin, PSA’s concerns and appointments officer, said: “We recognised that there is concern amongst members of the public with the role played by healthcare professionals in the PIP assessment process and about the response of regulators to the complaints they receive about them.

“We have therefore initiated a discussion with the regulators to find out more about their approach to the concerns they receive.”

He added: “We wrote to the regulators in mid-January asking them to tell us about their experience of the issue and their approach to it.

“We are hoping to explore if there are any specific difficulties the regulators face when considering these cases.

“We also want to explore with them if the PIP assessment process presents challenges to professionalism that may require the regulators to produce guidance for their registrants.”

Martin said PSA would “consider all the feedback we receive”, and that PIP claimants with evidence about how NMC and HCPC had dealt with complaints about assessors could contact his organisation through its website.

PSA, which is accountable to parliament, is responsible for overseeing nine UK healthcare regulators, including HCPC and NMC.

Martin stressed that PSA was not itself a regulator and has no powers to direct NMC or HCPC “to take a particular approach”, and he said it could not investigate individual cases on behalf of individuals.

He said: “Our role is to report on the regulator’s performance and identify areas where they can improve.

“We do work closely with them to improve professional regulation and we anticipate they will want to address this issue positively with us.”

PSA was contacted last year by disabled activist Mark Lucas, who has twice appealed successfully against the results of what he believes were dishonest PIP assessments.

He has lodged a complaint with HCPC over its failure to discipline an occupational therapist who assessed him for PIP.

Lucas has twice been given zero points after PIP assessments, but on both occasions was later awarded nine points – and eligibility for the PIP standard daily living rate – after appealing to a tribunal.

Frustrated at HCPC’s failure to take his complaint seriously, he contacted PSA.

PSA has the power to look at individual cases that have not been dealt with properly, and potentially refer them to the high court – but only if they reached a full HCPC or NMC fitness to practise hearing, which they rarely do – but also to look at wider problems with the regulators in particular areas, such as how they deal with complaints about PIP assessors.

Lucas believes DWP has been using HCPC and NMC to help “legitimise bad medical assessments”, and that the two regulators are failing to take the action necessary over nurses, physiotherapists and other healthcare professionals who lie in their assessment reports.

He welcomed PSA’s decision to begin an investigation but said he had hoped the watchdog would have issued a public call for information about dishonest assessors and announce a wider inquiry than simply contacting the two regulators.

He said: “The PSA have the power to refer individual cases to the high court, but will they use that power?

“I suspect if they do it will be a long drawn out affair and probably too late to have any real effect.”

He said he believed that embarrassing and shaming NMC and HCPC were now “probably the most effective weapons we have”.

An HCPC spokeswoman said: “We can confirm we have received the PSA’s request for further information on our approach to this issue. We will be responding to them directly.”

NMC had not commented by noon today (Thursday).

15 February 2018

 

 

Motability row sparks anger and demand to use huge reserves to support customers

Disabled campaigners have reacted to the political row over the Motability car scheme by calling for the organisation that runs it to use part of its huge financial reserves to increase support for disabled people.

Details emerged in a newspaper last week of the “grotesque” levels of pay and bonuses awarded to senior executives of Motability Operations (MO), the company that runs the scheme on behalf of the Motability charity*, and its reserves of £2.4 billion.

A series of investigations and inquiries have now either been requested or launched by MPs and work and pensions secretary Esther McVey.

The Commons work and pensions committee and the Treasury committee have announced a joint inquiry, with an evidence session likely to take place on 5 March.

But McVey has also asked the National Audit Office (NAO) to consider an investigation, while the Treasury committee has asked the Financial Conduct Authority (FCA) if there are “any issues relating to Motability that have required investigation in recent times”.

The Charity Commission has also been asked for its opinion.

Last year, it reviewed the charity’s financial accounts and its relationship with MO.

It said in a statement: “That review did not identify regulatory concerns about the charity’s governance or its relationship with the commercial company.

“It is not for the commission to comment on the pay of the CEO of a large non-charitable commercial company.

“However, we have made clear to the trustees of the charity Motability that the pay of the CEO of its commercial partner Motability Operations may be considered excessive and may raise reputational issues for the charity.

“These reputational issues are for the trustees to manage.”

It also said that it had viewed the level of reserves held by MO to be “cautious” and that it had “agreed with the charity, as part of its oversight of the scheme, that it would ensure that this matter is kept under continuous review”.

McVey told MPs that she believed the Charity Commission should carry out another review of the financial relationship between the Motability charity and Motability Operations.

She told MPs that, when minister for disabled people in 2013, she had persuaded MO to use some of its reserves to pay for “transitional support”.

This appears to refer to the announcement made by Motability in October 2013 that it would hand £2,000 to disabled people who had their vehicle taken away after being reassessed for the government’s new personal independence payment (PIP).

PIP was introduced by McVey when she was minister for disabled people in April 2013 and led to tens of thousands of people losing their Motability vehicles, with figures last year suggesting that about 900 customers every week were having to return their cars.

McVey told MPs: “Motability was set up 40 years ago, with cross-party support. It has done much good in that time, but today, anybody who looked at the size of the reserves and pay packages would question the direction that Motability has taken in allowing that to happen.”

Labour MP John Mann, who had raised the issue in parliament, called on McVey to order an urgent review, and he described the levels of reserves and executive pay as “grotesque”.

Labour’s shadow employment minister, Margaret Greenwood, said: “The news that the chief executive of Motability Operations Group plc [Mike Betts] took home £1.7 million last year and that the group is sitting on reserves of £2.4 billion has shocked people around the country.

“Particularly shocked are disabled people, 51,000 of whom, according to Motability’s own figures, lost access to the scheme last year after being reassessed for their personal independence payment.

“More than 3,000 were reinstated on appeal, but many lost their car in the meantime.”

Disabled activists have this week raised concerns about the size of MO’s reserves and its executive pay.

Ian Jones, co-founder of the WOWcampaign, said: “Motability CEO Mike Betts seems to think it is OK to overcharge disabled people for the provision of cars, vans and wheelchairs that keep them mobile and independent whilst building up billion pound cash surpluses and other fixed asset reserves that should be used to help disabled people now, not deferred until some point in the future.

“The WOWcampaign would welcome a forensic review of all related Motability companies and their relationship with their contractors, as the group and commercial structure appears to be designed to be as opaque as possible.

“Surely disabled people should be assured that the charity set up to help them stay mobile and the plc that the charity subcontracted the day-to-day operations of the scheme to, are not ripping them off, because the surpluses being stored away by ‘Motability’ come out of the pockets of disabled people.”

Linda Burnip, co-founder of Disabled People Against Cuts, said: “None of this is anything new of course and John Mann brings these facts up year after year.

“I think the £2.4 billion is actually a massive amount to have and far more than is needed as a reserve to safeguard the scheme.

“It could be used in a variety of ways to help disabled people, for example, by scrapping the contentious rule that you must be in work, volunteering outside the home or in education [or caring] for 12 hours a week before you can qualify for a grant [for a drive-from-wheelchair vehicle], more help with grants generally, especially for wheelchair-accessible vehicles, and more help while people are waiting for a PIP appeal.”

Disabled Labour councillor Wayne Blackburn, from Pendle, said on Twitter that the scheme was “a lifeline for people with mobility issues – myself included – and it’s important that we ensure funds are being used properly and in benefit of disabled people”.

There was also anger on social media.

One disabled campaigner, @HovellingHermit, said: “This is a disgrace, they should be using the billions to reduce the payments being made by the disabled who need those cars to not just get to work or to study, but to hospitals, the shopping etc. They aren’t a luxury. Disgusted with #Motability.”

Another, Andrea Burns, tweeting at @Airheadange, said she was “speechless” and “disgusted” by the revelations, and that she had been forced to rely on “family and loans to keep independent” because it would have been “unaffordable” to secure the vehicle she needed through Motability.

But Helen Dolphin, a member of the Disabled Persons Transport Advisory Committee (DPTAC) [but not speaking on behalf of DPTAC] and an independent mobility consultant, said she believed MO was well-run and that the level of reserves was necessary because of the market for used cars, which “can fluctuate enormously”.

Dolphin, who also runs the People’s Parking carpark accreditation scheme, said the salary paid to Betts was a result of “market forces”.

She said: “We would all like to be paid that, but we don’t run companies with thousands of members of staff and have all the things he has to deal with.”

She said the way the scheme had been run before Betts took over had been “a bit shoddy” and that he had “helped to turn it around”.

She said: “As a disabled person, all I want is a scheme that runs properly.”

Dolphin said that one of her biggest criticisms previously had been that the scheme had not done enough to fund adaptations for disabled people with high support needs.

She said: “They have done a lot in the past few years to fund a lot of standard adaptations, to provide grants for people who need bigger cars. A lot has been done to balance it out a bit.

“I think it’s well run. I don’t believe they would deliberately withhold that money if they didn’t need to.”

A Motability spokesman said last night (Wednesday): “You will not be surprised that we found the litany of inaccuracies in the exchanges in parliament last Thursday deeply troubling.

“The urgent question raised by John Mann MP, no doubt prompted by the earlier article in the Daily Mail, was in itself perfectly reasonable.

“However, because so many of the statements which followed in the parliamentary exchanges were, quite simply, untrue, the debate as a whole was deeply flawed and misleading.

“We will be writing to the secretary of state, and others who participated in the debate, refuting every single inaccuracy.”

The charity had said earlier: “Founded in 1977, Motability has always embraced public accountability and transparency, so we warmly welcome a NAO review and any wider scrutiny from parliament – as we did when the Charity Commission undertook a full review of the scheme last year.”

Motability Operations, which is owned by a group of UK banks, has insisted that its reserves of £2.4 billion are not held in cash but are “entirely invested in its fleet of around 630,000 cars”, which “protects the business against risk, notably in relation to price volatility in the used car market”.

It said that its executives are “paid for performance, according to targets set by the board and agreed with shareholders”.

*The Motability charity is a Disability News Service subscriber

15 February 2018

 

 

Deaf chief executive wins right to challenge Access to Work cap in court

A Deaf chief executive has won the right to question the government’s “discriminatory” cap on Access to Work (AtW) payments in the high court, in the latest legal challenge to the Department for Work and Pensions’ (DWP) disability policy agenda.

David Buxton, chief executive of Action on Disability in London, is one of many British Sign Language (BSL)-users who have been hit by the imposition of the cap on payments made by the AtW scheme, which provides disabled people with funding to pay for some of the extra disability-related expenses they face at work.

Now the high court has ruled that Buxton’s legal challenge can go ahead, with his lawyers set to argue – under the Equality Act 2010 – that the cap breached the public sector equality duty and subjected him to indirect discrimination.

His judicial review case is being funded by the Equality and Human Rights Commission.

It comes just weeks after another legal challenge forced work and pensions ministers into a climbdown over new personal independence payment rules that were found by the high court to be unlawful and “blatantly discriminatory”.

And earlier this month, a terminally-ill man, TP, won permission for a judicial review of the financial impact of the introduction of universal credit on disabled people with high support needs, through the loss of the severe disability premium and enhanced disability premium.

Disability News Service reported last year how Buxton had been told that AtW would only provide him with enough support to pay for interpreters three days every week.

He began his full-time job in London in May, and was immediately hit by the cap, which was introduced for new AtW claimants in 2015 and is due to affect existing claimants from April this year.

Less than three months ago, the government launched its 10-year work, health and disability strategy, which aims to increase the number of disabled people in work by one million by 2027.

But campaigners believe that the AtW cap, which currently limits the annual support that individuals can be awarded under the scheme to £42,100 a year, has had a disproportionate impact on the job and career prospects of Deaf BSL-users and disabled people with high support needs.

They say it places them at a disadvantage in the workplace, effectively removing employment support from those with the most complex needs and placing them at a disadvantage when trying to get into, stay in and get on in paid work.

Buxton said: “As a chief executive, it cannot be right that my career is impacted by limiting my language and communication needs because I am Deaf and use BSL.

“There is some way to go yet but the support from the Equality and Human Rights Commission and my legal team are signs that this is a case which could challenge and change existing practices, decisions and future provision.”

Buxton’s case is being supported by Inclusion London’s Disability Justice Project, and the StopChanges2AtW campaign.

Ellen Clifford, Inclusion London’s campaigns and policy manager, said: “We’re pleased that permission for judicial review has been granted as we see the cap as clear discrimination, effectively barring people with certain impairments from the same employment opportunities as others.

“We hope that the case will be heard as soon as possible because Deaf and disabled people are already suffering under the impact of the cap, with Access to Work writing to ask to meet with employers to look at what aspects of a person’s job can be taken away to meet the reductions in support.

“However, the cap is only one aspect of the many current failings with Access to Work.

“Limits to individual awards, hostile questioning by advisors, and financial and administrative errors on an alarming scale are all adversely impacting on thousands of Deaf and disabled people and the interpreters and personal assistants we employ on a daily basis.

“It’s a scandal that would have received much more attention had the government not at the same time been denying disabled people’s basic human rights through benefit cuts and the social care crisis.”

Buxton’s solicitor, Anne-Marie Jolly, from Deighton Pierce Glynn, said: “Mr Buxton’s claim makes the case that the Access to Work cap discriminates against Deaf and disabled people and fails to take account of the impact on them of such a regressive move.

“The cap perversely impacts on those with the most demanding jobs and highest support needs, the overwhelming majority of whom are Deaf BSL-users, preventing them and their employers or businesses from reaching their fullest potential.”

Research commissioned by Inclusion London, and published in October, described AtW as “a cornerstone of the movement for equality and civil rights for Deaf and disabled people in the UK” but found that the future of the AtW scheme was in jeopardy because of “bureaucratic incompetence” and a cost-cutting drive to reduce people’s support packages.

DWP said it could not comment on an ongoing legal case.

15 February 2018

 

 

Legal advice concerns after government abandons search for new contractors

Lawyers and campaigners have raised fresh concerns about the government’s approach to providing legal advice to people who need help with discrimination and special educational needs (SEN) cases, after ministers abandoned efforts to award new contracts in those areas.

The Ministry of Justice (MoJ) had been seeking organisations to take on contracts to provide advice from 1 September on discrimination and education cases through the Civil Legal Advice (CLA) service.

But it has now announced that it has abandoned those efforts because there were not enough “compliant” bids from organisations seeking the new contracts.

There are now fears that the government’s difficulty in finding organisations willing to take on the CLA services from September could make it even harder for disabled people to secure the legal advice they need.

Following the passing of the Legal Aid, Sentencing and Punishment of Offenders Act (LASPO) in 2013, it became possible to seek government-funded advice and assistance on discrimination and SEN issues only through the CLA telephone “gateway”.

But campaigners say the introduction of the telephone gateway has had a dramatic negative impact on the ability of disabled people – such as those with communication-related impairments, mental health conditions or learning difficulties – to access legal advice and support.

Jeanine Blamires, who gave evidence two years ago to the House of Lords Equality Act 2010 and disability committee about barriers to justice caused by the government’s legal aid reforms, said this week that she believed CLA was “chronically underfunded and from personal experience struggles to meet disabled needs regarding reasonable adjustments”.

She said: “I did not receive any reasonable adjustments to access the telephone helpline, making access to the specialist support ineffective and practically impossible.

“I asked for reasonable adjustments several times; I was not listened to.”

She said that the reforms to legal aid “look like the final piece in the removal of access to justice for disabled people, and that should scare everyone”.

The Equality and Human Rights Commission (EHRC) has previously raised concerns about the impact of the telephone gateway on disabled people’s access to justice.

And it told the UN’s special rapporteur on the rights of persons with disabilities in 2015 that it considered the reforms to legal aid in LASPO “raise issues for the protection and promotion of disabled people’s substantive rights” under the UN disability convention and “undermine access to redress in relation to these rights”.

Rebecca Hilsenrath, EHRC’s chief executive, said: “Cancelling the procurement process is an opportunity for the government to reconsider their approach to Civil Legal Advice services.

“Our disability report, Being Disabled in Britain, found that telephone advice can be an inappropriate means for accessing information, especially for those who struggle to communicate over the telephone.

“This is an opportunity for the government to listen to stakeholders and ensure any new provisions address these concerns, remove barriers and ensure appropriate access to advice, and therefore to justice, to those who seek it.”

Although the government has promised that reasonable adjustments will be made for disabled people seeking to use the telephone gateway, research by the Public Law Project (PLP) has suggested that it has been a “barrier to access to justice”.

It points out that Legal Aid Agency figures published late last year show that the numbers of people receiving face-to-face advice through the gateway in discrimination cases had fallen to zero in 2016-17, with only one education case.

In a statement, PLP said: “We would suggest it is time for the Ministry of Justice to recognise that the ‘gateway’ and associated services do not deliver access to justice or value for money.

“Our strongly held view is that the MoJ should abandon the mandatory telephone gateway for these areas of law.”

A Legal Aid Agency (LAA) spokesman said: “The LAA is cancelling the procurement process being run specifically for CLA education and discrimination services from 1 September, following receipt of insufficient compliant tenders.

“We have advised affected organisations of this decision.

“We are putting plans in place to ensure continued provision after 1 September, and will set [out] our approach shortly.”

The Ministry of Justice claims that the vast majority of discrimination cases have been progressed effectively through the mandatory gateway since its introduction in 2013.

It believes that the gateway offers the same level of service as face-to-face advice, while also benefiting from extended opening hours, while any client who needs face-to-face support will always be offered it.

And it claims that the figures showing that the number of people receiving face-to-face advice through the gateway in discrimination cases had fallen to zero in 2016-17 proves that this “remote access” is working.

15 February 2018

 

 

Anger over Royal Society’s ‘love fest for euthanasia’ conference

Disabled activists have attacked the Royal Society of Medicine (RSM) for hosting a conference on “choice at the end of life” that was little more than a “love fest for euthanasia”.

RSM said before the event that the conference would “question whether or not assisted dying is complementary or contradictory to the notion of person-centred care”.

But speakers in favour of legalising assisted suicide far outnumbered those who opposed a change in the law.

One of those behind the conference, Professor Roger Kirby, who chairs RSM’s academic board, told the audience that the idea for organising it came to him after reading an article written by the husband of a terminally-ill woman who travelled to the Dignitas clinic in Switzerland to take her own life.

The other senior medical figure who helped organise the event, he said, was Professor Gillian Leng, deputy chief executive of the National Institute for Health and Care Excellence (NICE), whose terminally-ill husband, Professor Paul Cosford, told the conference that he was in favour of a change in the law*.

Professor Cosford, who has incurable cancer, and is patient and medical director for Public Health England, suggested that having choice at the end of life should include the option of an assisted suicide.

He told the conference: “I cannot predict how I will die but I can focus on living well now if I know that I would have some kind of control at the time if I need it.”

He added: “To enable choice at the end of life, taking account of individual care needs, may well need a change in approach.

“I do think that might include [the option of] assisted dying.”

He was followed by two further speakers who were in favour of legalisation: Tony Wicks, whose wife ended her life at Dignitas; and Julie Smith, whose husband had been prevented from travelling to Switzerland to end his life at the clinic.

The first three speakers were all supportive of legalising assisted suicide, while the fourth, an assistant coroner, expressed no opinion.

The next speaker was Dr Catherine Sonquist Forest, a strong advocate of legalisation, who takes part in the practice of assisted suicide in California – where it is called “medical aid-in-dying” – where it was legalised in June 2016.

The conference did not hear from an opponent of legalisation until the sixth speaker, Juliet Marlow, from Not Dead Yet UK (NDY UK), who had only been added to the list of speakers after NDY UK raised concerns at not being invited to speak at the event.

She told the conference that legalised assisted suicide would “negatively affect the relationship between disabled people and society”, and she warned of the risk of people being “slowly” coerced into agreeing to an assisted suicide.

She said there was not one user-led disabled people’s organisation that supported legalising assisted suicide.

Instead of legalisation, she said, “we need to call for better funded social care and palliative care; that’s what makes the difference between a good life and a bad life for disabled people and that is being slowly eroded by the current administration”.

The later sessions of the conference were less unbalanced, although still tilted towards those in favour of a change in the law.

Throughout the conference, there were frequent loud rounds of applause for speakers who called for a change in the law, while more than 30 people linked to the pro-assisted suicide organisation Dignity in Dying were on the list of conference attendees.

The conference in central London came just a day after the British Medical Journal (BMJ) again called for the law to be changed.

NDY UK said BMJ had “sought to hijack the debate and marginalise the views of terminally-ill and disabled people”, and it pointed out that the issue contained several articles backing a change in the law “but not a single one by a disabled or terminally-ill person fearful of a change in the law to permit assisted suicide”.

Marlow said after the conference that she felt that it had been organised to push the case for legalisation among the medical profession.

She said: “I felt very outnumbered, and I think the people attending had made up their minds already, and everything they are hearing is just confirming what they already believe.

“I am open to honest discussion with people about this, as is everyone in NDY UK, but I don’t think we are going to achieve anything by being here, sadly.”

She said she felt like “a token disabled person” at the conference, and she added: “I am only here because I asked to be here.”

Nikki Kenward, director of Distant Voices, another user-led campaign group which opposes euthanasia and assisted suicide, said the conference had been “like a love fest for euthanasia”.

She said she could not believe how tilted the conference had been in favour of those who wanted the law changed.

Kenward, who had spoken briefly from the audience during the event, said: “I don’t know how they got away with it.

“The decision by an organisation with the prominence of the RSM to effectively endorse the work of Dignity in Dying in hosting this biased conference is outrageous, naive and fundamentally insulting to disabled people.”

She said it “would have been more honest if the RSM had offered tickets to euthanasia supporters only instead of paying lip service to the opposing view”.

She added: “You cannot effectively endorse the idea that euthanasia is a positive outcome to combatting terminal illness and disability without expecting those who live lives worth living not to react with anger and disdain.

“Disabled people will not allow such endorsements to go unchallenged.”

Roger Symes, an NDY UK member who attended the conference, has complained to RSM over what he believes was a “deliberately biased” event that was “unworthy of the RSM”.

Symes, who is married to the disabled crossbench peer and NDY UK co-founder Baroness [Jane] Campbell, told DNS that he was “alarmed by the bias displayed at the RSM event”.

He said: “I think it shows that NDY UK was right to express concern beforehand. Our presence was clearly resented.

“Going to the RSM I expected a high level of rigour to the debate, but it was only when Baroness Finlay [a professor of palliative medicine, and opponent of legalisation] spoke that I appreciated how much that had been missing from the rest of the day.

“She quoted numerous references to published studies, something which was almost entirely missing from most of the other medical presentations.

“I can only think that RSM was duped into believing that everyone is ‘DyingForChoice’ (as per their hashtag) and that jumping on the bandwagon was the right thing to do.

“Making the ‘choice’ of assisted suicide only available to terminally-ill and disabled people is discrimination.

“It is saying that whilst society will continue to strive to prevent suicides in the rest of the population, it is willing to collude in the suicides of terminally-ill and disabled people.”

An RSM spokeswoman refused to say if the organisation accepted that the conference was biased in favour of legalisation, and whether it should apologise.

But she said in a statement: “The RSM team worked extremely hard to provide an environment where different points of view could be voiced and listened to.

“While providing a forum for discussion of the important issues surrounding end of life care, the RSM remains firmly committed to its independence.

“The society does not and will not campaign for a change in the law on assisted suicide.

“Note that we do not check the views of delegates before we offer them a place. RSM events are open to all who want to book a place and bookings are carried out on a strictly ‘first come, first served’ basis.

“All delegates to RSM meetings are invited to give feedback. This allows us to evaluate our events and learn from our delegates’ experience.

“We will feed our learning about Friday’s event into programme development and the chairing of sessions for future meetings of this type.”

*Professor Cosford has asked DNS to point out that although his comments at the conference may have given the impression that he supports a change in the law, in fact he is undecided on the issue. He feels that reducing the issue to simply being one between whether the law should change misses the deeper point that we all need to face up to our own mortality and consider how we ensure a genuinely personal approach to health care at the end of life.

15 February 2018

 

15 February 2018

 

News provided by John Pring at www.disabilitynewsservice.com