Stephen Carré scandal: DWP ‘finds’ draft report that was never sent to coroner

The Department for Work and Pensions (DWP) has unearthed a “draft” report that ministers failed to send to a coroner six years ago, following concerns he raised about a suicide linked to flaws in the “fitness for work” test.
The draft report has finally emerged more than three months after Disability News Service (DNS) started questioning why DWP appeared to have failed to respond to a Rule 43 letter about the death of 41-year-old Stephen Carré in January 2010.
That letter, sent to DWP by coroner Tom Osborne on 30 March 2010, linked the suicide with serious flaws* in how the work capability assessment (WCA) was used to test the eligibility of people with mental health conditions for out-of-work disability benefits.
But letters from Osborne to DWP and the family of Stephen Carré show that ministers never produced an official response to the Rule 43 letter, as they were legally obliged to do.
Now DWP has finally admitted that it did exchange letters with Osborne during the summer of 2010, and even produced a “draft final response” to his letter in September 2010.
But the department has also admitted that it cannot prove that it sent this final response to Osborne.
Instead, a DWP spokeswoman claimed that colleagues had now found “a draft response that we meant to send back to the coroner” in 2010.
She said this draft response had now been sent to the coroner “for the avoidance of doubt and for completeness”.
She added: “Because we can’t confirm that it was sent [in 2010] and we can’t confirm that the coroner received it, for the avoidance of doubt we have sent the original draft.”
The existence of the draft report – and the admission that DWP cannot prove it was ever sent to the coroner – should raise serious questions about the political future of work and pensions secretary Iain Duncan Smith and former employment minister Chris Grayling.
They made key decisions in the summer of 2010 about the WCA process that Osborne had linked to Stephen Carré’s death*.
Among those decision was that they would roll out the WCA to hundreds of thousands of long-term claimants of incapacity benefit (IB) the following year.
They also failed to show the Rule 43 letter to Professor Malcolm Harrington, even though they had commissioned him to review the “fairness and effectiveness” of the WCA.
The following year, in December 2011, a long-term IB claimant – Ms D E – took her own life after being told she was not eligible for ESA, a death later linked by the Mental Welfare Commission for Scotland to similar WCA failings to those that led to Stephen Carré’s death.
And in 2014, another coroner wrote an almost identical letter to Osborne’s, again warning of concerns about the safety of the WCA, after the death of a north London man, Michael O’Sullivan, who also took his own life after being found fit for work.
DWP this week claimed that it was unable to confirm that Duncan Smith and Grayling were shown Osborne’s Rule 43 letter – and their department’s draft final response – in 2010.
The DWP press office has also been unable to say whether the draft final response has now been shown to Duncan Smith and his current employment minister, Priti Patel, and his disabled people’s minister, Justin Tomlinson.
Last November, government-funded research concluded that the programme to reassess people claiming IB using the WCA could have caused 590 suicides in just three years.
DNS has been asking DWP about the Rule 43 letter since being shown a letter from Osborne to the Carré family in October 2010 in which he said that DWP had failed to provide a “substantive response” to his letter, despite its legal duty to do so within 56 days of receiving it in early April 2010.
At the time the letter was received, DWP was headed by Labour’s Yvette Cooper, but a general election was called within days, and Duncan Smith replaced her as work and pensions secretary in May 2010 after the formation of the coalition government.
*Osborne ruled that the trigger for Stephen Carré’s suicide had been DWP’s rejection of his appeal against being found “fit for work”, and he called in his Rule 43 letter for a review of the policy not to seek medical evidence from a GP or psychiatrist if the claimant has a mental health condition.
Neither the Atos assessor who assessed Stephen Carré, from Eaton Bray, Bedfordshire, nor the DWP decision-maker who subsequently decided that he was fit for work and therefore ineligible for the new employment and support allowance, had sought information from his GP, his community psychiatric nurse or his psychiatrist.
18 February 2016

Ministers withdraw support from their own disability network

Ministers have withdrawn much of their support for a disability network they set up just three years ago, casting fresh doubts on the government’s disability strategy and the future of the Office for Disability Issues (ODI).
ODI announced this week that it would no longer provide the four part-time members of staff who run the secretariat for the Disability Action Alliance (DAA), and would instead hand a one-year grant of £69,500 to the user-led charity Disability Rights UK (DRUK) to run the network.
DAA was set up specifically to create partnerships between disabled people’s organisations (DPOs), government departments and other public, private and third society organisations.
The move to end ODI’s involvement with the secretariat – which civil servants have described as a cost-cutting measure – raises questions about the government’s commitment to its Fulfilling Potential disability strategy, and even about ODI’s continuing existence.
Last year, doubts were raised about ODI’s future when the Department for Work and Pensions (DWP) claimed it was unable to calculate how much of its budget had been cut since 2012.
The majority of DAA’s 400-plus members are not user-led organisations, but a significant number are, including the British Deaf Association, Disability Equality (North West), Disability Wales, Equalities National Council, Inclusion Scotland and Shaping Our Lives.
Andy Rickell, a member of the DAA steering group, and until last month chief executive of Action on Disability and Work UK (ADWUK)*, said ODI had explained that the decision to cease secretariat support was because of the need for “further budgetary savings”.
He said it was important to the DPOs that joined DAA that ODI remained involved in its work, and that there were “senior civil servants around the table that actually make the thing work”.
Rickell said DAA was “a means by which we can talk to the [civil servants] we need to talk to to make things happen, people who can get things done on a daily basis”, and was about developing practical projects rather than affecting government policy.
He said ODI had said it would still be involved in DAA, but he warned that “the proof of the pudding might well be in the eating”.
Before DAA, he said, DPOs involved in employment issues did not even know the names of the civil servants leading on disability employment issues for DWP.
Liz Sayce, chief executive of DRUK, insisted that steering group members – including Rickell – were “quite excited” about “taking the alliance out of government in order for DPOs (who form the majority on the steering group) with allies to take more control of how the alliance develops”.
She said: “However, we want ODI to remain involved in order to open doors to other government departments and public sector bodies. They state that they will do this.”
She said she was “not aware of ODI itself being at risk”, and added: “The DAA has shown that when DPOs and organisations from the public and private sector get together, this can generate tangible improvements.”
She pointed to the non-user-led English Federation of Disability Sport, which has “brokered new relationships with local DPOs which have linked more disabled people into opportunities for accessible physical activity”.
And she highlighted how in Blackpool, and nationally, “improvements have been made to transport services through inclusion of disabled people in training of bus drivers, train drivers, conductors and though the wider input of DPOs”.
She added: “The alliance acts in some ways as a matchmaker – putting people in touch with each other who can increase disabled people’s equality of participation.”
There was criticism from some DPULOs of the government’s decision to set up the new network three years ago, with fears that it could prove to be “tokenistic” and concerns over a lack of strategic thinking about what it would do.
As part of Fulfilling Potential, the government also set up the Fulfilling Potential Forum, a smaller network of disability organisations – a majority of which were DPOs – that was tasked with examining strategy across government, and providing a “community-based route into government” and a “route out to local disabled people”.
The forum and DAA were two of three bodies the government set up to replace Equality 2025, its high-level committee of disabled advisors, although it provided a collective budget of just £80,000 a year for the three new networks.
The third network, the Fulfilling Potential Policy Advice Service – a body of expert, independent advisers on disability – has since been scrapped by ministers.
But Sayce said: “The DAA has made a good start, achieving new collaborative projects both locally and nationally.
“We will be building on this through engaging the members of the DAA in deciding on top priorities for the next three years and enabling the wider membership to link up with each other more easily, to get most benefit from the alliance.”
DWP had not been able to comment by 11am today (18 February).
*On 1 February, ADWUK became part of West of England Centre for Inclusive Living
18 February 2016

Concerns after patient website is flooded with Whizz-Kidz five-star reviews

Industry figures have raised concerns about a healthcare ratings website that has allowed a wheelchair charity to submit a string of glowing reviews about its own services.
The Posture and Mobility Group and the National Wheelchair Managers Forum have sent a joint letter to the I Want Great Care (iWGC) website, raising concerns about its relationship with Whizz-Kidz.
iWGC claims that it provides patients with the opportunity to provide feedback about the care they receive from healthcare services such as GP practices, hospitals and pharmacies, that reviews posted on the site are “totally independent”, and that visitors “can be confident that comments have not been edited and represent true patient opinion”.
But some wheelchair services professionals point to the overwhelmingly positive reviews given to Tower Hamlets NHS wheelchair services, provided through a partnership between Whizz-Kidz and Mile End Hospital in east London, with review after review giving the service five stars, often in all three sections (recommend, involvement and equipment).
They highlight the arrangement by which Whizz-Kidz is allowed to collect reviews from its own Tower Hamlets service-users on paper and then send them to iWGC to be uploaded onto the site.
And they fear that the flood of positive reviews could be used by Whizz-Kidz as it bids to secure new NHS wheelchair services contracts.
A brief analysis of 135 reviews shows similar phrases that keep appearing in supposedly independent entries, such as “I cannot thank them enough”, “I cannot praise them enough”, “I really can’t thank you enough!”, “I cannot thank you enough”, “I cannot thank them enough” and “I cannot thanks them enough!!”.
But the most suspicious example came in the similarity between two reviews of the Tower Hamlets wheelchair service that were posted 11 days apart.
The first review, on 23 December – which has since been removed by iWGC – stated: “I was give a good decrper of what the weelchair was and was clearly given good intructon on how to use the chair and also what to do when using the chair in deffrent plasces. The staff were very frendly and undersand of my needs.”
Another review, posted on 4 January, is almost identical, except that the spelling mistakes have all been corrected.
It states: “I was given a good description of what the wheelchair was and was clearly given good instructions on how to use the chair and also what to do when using the chair in different places. The staff were very friendly and understood all of my needs.”
There are also concerns at the large batches of reviews that are uploaded after apparently being provided by Whizz-Kidz, with 10 posted by iWGC on 15 February 2016, 12 on 12 February 2016, 13 on 23 December 2015, and 12 on 30 November 2015.
And whereas by early this week the Tower Hamlets wheelchair service boasted 150 reviews, nearby Camden and Islington had attracted just one, while a wheelchair service in Roehampton had just two.
Sir Bert Massie, former chair of the Disability Rights Commission, and now chair of the Community Equipment Code of Practice Scheme (CECOPS), the UK’s independent standards body for disability equipment, wheelchair and seating services, said his organisation was concerned about the relationship between Whizz-Kidz and iWGC and whether the reviews of the Whizz-Kidz service were “genuine independent reviews from service-users”.
He said: “As the independent standards body for disability equipment, wheelchair and seating services in the UK, CECOPS’ aim is to improve the quality of these services, regardless of who provides them.”
But he said he believed that the reviews being uploaded about the Whizz-Kidz service were “unhelpful to commissioners of services, unfair to other providers, and ultimately detrimental to service quality.”
A Whizz-Kidz spokeswoman said in a statement: “Our customers are given the opportunity to feedback their experience independently and we do not input our customers’ feedback in to the website.
“This is managed by iWantGreatCare and we trust they administer the platform appropriately.”
She added: “Thank you for highlighting the double entry examples. We have referred this to iWantGreatCare and they are looking into it.”
She declined to say exactly how the process worked by which Whizz-Kidz submits reviews of its own services to iWGC, or to say whether Whizz-Kidz was putting any pressure on service-users to submit reviews.
Balshen Izzet, the charity’s director of communications, had earlier said in a statement: “The customer voice is at the centre of all of our work at Whizz-Kidz and we take pride in ensuring that our customers have the opportunity to give genuine feedback on the services and equipment they receive from us.
“This feedback enables us to improve the service that we provide to our customers.”
Last year, DNS reported on concerns about the influence of Whizz-Kidz on NHS England’s wheelchair services improvement programme, which included a new Wheelchair Leadership alliance, chaired by Baroness [Tanni] Grey-Thompson.
The charity has close links with the former NHS England chief executive Sir David Nicholson, and is believed to have had about 10 representatives and service-users at an NHS England wheelchair summit in February 2014 – an event chaired by Sir David – even though it was attended by less than 80 people.
Sir Bert has warned that Whizz-Kidz has a “very clear vested interest” in the reform process because “they want to compete for services”.
Whizz-Kidz has wheelchair services partnerships with a string of NHS trusts, and says on its website that it is “continually seeking opportunities to work collaboratively with the NHS to deliver wheelchair services”.
iWGC refused to comment on the Whizz-Kidz reviews, other than providing a copy of the organisation’s response to the complaint submitted by the Posture and Mobility Group and the National Wheelchair Managers Forum.
In that response, iWGC’s web manager, Jenny Heelis, says that iWGC offers “multiple feedback collection methodologies to ensure maximum inclusivity for all service users”, including allowing services to use “forms, media and format customised to the specific needs of their service, and their patients”.
She says that all of the feedback collected by iWGC “undergoes a moderation process”.
And she says that iWGC set up a project with Whizz-Kidz in 2014, which “includes a whole range of ways to collect feedback”, and that the results of this pilot scheme “will help iWantGreatCare understand what is effective for patients and the service provider”.
The letter also says that it is “absolutely possible for other wheelchair services to collect feedback through paper”.
18 February 2016

South Pole trek vet puts PIP reforms in the firing line as he joins motoring charity

One of the disabled armed service veterans who trekked to the South Pole two years ago with Prince Harry has become the new public face of the user-led charity that campaigns for the rights of disabled motorists.
Duncan Slater, who has been appointed as the external affairs manager of Disabled Motoring UK (DMUK), has himself been a holder of a blue parking badge since he was seriously injured in Afghanistan six years ago.
He was on patrol when the vehicle he was in struck an improvised explosive device, with the explosion throwing him 40 feet and leaving him so badly injured that his right arm was the only part of his body left unbroken.
He later had a double lower leg amputation, and had prosthetic limbs fitted, and was medically discharged from the RAF.
Slater said that joining DMUK six years on was not a difficult decision because of its focus on the importance of independent mobility for disabled people.
After his hospital treatment six years ago, almost the only thing he was allowed to do was drive.
He said: “I had to get a car adapted and I was entitled to a blue badge. I realised quite quickly how much independence you had just by driving.”
He also rides motorcycles, with the help of an adaptation that allows him to change gears with his hands rather than his feet.
“I was keen to get back to riding because I had done a lot of it before,” he said. Continuing his hobby showed him that being an amputee did not mean having to “stop doing the things I enjoy”.
Slater, who has an adapted Motability vehicle, has major concerns about the number of disabled people losing their eligibility for the scheme as a result of the government’s move from working-age disability living allowance (DLA) to its new personal independence payment (PIP).
Motability confirmed last year that more than 100 disabled people every week were losing their Motability vehicles after being assessed for PIP, while some estimates have suggested that as many as 180,000 DLA claimants could eventually be forced to give up their Motability vehicles.
He said: “If you change the goalposts overnight, people are going to be excluded.
“It does seem flawed because you can’t have people who are considered disabled and qualify for Motability and then suddenly it’s taken off them.
“The worry is, what happens to those people now? Are they now struggling?
“I don’t think it will save money in the long run because they will end up having to reply on other services and it just shifts the problem, it doesn’t really solve it.
“You can guarantee that there will be people who really rely on those Motability vehicles and then suddenly they have to hand them back.
“What do they do now? How do they get to the shops? How do they provide for themselves?”
Key among DMUK’s campaigns is the ongoing battle to stop the abuse of accessible parking spaces, which he said can be done by “changing people’s mindsets”, and highlighting why the bays are needed.
Slater said: “People don’t need disabled parking bays because they can’t be bothered walking to the shops.
“We get phone calls from people who, if they can’t get in a blue badge space in their local supermarket… they will go home, and they will wait another few days, and all because someone is in a blue badge space without a blue badge and they want to go to a cashpoint.”
Since 2009, he has had to confront the assumption among many members of the public who see him sitting in his car that he is not entitled to use a blue badge space.
He said: “There is a strange perception that if you see somebody young or younger in a car and they pop into a blue badge space, instantly people are watching, because [they think] ‘there’s this young lad, there’s no way he can be disabled.’
“I’ve been told off for taking up blue badge bays. People have got me to wind the window down and told me, ‘You should be ashamed.’
“It’s incredibly frustrating. It’s another reason for being here [at DMUK]. If we can change enough perceptions in people then hopefully that won’t happen to someone else.”
There is also the ongoing fight to overcome the reluctance of councils and other providers to offer car park ticket concessions to blue badge holders.
He said: “It’s trying to get the point across that because you are disabled, it does take you longer to go round the shops, and you are not going to go to the shops as often as most people.”
Part of his job will be to run the charity’s Disabled Parking Award, which offers accreditation for car parks that are accessible for disabled people.
Slater became the first double amputee to trek the last 200 miles across Antarctica to the South Pole in December 2013 as part of a team which was raising money for the charity Walking with the Wounded.
Slater and his fellow team members spent nine hours every day on skis, dragging their belongings behind them, from nine in the morning until six in the evening, in temperatures as low as minus 48 degrees.
But he said the process of trekking through the snow was actually therapeutic and “quite cathartic”, and helped him deal with the serious post-traumatic stress he has experienced since 2009.
“It’s silent,” he said. “No sound, apart from the howling wind. For me, it helped put everything in order. It was lovely.
“Nine hours a day – although you would stop every two hours to eat and hydrate – you were locked into your goggles with your hood up.
“You pick things to think about, your mind just drifts constantly, and two hours will fly by, and when you sit down you feel quite at ease with everything. Mentally, it is really relaxing.
“You literally think about everything to the nth degree and it helped put stuff in perspective – how lucky I was to be there, to survive the blast, to walk again.”
He believes he will be able to take the patience he learned on the trek with him into his new role at Disabled Motoring UK.
And he does not rule out asking Prince Harry to support the charity in the future.
But he added: “It’s not always great to have people of that magnitude, because people overlook the charity, [because they think], ‘you don’t need our help, you’ve got Prince Harry.’
“I would be wary [about approaching him] but if we were doing an event or something where it would really benefit us, then yes, definitely.”
18 February 2016

New survey reveals PIP’s poor satisfaction levels

Levels of satisfaction among claimants of the government’s new disability benefit are far lower than for other benefits, according to new Department for Work and Pensions (DWP) figures.
The survey found that only two-thirds (68 per cent) of personal independence payment (PIP) claimants were satisfied with the service they received from DWP, compared with an average of 82 per cent across all 10 benefits surveyed.
The report covered the period from summer 2014 to summer 2015.
PIP, which is gradually replacing working-age disability living allowance (DLA), has been mired in controversy, delays and backlogs ever since its launch in April 2013.
Government documents have previously estimated that the number of working-age claimants would be cut by as much as 28 per cent by 2018, with 900,000 fewer people receiving PIP than if DLA had not been replaced.
Some disabled people had to wait more than a year just to be assessed, while Atos – one of two government contractors carrying out the assessments – had to fend off claims that it misled the government over how many assessment centres it would provide across London and the south of England.
And earlier this month, research by Caroline Richardson, Stef Benstead and Emma Nock for the user-led Spartacus online network concluded that DWP had failed to provide “adequate” or “robust” evidence to justify changes set to tighten eligibility for PIP, through changes to how assessments take account of the way a claimant uses independent living aids and appliances.
In the survey, one in five PIP claimants (19 per cent) believed they had received incorrect or contradictory information, while only two-thirds (69 per cent) said that DWP had done what it had said it would do (compared with an average of 87 per cent across all 10 benefits).
And more than a quarter (26 per cent) of PIP claimants reported some difficulties or problems in their dealings with DWP, compared to 12 per cent overall, and as low as four per cent for attendance allowance and five per cent for state pension claimants.
Overall levels of satisfaction were lower and levels of dissatisfaction were higher for PIP than for any of the other nine benefits.
But there was some good news for DWP, as the survey showed that, for each of the 10 benefits, more than 90 per cent of staff encountered in person were polite.
For all but three of the benefits, this level of satisfaction was at least 96 per cent, while for PIP it was 97 per cent, although based on a sample size of just 38.
The report, commissioned by DWP, concluded that PIP claimants were “more likely to report their calls left unanswered; explanations of decisions inadequate; information incorrect or contradictory; timings unclear; and progress updates lacking”.
A DWP spokeswoman said: “The survey results show the significant progress made since the PIP rollout began in 2013.
“The vast majority of claimants have been satisfied with the service they were provided with, but we’re not complacent and are making improvements.
“Crucially, PIP decisions are now made in 11 weeks – three times faster than in January 2014.
“Since the introduction of PIP we have continued to make improvements to the system.
“We accepted the majority of the recommendations of the first independent review of PIP, carried out by Paul Gray, and have also recently changed the process for providing support to terminally-ill people, meaning they now receive their payments at an earlier point than ever before.”
18 February 2016

Peer support for job-seekers ‘could prove as important as direct payments’

The use of peer support to help disabled people into sustainable jobs could prove as important in promoting independent living as the development of direct payments, according to a leading figure in the disability movement.
Andy Rickell, a former chief executive of the British Council of Disabled People, called on the government to realise that its ambition to halve the disability employment gap could only be achieved if other aspects of independent living were not ignored.
He said the government needed to understand that equal employment opportunities for disabled people were only possible if the other 11 “pillars of independent living” – which include appropriate and accessible health and social care provision, accessible and adapted housing, and adequate provision of personal assistance – were also in place.
He said: “All the 12 pillars have to stack up for disabled people’s employment to work.”
He said disabled people’s support was a “house of cards” and that the government was “in danger of taking away some of the cards” through cuts to support and services.
Rickell said: “I am just hoping that they will get it, and work out the priority they need to give to disabled people’s support if they really want employment to be cracked.
“They have given that policy commitment in their manifesto to halve the disability employment gap [the gap between the employment rates of disabled and non-disabled people].
“To make that work they are going to have to rethink how they do disability.”
Rickell said there was no sign of that happening yet, and he called on ministers to “join up the dots”.
But he did say there had been significant progress on disability employment in the last 30 years, even if it felt that he and others were constantly “pushing an elephant up a hill”.
He said that Department for Work and Pensions funding now needed to be redirected at peer support, provided by disabled people’s user-led organisations, and “with a bit of luck in the next couple of years it will be”.
Rickell was speaking as the user-led organisation he headed, Action on Disability and Work UK (ADWUK), was transferred into the ownership of another Bristol-based disabled people’s organisation, the West of England Centre for Inclusive Living.
The move was necessary, he said, because of the lack of funding for disabled people’s organisations in the employment sector, a situation he hopes the government will address in its forthcoming white paper on employment support.
ADWUK provided support, training and advice to enable disabled people to fulfil their potential in work.
Rickell said that it was “probably two or three years ahead of its time” in emphasising the importance of peer support – involving disabled people themselves in providing advice and support to other disabled people seeking work – in disability employment.
Rickell was the only staff member to lose his job in the transfer, but he said he believed the decision to bring the two organisations together was the right one for disabled people.
He said: “We tried something out and demonstrated that it would work, and that we could do it really cost-effectively.
“The work will continue in an organisation that has a really good track record and believes in what we believe in, but we don’t need two chief executives.”
He added: “Obviously it is a bit sad for me, having helped ADWUK get to where it was, but this is the right outcome for disabled people as a whole.”
18 February 2016

News provided by John Pring at