In addition, the process even ignores previous Atos assessments. A constituent of mine was employed by Royal Mail, which used Atos to assess capability for work, and was assessed as not being capable. My constituent then retired and applied for benefits, and following another Atos assessment was found capable of being re-employed in the same type of work.
The fly-on-the-wall exposés by television programmes have exposed the pressure exerted on assessors to fail people. If people are assessed as capable of working correctly, they are then regularly harassed with challenges that they are unable to cope with, and they lose their benefit as a result. If they succeed at the assessments, they are harassed with reassessment after reassessment. We have heard the appeal statistics, but most of my constituents must wait six months or longer for an appeal. Those who have support—and I do support them; I represent people now at appeals—win. However, there is a lack of support, because of cuts in local government support for advice centres, and Government cuts; so many people are not supported.
The result? To be frank, it is financial hardship. People are living in poverty because they lose their benefits. In addition, there is emotional stress, breakdowns, and, as Mind points out in its briefing, self-harm and suicide. Why do the Government defend the company? Why have they awarded it the personal independence payments process?
I share the disgust of many disability groups about Atos being allowed to sponsor the Olympics. It is a disgrace. I support Disabled People Against Cuts, and the Black Triangle campaign, which organised the protest against Atos sponsorship. I am calling for an inquiry into violence against people with disabilities who protested last week at the Department for Work and Pensions, and elsewhere. A few months ago, I tabled an early-day motion calling for Atos’s contract to be withdrawn, and for the establishment of a new system; 103 hon. Members have signed that early-day motion. Surely after that, and following debate after debate and the protests on the streets, the Government must reassess the role of Atos, and establish a new system based, as my hon.
Order. Ladies and gentlemen, please take your seats. To be frank, there are more people standing than we shall have time to hear from in the debate. The Opposition spokesman has said he requires eight minutes. I suspect that, because of interventions and so on, Members will want the Minister to have slightly longer. I propose that we begin the winding-up speeches just after five past, so we probably have time for two more speeches before then. I have a list given to me by the previous Chairman, and I shall take speakers in that order.
I congratulate my hon. Friend Tom Greatrex on securing the debate. It is worth reminding people that behind the statistics we have talked about are people who have wrongly been denied the money they need to live on and the support they need.
Like many hon. Members, I have dealt with innumerable cases, and I want to return to the issue of recording. A constituent who came to me wanted his Atos assessment to be recorded, because he had heard of problems in the past. He was told that there were 10 working sets of recording equipment for 140 centres, and that he would have to attend an assessment that could not be recorded, although I believe that it is his right to have it recorded.
Recording might have helped another constituent who came to me, who had been suffering from depression and anxiety, and who had an assessment. She does not cook; in fact, she has not got a cooker, because her lack of concentration means that it would be unsafe. She could barely communicate with me, but the Atos assessment said that her communication was good. She forgot to mention that she lives with her sister—she had to be reminded by her mother—so that was never mentioned in the assessment.
Those clients are appealing with the help of advice agencies, but I fear that when legal aid goes in 2013, there will be a drop in the number of appeals. That drop will not be because Atos is getting it right first time; it will be because people have nowhere else to go for an appeal and will be living without the benefit to which they are entitled. In particular, Atos needs to request medical evidence, which costs money—I have known doctors’ reports to cost anything from £35 to £200—and people eligible for legal aid can get those reports paid for, if they go to an advice agency. What will happen when that system stops?
Lastly, in the short time we have left in this debate, I want clarification on the compulsory reconsideration phase that will come in from April 2013. Will claimants still receive employment and support allowance during that period, as is vital? As we have already heard, 35% of appeals are successful, which means that those people were not fit for work—the decisions were wrong—and if they are not fit for work, they cannot meet the work search requirements. It is therefore essential that ESA continues during that period, and I want clarification about that in relation to all the groups.
I am so grateful to have been called, Mr Hollobone. I congratulate my hon. Friend Tom Greatrex on securing this important debate, because there is no doubt that Atos work capability assessments are not working. When campaign groups adopt the slogan, “Atos kills for profit”, something is deeply, deeply wrong. Any organisation that is proved wrong on 40% of its decisions is failing, and it certainly came as a real surprise to us all when Atos was given the contract for the personal independence payment. Of course, we want to help into work disabled people who are able to work, but removing benefit from those who cannot work is heartless, cruel and just plain wrong. Assessments should take notice of medical reports, whether from GPs or specialists, and of prognosis and treatment programmes, and they must take better account of fluctuating conditions and mental health issues. I want to ask the Minister two questions: how many people have died between being rejected for ESA and their appeal, and how many people have actually committed suicide?
Time is short, so I shall give only two examples. Aaron, who came to me last week, was injured in a bomb blast in Afghanistan in 2009. The explosion broke virtually every bone in his body, and he suffered a crushed-leg injury. Despite immediate medical care, his injury resulted in a partial leg amputation—below the knee—in 2010, and he has had several other surgical procedures. He originally received disability living allowance, but after his Army discharge, his benefit was stopped. He was reassessed for benefit in November 2011 and was told that, as his walking had improved, he would no longer get it. That was a bit of a surprise to him, because he is still struggling with his transition to having a prosthetic leg as his stump is regularly infected, he has required other surgical procedures, and he is still waiting for an operation this autumn. I have a second question relating to Aaron. It is not only the Department for Work and Pensions that has failed him; what about the Prime Minister’s assurances earlier this summer guaranteeing welfare support for ex-servicemen and women injured in military conflicts?
I have been visited by the mother of someone whom I will call Tony. Tony lives alone and is struggling to have as normal a life as possible, despite the world appearing to be very difficult for him. His mother was desperately worried about him, because he has just scored zero in his Atos assessment, despite the fact that he is bipolar and has obsessive compulsive disorder and Asperger’s. Tony has really wanted to work and has tried several jobs. He tried a job as a postman, but because of his OCD he could never get out the door—he would sort the letters by address and would then have to re-sort them by size and colour. Although he has been supported by a number of employers, he found that he was unable to work. In the end, he had a breakdown and ended up in hospital. His consultant has said that he cannot work, and his family is now terrified about his suicide risk.
More than 40 people have approached me with cases of being denied benefit following a WCA, or about their fear of that happening. The Member who mentioned the culture of fear among that group of people is absolutely right. A number of them have described being afraid to appeal, because the experience that people they know have had of Atos staff members has been so terrifying that they are scared to proceed with the appeal. That is why some appeals do not take place, and it is artificially depressing the level of appeals.
I want to describe a few of those 40 cases. One involved a lady who had a serious operation because of cancer—what operation is not serious, following cancer?—and it took her more than a year to get her backdated pay after her claim was denied. In a second case, it took four months for a decision to be overturned after someone’s ESA claim was rejected following their heart-bypass surgery.
Colleagues have mentioned the work-related activity group; I will talk in detail about what happened to my constituent, George Mullen. Mr Mullen had one leg amputated at the age of 18, after an accident as an apprentice joiner. Despite that, he continued to work full time for more than 35 years. A solicitor told him that he would be a fool to try to get back to work, but he ended up as a successful clerk in a small business, even though he was in considerable pain. To aid his mobility for work, he did not use a wheelchair, but got about either on a false leg or on crutches. He suffered with chronic infections and abscesses at the amputation site, and he developed arthritis in his neck, shoulders and back, and in the knee and foot of his remaining leg. In spite of all that, he continued to work until he was told that he was being retired on health grounds, because there was absolutely no way his health would allow him to continue performing his job. He is on 24-hour blood-pressure monitoring, because stress pushes his blood pressure to a dangerously high level.
Mr Mullen applied for ESA as an absolute last resort. When he attended the WCA with his wife, the questions he was asked included: “Are you married? How did you travel here? How long have you been married?” There was not one question about his physical or mental condition, and no physical examination was carried out. Mr Mullen insists that he tried to offer information about his condition, but he was ignored. He was placed in the work-related activity group, but at no point was it explained that that lasts only for a year, and that ESA is then means-tested, or that if he felt he ought to be in the support group he had to appeal within a month. It came as a complete shock to have his ESA stopped when the year was up. He has applied again, and he awaits his assessment. He has had to attend counselling, because the situation has caused him so much stress. There was no explanation that, in the work-related activity group, ESA stops after a year—that is the reality that faces the real people who are affected. As someone said earlier, this is not about figures; it is about real, vulnerable and at-risk people in our society.
I, too, congratulate my hon. Friend Tom Greatrex on securing this debate about a matter of huge importance to hundreds of thousands of people, as well as on the work that he has done to highlight the problems that people face. I give the Minister my hearty congratulations on his appointment as Secretary of State for Justice and thank him for turning up to discharge his final responsibility in his old job. I am also very pleased that my right hon. Friend Mrs McGuire is in the Chamber because she and I have had a close interest in this issue for a long time.
The previous Government introduced the work capability assessment and employment and support allowance to provide support for people who are out of work for health reasons, but who are able to plan for a return to work. The current Government chose to take a drastic short cut by curtailing the bedding down period for the new benefit and rolling out the assessment without any improvement, even though by that stage improvements had been identified and proposed. The predictable result of that has been severe problems. Ministers are failing in their task of managing the contract with Atos, of ensuring that people who claim employment and support allowance are treated as they should be, and of reviewing and reforming the test so that it works as it should. The test needs major improvement. Two of Professor Malcolm Harrington’s reviews have reported so far—Nick de Bois was right—and while the Government say that they have accepted most of the recommendations, they simply have not implemented them, and that is the heart of the problem.
One simple example that shows the muddle that the Minister has got into has been raised several times in the debate. The year one Harrington review recommended that Atos should pilot the audio recording of work capability assessments, and a pilot of 500 claimants followed. Atos said that it was a good idea, but we have heard what has happened in practice from my hon. Friends the Members for Makerfield (Yvonne Fovargue), for Stoke-on-Trent North (Joan Walley) and for Airdrie and Shotts (Pamela Nash).
In a previous debate secured by my hon. Friend the Member for Rutherglen and Hamilton West, the Minister made a commitment that
“we will offer everyone who wants it the opportunity to have their session recorded”.—[Hansard, 1 February 2012; Vol. 539, c. 291WH.]
He has not delivered on that pledge, and it turns out that the problem is a shortage of tape recorders. I was contacted by someone who struggled for weeks to get her assessment recorded. Eventually, Atos wrote to tell her that she could not have a recording or a rescheduled appointment. I wrote to the Minister about that and reminded him of the commitment that he had made. He said that he thought it would be unreasonable to delay the assessment indefinitely for such a reason, but that was not the commitment he gave to the House in February. I am afraid that this mess and shambles shows all we need to know about the Minister’s management of this process. The Government need to get a grip on Atos. I wish the Minister great success in his new job, but I wish he had put a bit more effort into this aspect of his old one.
We have also had a series of mishaps. For example, the Minister made rather farcical efforts to suppress a YouTube video giving advice to people who were claiming against their work capability assessment. It turned out that the subversives who were responsible for this pernicious video were his colleagues at the Ministry of Justice.
Perhaps the most harmful thing to the credibility of the work capability assessment has been the delay in making the changes needed so that the test can work. Professor Harrington’s first review in 2010 asked Mind, Mencap and the National Autistic Society to propose better descriptors for people with mental health conditions. They produced recommendations in November 2010, and Professor Harrington commended them to the Department in April 2011. Further recommendations went to the Department in November 2011 about changes to the descriptors for fluctuating conditions.
Several announcements that have been made, including about having mental health champions, have not been rolled out to assessment centres. Atos is still being inconsistent about allowing support workers or friends to assist those with mental health illnesses who are going to assessments.
I agree that commitments have not been delivered, and my hon. Friend cites a good example.
The work capability assessment must not be a snapshot of someone’s condition on the day they attend the medical assessment. By definition, that is likely to be a good day, because otherwise they would not be able to show up. The assessment needs to take account of the frequency with which they can do work-related tasks and that with which they suffer the ill effects of their condition. The alternative descriptors proposed do just that. They are now in the public domain thanks to the Grass Roots disability blog, without which we would not have known what they were, and they look like a real step in the right direction.
The Department has had the recommendations on mental health descriptors for 17 months and those on fluctuating conditions descriptors for nine months, but hardly any progress has been made in that time. On
“we have been carefully considering how to build an appropriate evidence base around the proposed new descriptors…Terms of reference have been agreed and we aim to publish a report of the Evidence Based Review in the spring of 2013.”—[Hansard, 25 June 2012; Vol. 19, c. 54W.]
The Minister’s successor will need to get a grip on this. If that ambiguous deadline is even met—and that would be a first—it will be two years after expert guidance was received on how to improve the assessment for people with mental health conditions, and a year following the other recommendations.
Does my right hon. Friend agree that if a person suffers from cancer but does not require chemotherapy, they should still be deemed to be not capable of working if they are in treatment? Why have the Government not changed that indicator when they could do so immediately?
My hon. Friend raises a good point that we discussed when we considered the Bill that became the Welfare Reform Act 2012. My understanding was that the Government had committed to make precisely that change, but it appears that that has not happened.
I want to ask the Minister two questions. First, on recording assessments—this might appear to be a minor issue, but it has been raised several times in the debate—will he stand by the commitment he made in Westminster Hall in February that people who want recordings will be able to have them? He seemed to have reneged on that commitment in the letter to me that was written by officials, but signed by him, about a case that I raised. Secondly, will he get these new descriptors evaluated quickly—he can urge his successor to get a move on—do so transparently, and make the changes quickly after the evaluation is completed?
It is a pleasure to serve under your chairmanship, Mr Hollobone. I know that this is an issue of great concern to many Members, as it was always going to be. I totally accept that this is a long and difficult process, and I have always said that, both in this Chamber and in the House. I will not be able to respond to every individual point. One or two hon. Members have raised individual constituency cases, and if they write to the Department, I will ensure that it addresses their specific questions.
Let me make one point in relation to a comment made by John McDonnell. He drove to the absolute heart of what we are trying to achieve, and this is an ambition that was and is shared by both the Opposition and the Government. If people can make a return to work, even if it is a different form of work from the one they did before their health issue arose—[ Interruption .]
Order—[ Interruption. ] Order. Parliamentary rules state that there should be no noise at all from the Gallery—[ Interruption. ] Madam, if you persist in carrying on talking and shouting, I will have no choice but to suspend the sitting and clear the Gallery—[ Interruption. ] This is your last chance. If there is any more noise from the Gallery, I will have no choice but to suspend the sitting, meaning that no one will hear from the Minister.
If people can make a return to work, even if it is a different form of work from what they were able to do before their health condition arose, that is better for them than spending the rest of their life on benefits. That is the principle that we are working towards.
If the Minister has read the current descriptors, will he explain what kind of work a person could do when their engaging in social contact with someone unfamiliar is always precluded due to difficulty relating to others? There are those who have reduced awareness of everyday hazards, which means that they face significant risk of injury to themselves or others, and those who are at risk of loss of control leading to extensive evacuation of their bowel and bladder. What work can these people do?
Let me pick up on that point straight off. It is all well and good for Opposition Members to stand up and rail about the system, but it is a system that was created by Labour four years ago when they were in government, and it is a system that we have consistently tried to improve.
Let me be absolutely clear. I put it on record that this is not a financial exercise. There are no targets attached to the reassessment of people on incapacity benefit—[ Interruption. ] The assessment that is in place for new claimants for employment and support allowance—
Order. If there is any more noise from the Public Gallery, I am afraid that, under the rules of Parliament, I have no choice but to suspend the sitting and clear the Gallery. I understand that people are very concerned about this issue—my constituents are concerned about it as well—but under the rules, I will have to clear the Gallery if there is any more noise. This is the last time that I will say it: if there is any more noise, I am afraid that I will have to suspend the sitting.
It is really important to emphasise that the reassessment of people on incapacity benefit is not a financial exercise and that there are no financial targets attached to it. It is about finding the right number of people who can make a return to work. It is not an exact science—it never was and never could be—but it is all about trying to help people back into the workplace if they can possibly return to it. That was the previous Government’s motivation when they established the work capability assessment. When we took office, we put in place the changes that they themselves had put in the pipeline through the internal review of the work capability assessment.
When we took office, I fully accepted that the whole process needed to be improved. That was why we brought in Malcolm Harrington and it is why I am absolutely clear that we have implemented his recommendations. I have regularly met and talked to Malcolm Harrington, and at no point has he said to me that the process is not fit for purpose. At no point has our independent adviser, who I believe has the confidence of most people in the charitable sector who are involved in this work, said to me that this is a system that has to stop or that is unfit for purpose. He has made suggestions about improvements, and we have followed his advice in that regard. Our objective is to do the right thing, but of course this is not an exact science. We will never create a system that is perfect, and that is why people have a right to appeal.
It is a matter of record that since we have implemented changes as a result of the Harrington process and the internal review that we inherited from the previous Government, the number of people going into the support group, including the number of people with mental health conditions, has increased. That is a good thing and I am pleased that we made those changes.
The issue of cancer has been raised. It has taken us longer than I expected to address that, because of various issues that arose in our discussions with Macmillan Cancer Support, but I believe that we are now in the right place. We will be making a formal announcement very shortly, but I have said before that I believe that we should extend to those receiving oral chemotherapy the access to the support group that is offered to people receiving intravenous chemotherapy.
I will make just one more point and then I will answer that question.
It is really important to put on record that Atos does not take decisions. In no circumstance does Atos take a decision about whether somebody receives a benefit or does not. A claimant will be asked to fill in a form that goes to Atos for consideration of whether they should be put to an assessment, or passported straight through to the benefit. Atos carries out the assessment, but the decision about benefits is taken by a Department for Work and Pensions decision maker in Jobcentre Plus. It is really important that people understand that Atos does not take decisions.
When we talk about Atos, we are talking about a team of perhaps 1,500 health care professionals, many of whom have trained in the NHS. Those professionals are carrying out an assessment that was designed by the DWP under the previous Government and that has been continued under the current Government. Atos does not take the decisions itself.
As a result of the Harrington recommendations, we have gone out of our way to address people much more directly. Rather than letters, they now receive phone calls, in which they are asked to bring forward additional evidence. A question was asked about the mandatory reconsideration phase. Effectively, that phase already happens. Every case in which the person says they are not happy will now involve a reconsideration within Jobcentre Plus. I am keen that we have that second opinion, because we will not always get things right and I want to try to see if we can bring forward further evidence that would enable us to make the right decision before a case ever reaches the tribunal service. Effort is being put in to make that happen.
Stephen Timms asked about recordings. Let me be clear that Harrington recommended that we carried out a pilot to test recordings.
I was keen that we just did it, but Harrington said to me, “Actually, it may not work, so I really think that you should pilot it. It may prove to have a negative effect.” We therefore tested recording and found that there was little enthusiasm among those being assessed to have their assessment recorded. In the end, the conclusion was that we should make recording available on a voluntary basis, but it should not be something that we do across the board.
I do not rule out recording. If there was overwhelming evidence showing that it was necessary, I would make it available, but let me give some statistics. There are 300 claimants waiting for an audio-recorded assessment, while Atos is conducting 8,000 assessments a week. We are ordering additional audio-recording machines so that people can have their assessment recorded, if they want. They are perfectly entitled to bring their own recording equipment to an assessment as long as it can record two copies of an assessment, because they need to be able to take one copy with them and leave the other behind. That is why we have to buy what is fairly expensive equipment, and we have ordered additional equipment because there has been an increase in demand in the last few weeks.
I am perfectly relaxed about recorded assessments and I am perfectly happy to make recording facilities available. However, the advice that I received from Malcolm Harrington was that we should test recording. The result of the pilot was not only that there was not a need for recording, but that many people felt uncomfortable being assessed with a tape recorder running.
The right hon. Gentleman also asked about the new descriptors that were brought forward by the charities, but he is out of date. The charities have been working with us for the past few weeks on the assessment project of the package that they brought forward. The work was finished last week. The charities actually wanted more time to work with us because the process is complicated and we are trying to mesh mental health issues and fluctuating conditions. As I said in Westminster Hall about 12 months ago, the problem that I had with the recommendations that the charities made in the first place was that they did not come forward simply with adjustments to the existing descriptors, but instead with a comprehensive reorganisation of the whole assessment, which would also have involved a redesign of the physical descriptors. Given that the right hon. Gentleman has carried out such projects in the DWP, he will know well that that would be a two or three-year project.
We have tried to take forward some of the suggestions that the charities made and embed them into elements such as the ESA50 form, and we are now working with the charities to road test all this work to see if it really makes a difference. However, I am not going to embark on a major overhaul of the whole exercise based on a set of recommendations that are not backed by evidence without our having tested them in the way in which the previous Government tested recommendations: by putting real cases against proposed descriptors and making a comparison between the outcomes of the theoretical new descriptors and the old descriptors. Such work is on track. We are pushing the charities to make progress, because I want to get the work done, and we are still on track to complete the gold standard review in the spring.
Tom Greatrex referred to the National Audit Office report. I have had the benefit of having read that report, although I know that he has not. The reality is that the report highlights a number of what I regard as not particularly major areas of improvement. If he reads the report, he will see that it reflects a big and complicated contract. It makes some suggestions for improvement, but it is not as he portrays it.
When the hon. Gentleman talks about the performance of Atos during the last two years, the key point he must remember is that the recommendations that Malcolm Harrington made, combined with some fluctuation in volumes coming through to Atos, which are certainly beyond its control, have caused significant operational difficulties. I can give him my word that I have sat in meetings with representatives of Atos and put them under intense pressure. Atos has brought in extra capacity at cost. We have made sure that we deliver at every stage. However, it is not possible to change the goalposts totally and then expect the subcontractor to take it on the chin with no consequences.
We have seen some consequences of the introduction of the Harrington recommendations, particularly the personalised statement. However, as I stand here today, we are on track to close the backlog time to where it should be later this autumn. The numbers that the hon. Gentleman gave are already well out of date. We have brought down the backlog in the number of appeals that we inherited two years ago, but it is a big task. We are dealing with a large number of people and this is a big challenge.
Let me be clear that we want to get this process right and we want to do the right thing. I want people who need long-term ongoing support to be in the support group. The Government have no interest in doing anything other than looking after those people who need that, but we will also give encouragement and support—and a bit of a push—to those who can get back into work, because I believe that that is the right thing for them.