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Leaked Evidence Shows DWP Set Quotas For ‘Fit For Work’ Assessments

December 3, 2013

Cross posted with the permission of the brilliant campaigner Kaliya Franklin, who wrote the report.

 

Why are so many sick and disabled people being failed by the Work Capability Assessment and who is to blame?

1. The contract between DWP and Atos Healthcare specifies all costs and solutions MUST be based around an artificially imposed ‘statistical norm’ for the Support Group of 11% (which has since been allowed to rise slightly). This ‘gears’ the whole WCA system to deliver that ‘desired result’.
2. The manner in which the audit system is used within Atos Healthcare, including whistle-blower evidence of ‘punitive auditing’, means there is insufficient latitude for assessors to freely use their professional judgement about an individual’s true fitness for work.

The Work Capability Assessment (WCA), used to determine eligibility for Employment and Support Allowance (ESA), which replaces Incapacity Benefit, has been dogged with problems since its inception. Department for Work and Pensions (DWP) ministers and Atos have always denied the existence of ‘targets’ for the WCA. Now, for the first time, evidence is presented that the WCA operates to a norm-referenced system. This is a de facto target system, since when ‘statistical norms’ are applied to a process such as the WCA they deliver the same outcome as targets. As Lord Boswell predicted in 2007, this use of statistical norms means “the test will, in effect, be geared to deliver that [desired] result”. Being able to consistently deny the existence of any targets has been crucial both for the Labour government who introduced the WCA, and the Conservative/Liberal Democrat Coalition government who have continued with its use despite evidence of significant faults in the process.

The media regularly feature stories of people even the Daily Mail would consider deserving of ESA who have been refused the benefit – people with sickness or disabilities as diverse as Huntington’s Disease, uncontrolled epilepsy, kidney failure or brittle bone disease – but until now there has been no completely satisfactory explanation for this misery and hardship.

Ministers, MPs, the DWP and campaigners point the finger at Atos, the company contracted to carry out these tests on behalf of the DWP. The DWP say Atos are at fault and that they will improve the system by breaking their monopoly and allowing other companies to bid for the contract.  Labour have also announced that they will “sack Atos”. DWP ministers blame the civil servants and the civil servants seethe. It is a classic case of political, “it wasn’t me Miss, it was them”.

To explain what all this really means education analogies are helpful. Exams can be either ‘norm-referenced’, ‘criterion-referenced’ or a mix of both. A criterion-referenced exam system means students receive an objective grade based on their performance against a pre-defined marking scheme. A norm-referenced exam system sets ‘quotas’ which limit the overall proportion of students able to achieve each grade.

Originally ‘A’ levels were simply pass or fail, but in 1963 guidance was issued which limited the overall proportion of students allowed to receive each grade. This was a norm-referenced system which ensured that only a small proportion of students could achieve ‘A’ grades. This was widely perceived as unfair to students and during the 1980’s ‘A’ level marking systems were changed to remove quotas.

The audit system as controlled by the DWP can be seen as a teacher, and Atos the poorly performing pupil. The teacher punishes the pupil, focusing on reprimanding him when he smudges his ink (deviates from the ‘norms’ imposed in the contract) whilst ignoring the content of his answers or his behaviour. The teacher blames the pupil for not learning and the pupil blames the teacher for everything. Before anyone should feel too sorry for the pupil, it’s important to note, this pupil is more Harry Flashman than Harry Potter; the real victims are those affected by their combined bad behaviour.

The test for the old Incapacity Benefit – the Personal Capability Assessment – was a criterion-based system. People were awarded points based upon how they scored against certain criteria – for example, those who could walk less than 50 metres were awarded more points than those who could walk less than 200 metres. If the person scored the number of points, across all the criteria, necessary for benefit receipt, they would be entitled to the benefit.

However, the WCA is a norm-referenced system. People must both score the number of points required for benefit receipt and fall within the proportion of people the norms system will allow to receive the benefit. In practice this means there is a finite number of claimants the assessment system will allow to be awarded the benefit, regardless of the number of people who objectively meet the criteria for benefit eligibility.

New evidence gleaned from the original contract between Atos and DWP, testimony from Atos employees and Freedom of Information requests, clearly indicates that the outcomes for individual sick and disabled ESA claimants are not driven solely by the severity of their condition or the nature of their disability. On the contrary, as Lord Boswell warned in 2007, the imposition of statistical norms onto the WCA gears the outcome of the whole system to achieve the desired result: in effect a cap on the overall number of people the system will permit to be granted eligibility for ESA.

Evidence shows that Atos uses a ‘management information tool’,  based on the ‘statistical norms’, to ‘manage’  the behaviour of individual assessors. Although officially the audit of assessments is not supposed to be punitive, it’s clear from whistle-blowers that in many regions there are negative consequences for assessors if they do not restrict the number of points they award to claimants to comply with the norms. This makes it difficult, for example, for them to award a high point score to every claimant who, in their clinical judgement, has a serious condition affecting their ability to work.
 
There is therefore a serious risk that the overall outcome for the claimant  – whether they are placed in the Support Group and given unconditional support because they are unable to work, placed in the Work Related Activity Group on the basis that they are likely to be able to return to work in the future, or denied ESA altogether and expected to actively seek employment – may be driven as much by the severity of other claimants’ conditions as their own, particularly those claimants assessed on the same day by the same assessor!

So is removing Atos actually a solution to the problems with the WCA? The answer is no. As long as the WCA remains a norm-referenced system of assessment, removing Atos is the political equivalent of fiddling while Rome burns.

It is clear, and in the light of this evidence totally unsurprising, that this iniquitous system is causing immense distress, hardship and increased ill-health for the very people who most need support, whilst at the same time costing the taxpayer many millions of pounds in unnecessary assessments and appeals.

This evidence and analysis must be understood by politicians of all parties, since only a cross party solution can fix this cruel, wasteful, immoral system and prevent more unnecessary suffering. If sick and disabled people are to receive the support they need – and which a civilised, compassionate Western society is expected to provide – this new report, published by The Centre for Welfare Reform, “Investigating the real reason for the misery of ‘fit for work’ assessments”, is essential reading for both Parliamentarians and the public alike.

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16 Comments leave one →
  1. samedifference1 permalink*
    December 3, 2013 3:20 pm

    Reblogged this on Disability Voices.

  2. fred permalink
    December 3, 2013 3:31 pm

    Kaliya Franklin is as trustworthy as the DWP ATOS and the Party she promotes , isn’t she in with Anne McGuire MP who done so much damage to the Disabled, just like her friend Sue Marsh who is supposed to be going Political,

  3. December 3, 2013 3:44 pm

    Reblogged this on Benefit tales.

  4. December 3, 2013 3:46 pm

    Reblogging this on ‘Benefit tales’. Important article, but why oh why the red font? Makes it very hard to read, especially for people with any sort of visual impairment. WordPress’ default grey font is also not ideal, I try to make everything a good clear black when posting.

  5. Florence permalink
    December 3, 2013 5:34 pm

    Ditto the remark about font colour – also font size and narrow margins make it impossible to enlarge enough and still get the document width on the one page.

    But not to detract from the article, which is very good & timely. I haven’t read the original report yet, but could I just point out that the “statistical norm” IS a target, not a de facto target. Knowing the total number of IB claimants, and then setting an 11% goal for Support group very quickly distils into an actual number of assessments per day per assessor. It is the target driving every thing ATOS / DWP do, the target driving misery and pain, and denial of real disability. At least whenever we encounter those poor souls online who have lost everything, and may even begin to believe the propaganda through constant repetition, we can now point at this source and say – it’s not you. It’s the target, and the sheer misfortune to be seen at the wrong time of day by the wrong assessor in the wrong office. This knowledge is power, and can be used to allow disabled and chronically sick people to begin to get their fight back, along with their dignity. We are not scroungers, skivers, we are ATOS/DWP victims.

    I would like to know how the original 11% was derived though. Again, before I’ve read the report, the knowledge of Unuum’s involvement from the 1990’s makes the origin look about right, but the actual figure? Is there any way to be able to link it back to the court cases in USA where Unuum was totally discredited for their “disability denial factories”? Was that a target set there? I think I need to go and have a good ferret through the data.

  6. December 3, 2013 5:47 pm

    Reblogged this on Vox Political and commented:
    I would urge people to read the original post that this references. It makes the clear point that the Department for Work and Pensions is responsible for the rot in the work capability assessment, as it has targets and norms that must be met; blaming Atos is “fiddling while Rome burns”, as the author describes it.
    It is the political intention behind the system that must be changed. I’ve been saying that since before THIS blog began.

  7. samedifference1 permalink*
    December 3, 2013 6:22 pm

    Point about font colours noted for future reference. Thanks for all the reblogs!

    Best

    Samedifference1

  8. December 3, 2013 6:29 pm

    yet there are no figures the dwp say yet out it comes it was 1in8 now 1in11 ah how devious they are ids is a very bad human and most of hiscolleges has he hasn’t the wit to plan all but does the abiding of his masters well when we get the children asking their parents mammy daddy whot was a disabled person look like jeff3

    • Kerry Davies permalink
      December 3, 2013 10:40 pm

      11% not one in 11. 1 in 8 is 12.5% and 11% is 1 in 9, more or less. Always best for them to work on 1 in 8 and have room for manoeuvre. It means that every two hundred “victims” they can allow 3 extra serious cases through.

  9. December 3, 2013 6:30 pm

    Reblogged this on Through My Eyes.

  10. beastrabban permalink
    December 3, 2013 6:48 pm

    Reblogged this on Beastrabban’s Weblog.

  11. Boz permalink
    December 3, 2013 8:44 pm

    interesting review

    as an side – why does my antivirus say that this site is ‘dangerous’ and i view it elsewhere?

  12. December 4, 2013 9:55 am

    Reblogged this on and commented:
    This excellent post from Same Difference explains how the DWP set targets for ATOS for the outcomes of the Work Capability Assessment. The DWP and Iain Duncan Smith have been able to use ATOS as a blaming tool and remove themselves from responsibility – but it IS the DWP setting the targets, demonstrating that this process is ultimately a culture inside government which needs to be removed. Labour may have promised to sack ATOS, but unless they halt the processes and target setting from inside government, then the problems will continue with another healthcare contractor.

Trackbacks

  1. ATOS Norms = Targets For WCAs? | Same Difference
  2. British disabled widow’s suicide after ATOS witch-hunt | Dear Kitty. Some blog
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