On 20th August this year Dr Greg Wood, the former naval doctor who resigned from his post as an Atos disability assessor and subsequently became a whistleblower by going to the press to expose the cruelty of the Work Capability Assessments, published the following article in the British Medical Journal (BMJ):-
PERSONAL VIEW I blew the whistle on the government’s disability assessments
Greg Wood former naval doctor and Atos disability analyst.
Greg Wood went to the media with concerns about the ethics surrounding tests for fitness to work—and eligibility for benefits—that the UK government outsourced to Atos
Actually, two whistleblowers went public before me, and several other doctors have raised concerns anonymously. I am a former general practitioner in the Royal Navy, where work related
assessments are bread and butter stuff. The UK Department for Work and Pensions (DWP) devised the work capability assessment (WCA) to judge whether people who receive out of
work sickness benefits could, in fact, cope with most forms of work. A more stringent test came into use in 2011, and the government made no secret of the fact that it hoped this would boost the labour market, improve people’s self esteem and personal income, and, of course, reduce government debt.
For many years the information technology and “business process outsourcing” company Atos has had a contract, now worth £100m (€116m; $155.4m) a year, to carry out several
social security benefit assessments, including the WCA, for the Department for Work and Pensions. In my view this risks tension between doctors’ professional concerns on the one hand and business imperatives on the other.
The WCA had a troubled childhood. From early on, claimants and disability groups were reporting problems. They felt the assessment was a box ticking process, where medical assessors spent most of their time punching superfluous lifestyle data into the computer. And the likely outcome as they saw it? Computer says no. In fact, the test, on paper at least, isn’t too bad, though it isn’t going to win anyone a Nobel prize. But it cannot adequately
take into account health conditions that fluctuate unpredictably, and it tries to include too broad a range of jobs. Driving, call handling, shelf stacking, data entry, and cleaning, for example, are all theoretically covered. And although the test is nominally a pre-employment medical test of sorts, it is really still about measuring the person’s level of disability.
In early 2013 the WCA was still causing a rumpus in public, despite a series of external reviews.
One problem that dawned on me over time was the widespread use of five ill conceived so called rules of thumb that were promulgated during the training of new assessors. On one,
manual dexterity, the guidance was just plain wrong. The training said that this all boiled down to an inability to press a button, whereas the regulations allow points to be awarded when there are difficulties forming a pinch grip, holding a pen, or operating a computer. The other “rules of thumb” showed a combination of discrepancies and questionable interpretations of medical knowledge—for example, moving from one room to another at home was supposed to be equivalent to moving 200 metres. The effect was to reduce a claimant’s likelihood of entitlement to financial help. Another concern was the absence of documentary evidence, which, in my experience, occurred in about a fifth of assessments. This was a simple failure to move important pieces of paper from one building to another but the assessment was expected to go ahead regardless. And my third concern was that there was an implicit assumption that the most likely outcome of an individual face to face
assessment was that the person would be found fit for work. Ihave no reason to believe that this was deliberate; it was probably more a question of wishful thinking and a misunderstanding of basic statistical principles. You can’t expect the proportions of claimants who are fit to work who are seen by an individual doctor to correspond to national trends. The general culture was one where, at the point when their file was
being opened for the first time by the assessor, it was broadly assumed that an individual claimant was more likely than not to be found fit for work.
My fourth concern was that Atos auditors, for quality assurance purposes, were in the habit of demanding that healthcare professionals change their reports without seeing the patients themselves. This seemed fairly reasonable if the amendment could be justified, but not so reasonable when the doctor who had seen the patient thought otherwise. For instance, auditors supposed that they could tell that a patient with a chronic and only part treated psychotic illness had adequate mental focus, despite not assessing the patient for themselves, and using solely a report.
Yesterday, 24th August, the BMJ published another article by GP Dr Glyn Phillips, written in response to Dr Woods’ piece. Dr Phillips helps claimants who are going to a Tribunal to appeal against the outcomes of their WCA and fully supports Dr Woods. Here’s what he had to say:-
Re: I blew the whistle on the government’s disability assessments
Glyn Phillips, GP
Greenhills Medical Practice, Greenhills Health Centre, East Kilbride,
24 August 2013
Dr Wood deserves to be thanked for his publicising of what lies behind the seemingly dark and at times Kafkaesque outcomes of Atos WCAs. Over the past few years I (and many others) have seen a growing number of patients becoming victims of mind-boggingly cruel and unfair assessments which have led to stoppage of their ESA payments.
How can a patient with a quite profound depressive illness somehow manage to score zero points at an Atos WCA but 27 in a PHQ-9 assessment in the same week? In their defence they would cite that they do not actually make that final decision, it is made by an adjudication officer, a clerical worker, back at the DWP. Thus they can sanitise their tainted and increasingly cruel and unfair judgements. Atos and the DWP seem to deny the existence of a target driven culture. However, their methods and tactics cannot be explained by any other logical reason.
In 1996 I spent 6 months doing two sessions per week with the then Benefits Advisory Medical Service. The assessment tool was the All Work Test, not totally dissimilar to the WCA. Available to assessors were two exclusion clauses for those occasions where a ‘client’ clearly would not achieve the magic score of descriptor points to retain their benefit but equally clearly was not fit for work. This facility remains present in the WCA assessment. This option to apply exceptions, without restriction from management, was what allowed latitude for commonsense, experience, empathy and compassion.
The recent marked increase in grossly unfair decisions by Atos/DWP is, in my view, solely due into the fact that doctors and nurses performing the assessments have had those four safety valve qualities blocked in an over-bearing and bullying fashion by their employer Atos. The DWP, as the commissioning public body, carries equal responsibility for this.
Atos employed doctors and nurses (especially those in managerial roles) should be examining their consciences in these matters. They should be reminded that the decision will be based largely, if not entirely, on their assessment. They are answerable to their governing body. They are also answerable to their ‘client’ who is our patient and therefore answerable to us. When they see somebody who has not scored enough descriptor points, but who they must know is not fit, it is their duty to apply an exception clause. It is their duty not only to our patient but also to their governing body.
This past year I have been involved with supporting appeals for increasing numbers of patients who have had their ESA stopped. One example is a significantly unwell man with complex multiple medical conditions including SLE and ‘shrinking lung syndrome’. He walks very slowly with difficulty and is significantly short of breath after just a few metres. I am convinced that a child would have come up with a more appropriate decision regarding his fitness.
Working with a like-minded local lawyer our success rate is currently 100%. There are more to come. This is a frustrating waste of time for me as it is so unnecessary. What is more frustrating is the total lack of transparency following such a successful appeal. The appeal is successful, the ESA is restored but there appears to be no other outcome. No acknowledgement of accountability on the part of Atos or its employee. The misery and extra unwelcome stress put upon our patient seem not to matter. Apologies do not exist. The tremendous waste of public money expended in dealing with the dramatic increase in levels of appeals is a disgrace.
Making unwell patients more unwell is a disgrace too
Competing interests: None declared
With the recent disturbing news that GPs are being urged by professional bodies to refuse to provide benefit claimants with the medical evidence they desperately need for their WCAs whilst the DWP and Atos refuse to do the job themselves, leaving disabled people in an impossible position, its good to read stories like these by doctors who put their principles and humanity before anything else.
We desperately need more health professionals who are or who have previously worked for Atos to come forward and speak out and put the powerful weight of their professions behind the people being criminally treated by Atos with the approval of their own government.
With each passing day, as I read and see more and more injustice and cruelty from this feeble excuse of a government, I wonder just what the hell is going on here?
Here’s a selection of video interviews by the amazing Artist Taxi Driver to make my point for me. The last one made me so angry and frankly, ashamed to be British and it reminded me of a documentary I saw online recently exposing the truth about the British monarchy. Its called Royal Babylon and I’ve included that too. Prepare to be shocked if you’re the kind of person who thinks the Queen is just a sweet old lady and Winston Churchill etc were ‘great’ British leaders…this is definitely NOT the version of British history that Michael Gove wants to ram down our kid’s throats.
If, after you’ve read this, you feel moved to do something about it, please start by signing the WOWPetition, by clicking here
I’ll tell you upfront what one of the worst things about this story is. It’s that I don’t feel comfortable naming the time or place of my first encounter with an ATOS Medical Assessment Centre. Certainly, I’ll be clear about it in a letter to the relevant MP, and to the organisation itself, and with no hope of being heard, to the Department for Work and Pensions, whom I hold solely accountable for what I witnessed today.
Also, the actual assessment I witnessed, by two sympathetic, understanding, quiet, professional, helpful Eastern European Doctors seemed fine. It was the only bit of sanity in an experience that has left me with the impression of an enormous, industrialised processing of sick people by one organisation; ATOS, doing the bidding of a dangerously distant government department, the DWP, pursuing a dispassionate ideology incapable of engaging with the individual needs of those being palpably dragged through assessment.
A little background; I attended as a ‘plus one’ for a friend of mine who has been in receipt of a benefit for many years that is being subsumed into the Employment and Support Allowance. I went along because some of the drugs my friend is on prevent them from driving, or staying awake, and my friend often suffers from a terrible memory, so I planned to prompt when my friend got stuck, and take in as much of what happened today so that I could remind them of it afterwards.
I wasn’t really looking forward to the Work Capability Assessment (WCA) and I know my friend wasn’t either, as it has been hanging over them like a weight for a number of weeks. Without drilling down into all the detail, my friend relies on this benefit to survive with their children, and although my friend is probably eligible for Disabled Living Allowance, or Personal Independence Payments as they are set to become, I have not been successful at pressuring my friend to apply for them. A lot of people are reluctant to label themselves, or to be judged by others, given the stigma that is increasingly attached to recipients of disability benefits by an ignorant public.
So, this story has had all the names, some sexes, and some other details changed for public consumption, but I’m leaving in the facts as I witnessed them. It was horrific, and I’ve been seething with a dark anger about the events, kicking myself about not taking the phone numbers of the other witnesses, or the names of the staff involved. If only I hadn’t been so wrapped up in looking after my friend and their concerns about today, I could’ve acted like a better citizen, although after today I’m not even really sure what that means, and whose standards that could possibly be judged by.
The story starts in the waiting room of an ATOS assessment centre. Present are A lady and her daughter, who I shall call Mrs and Ms. Nice. They are a quiet couple, apprehensive. The mother cares for the daughter and had helped her crutch her way into the barren, industrial waiting room, and was sat trying to reassure her daughter that it was going to be ok. After later conversation, it turned out Mrs Nice has been to three tribunals for members of her family and friends, all of which have been successful in overturning incorrect DWP decisions on DLA awards, so she is no stranger to the system.
Also present is Builder John, a man who comes to play a pivotal role and who doesn’t even want to be there. John is self-employed and is used to earning lots of money every week through contracting his services out. Unfortunately John is awaiting surgery for an injury that is preventing him from engaging with the very physical nature of his job. John doesn’t want to be there, but has no choice but to do so to carry on qualifying for the measly £140 a fortnight in benefits that he will lose if he doesn’t, metaphorically speaking, jump through hoops. John cannot understand why there is a procession of sick and disabled people being dragged through assessments. He speaks of a happier time, before he was forced to claim benefits for those pesky asides like eating food, when he was blissfully ignorant of just how unfair the system is.
Also waiting are Mr Shirt and Ms. Shirt. Ms. Shirt enters unsteadily on one crutch with Mr Shirt’s support, and after discovering that she is half an hour late, having got the time of the appointment wrong and with one arm shaking uncontrollably as a result of her disability, Ms. Shirt bursts into tears and nearly stumbles over in the waiting room, setting off a chain of events that lead me to witness something unsavoury, cynical, corrupt and distressing.
Mr and Ms. Shirt are sent away for being late, but shortly afterwards, one of the other actors in this piece, “ATOS Receptionist” makes a phonecall to try and accommodate Ms Shirt getting an appointment later that afternoon. With good intentions, Receptionist calls another person who has an appointment that afternoon to cancel their appointment, and sends another player, “Security Man” to intercept Ms. Shirt as she struggles back into her car, apparently to let her know that if she can hang around for half an hour or so, she can stay and see the Doctor after the next appointment has finished.
The time of the appointment Ms Shirt is given turns out to be exactly the same time that John Builder and Ms Nice have been given as *their* appointment time, too. Mr Shirt looks gravely concerned when he learns this fact, he’s clearly been trying to reassure Ms. Shirt that everything’s going to be ok, but he no longer looks like he believes it, and Ms Shirt sits on her hand in an effort to control the obvious, wild tremor in her arm.
The catalyst characters arrive next. Mr and Mrs Cancelled. Mrs Cancelled answered the phone when Receptionist called to make room for Ms. Shirt in the already triple-booked afternoon slot. Mrs Cancelled is apparently no stranger to this assessment centre. She’s already had some of her benefits stopped, and has had to get Mr Cancelled to start and finish work early to accompany her to this re-assessment. She failed to convey to Mr Cancelled that she’d been told not to come in this afternoon, because one gets the sense she hadn’t fully understood how long the wait would be if she did choose to attend, despite being told not to. She attends, out of a fear you can see in her face of continuing to have no money at all, stretching the resources of Mr Cancelled, who is philosophical about the burden placed on his wages, but who chooses to express a perfectly reasonable opinion that his wife is being messed around with when her appointments are being scheduled and rescheduled, with knock-on effects for his employment and pay and convenience. Mr Cancelled makes it perfectly clear that he does not think the ATOS staff are to blame for this, but that it is the stupid DWP system that is causing this upset, pressure and hardship.
Unfortunately, Receptionist chooses to interpret the valid concerns of Mr Cancelled as a personal attack. Nobody else in the room understands why, and the surly, abrasive, combative face that Receptionist presents changes the course of the rest of the day. It’s probably a face that has become necessary to present to difficult clients. It’s a face that, reassures Receptionist, is not for the genuine claimants – she thinks it’s a massive waste of time and effort that the deserving poor are subjected to these humiliating, inconvenient, and often painful assessments, too. Receptionist’s true views, however, are informed by DWP rhetoric about statistics. The same statistics that are so clearly unsafe in the hands of the Iain Duncan Smith, the man who has constructed a House of misinformation, and not yet taken to task over it by the Department for Work and Pension Committee, though they have asked him to answer for his misinformation on repeated occasions.
Mr Cancelled is asked, in no uncertain terms, to leave with his wife, who seems distressed and confused and willing to leave to avoid causing more conflict, and to avoid upsetting her husband further. Her husband loudly proclaims that they will leave, his language may now be peppered by distressed obscenity but all he really wants is some clarity about when his wife’s next appointment will be. Receptionist can not give a date, nor reassurance that that appointment will not also be cancelled. Ms. Shirt realises that her assignment to an appointment is what has caused this mess, and starts to cry again. Ms Nice starts to cry too, and John the Builder stares on in disbelief. Mr Shirt is banging his head quietly against the wall behind his chair, and is heard to say “How did we come to this?”.
Mr and Mrs Cancelled close the door behind them from the waiting room, but they are pursued down the corridor by Security Man. He says “AND I’LL TELL YOU ANOTHER THING”, for some inexplicable reason, he has chosen not to just let them leave, but to take issue with the fact that Mr Cancelled is upset that his wife keeps having her appointments change. Even though Mr Cancelled specifically said he knows it isn’t the personal fault of Receptionist and Security Man, they both seem to have taken it so. There is shouting from the corridor outside, and then the sickening sound of a scuffle, as Mrs Cancelled’s carer and husband is apparently tackled by Security Man, simply for having the audacity to speak out. John the Builder joins them in the corridor, quick to his telephone, where he films the ensuing, angry shouting and the insane exchange of angry words between a man upset about his wife being caused more pain, and a man, acting unprofessionally and physically, upset that his organisation might be deemed to be responsible for this. Mr Shirt checks through the window of the door. Ms Nice is now inhaling heavily, clearly in the throes of a panic attack, while Mrs Nice, also close to tears now desperately tries to calm her down. Ms Shirt is crying, shaking, uncertain. John the Builder tries to remonstrate with both parties in the corridor to diffuse the situation.
It’s simply insane. In Britain, in 2013, there is an industrial, machinated subjugation of ill people to demeaning, degrading, invasive medical assessments being enforced at the behest of a pathological DWP and implemented by an arrogant, uncertain ATOS.
John Builder returns to the reception room, an angry but drawn expression on his face. He expresses his frustration that neither Receptionist nor Security are to blame for this crazy mess, but as he is defending the difficult situation they are in, they return to the room.
“STOP TALKING!” Mandates Reception. There is a pause in the room, a little confused. Mr Shirt points out that John Builder was just trying to defend the position of Receptionist, but John’s temper is blown. In an emotive outburst, John tells Receptionist he won’t be told to shut up. Rightly, he gives what-for, in that most British of manners he explains he is perfectly entitled to talk to other people, to Mrs Nice and Mr Shirt in the waiting room, that this is not a fucking concentration camp. The words hang, pregnant, because that is exactly what it fucking feels like.
Receptionist explains that it isn’t her fault, that the huge number of false claimants are the reason that the DWP has to test everybody to make sure the system isn’t being sucked dry. Mr Shirt looks crestfallen, and after Receptionist and Security simmer down, he explains to everyone else in the room that DLA fraud rates are 0.5% and that ESA fraud rates are 0.3%. This seems like a tired, rehearsed skit from him, and he borrows a pen from Mrs Nice, and a couple of post-it notes, on which he scribbles “wowpetition.com”.
John Builder, Mr Shirt and Mrs Nice express their utter disgust at the government, both Conservative and Liberal Democrat bits of it, although they all agree that they can’t understand how looking after vulnerable people became so distasteful to government, and how people who’ve paid into the social security system are now being subjected to this cynical, judgemental, prejudiced, ignorant DWP system, administered by an inappropriate, unprofessional, reactive and dangerously ignorant private company that keeps getting it wrong.
It’s a disgrace, it’s the most depressing scene I think I’ve ever witnessed, and the dehumanisation of all involved has left me with a sick feeling in the pit of my stomach.
Earlier today I posted a summary of research into Unum and ATOS by Mo Stewart. Here are two further summaries she has sent me with permission to post on this blog.
Mo Stewart is a former healthcare professional, a disabled female veteran and, for the last 3 years, has researched the links between the DWP, Atos Healthcare & Unum Insurance. To date, the research evidence has been quoted during welfare debates in the House of Lords, the House of Commons and in Westminster Hall. Mo routinely shares all research evidence with academics, medical and healthcare professionals, frontline national charities, selected
politicians and service users.
Her most recent report has just been published by the Centre for Disability Studies at Leeds University.
Since 2008 successive British governments have adopted the WCA with the intention of the Department for Work and Pensions (DWP) removing as many claimants as possible from disability benefit, to permit the long ago planned move from the welfare state to welfare funded by private insurance. During three years of detailed independent research, I exposed the links between the British government and the American healthcare insurance giant Unum (Provident) Insurance as first identified in the 2010 report: Atos Healthcare or Disability Denial Factories.(1) This report exposed the links between the DWP and the healthcare insurance giant, and also identified the fact that the WCA had been designed in consultation with Unum Insurance and was the realisation of the long ago planned ‘Thatcher Legacy’, which was the total destruction of the welfare state.(2) This foreign influence on British welfare reforms was to become the focus for the second year of my
research that culminated in the report: Welfare Reform – Redress for the Disabled(3) as first
quoted during the welfare reform debates in the House of Lords during September 2011.
Over time, this often disturbing research evidence was published across the Internet and was welcomed by various academics, a growing number of frontline national charities, medical and healthcare professionals and service-users. The interest was growing as the research exposed the fact that the DWP’s American corporate ‘adviser’ was identified as one of the most discredited health insurance giants in the world.(1)(3) By 2005, following copious numbers of successful legal cases throughout the USA, the California Department of Insurance Commissioner, John Garamendi, stated: “Unum Provident is an outlaw company. It is a company that has operated in an illegal fashion for years…”(4) By 2006, New York Attorney General Spitzer ordered Unum (Provident) Insurance to reconsider 200,000 previous claims, in a settlement benefitting 48 States, and also levied another $15 million dollar fine against the company in addition to the multimillion dollar fines already imposed over several years via successful litigation.(1)(3)(5) In 2007, the American Association for Justice identified Unum (Provident) Insurance as “..the second worst insurance company in the US.”(6)(7) To date, the company have not carried out the 200,000 reconsiderations, ordered in the 2006 multi-state settlement, as Unum Insurance does appear to
continue to be a law unto themselves. A name change to, simply, Unum Insurance has not altered this company’s long history of resisting payment to genuine health insurance claimants(8) as confirmed in a compelling CBS News interview.(9)
Yet this is the company chosen to ‘advise’ successive British governments since 1994 and this
American influenced system of disability denial was adopted by the DWP, using Atos Healthcare to conduct the WCA as a guaranteed method of reducing the welfare budget, regardless of the large amount of detailed evidence against it.(1)(3)(7)(10) Indeed, in America, Professor John Langbein of the Yale School of Law produced a paper identified as ‘The Unum Provident Scandal’ that exposed Unum’s policy of disability denial that continues to be referenced to this day.(10)
Not only was the Atos examination exposed as being ‘unfit for purpose’ by the President of the Appeal Tribunals,(11) but also most recently by the representatives of Britain’s doctors and nurses as the WCA was identified by both the British Medical Association (BMA)(12) and the Royal College of Nurses (RCN)(13) as being totally detrimental to the welfare of patients. DWP Ministers continue to disregard all reported evidence against the Atos assessment.
For six years from 2003 Unum (Provident) Insurance funded the former DWP Chief Medical
Officer, Professor Sir Mansel Aylward, who retired from his role at the DWP to become the
Director of the ‘UnumProvident Centre for Psychosocial and Disability Research’ at Cardiff
University. During that time, Professor Aylward co-authored arguably the most damaging report in the history of British welfare as The Scientific & Conceptual Basis of Incapacity Benefits, TSO 2005(14) was, effectively, a blueprint for the introduction of the WCA.
The Green Paper: A New Deal for Welfare: Empowering people to work – 2006(15) was
subsequently exposed by the academic Professor Alison Ravetz, whose detailed independent
assessment identified the content of the Green Paper as leaving much to be desired.(16) It remains cause for concern that Professor Ravetz’s critical assessment of the Green Paper was provided as a contribution to the public consultation process; so the DWP accessed this disturbing evidence and then totally disregarded the significance of it,
“On closer examination, it appears that this entire body of work is largely self-referential – that is, it appeals for validation to itself and is framed within the same political and policy agenda. In practical terms, it means opting out by the state of responsibility for a large section – estimated two thirds – of those affected by illness or disability. In future, it will be harder to qualify for the benefit, while those already receiving it, in many cases over long periods will, despite assurances, have justifiable anxieties about their future benefit status UnumProvident, an American company, is involved in a number of lawsuits for ‘bad faith’ in refusing to honour disability insurance claims. This reinforces the caution against taking this apparently impressive body of work at face value. It is not research undertaken in the spirit of open enquiry. It is commissioned research and, as such, pre-disposed towardsideologically determined outcomes.”(16)(My emphasis. MS)
This statement was written by Professor Ravetz in 2006 and it has now come to pass, with the nation’s chronically sick and disabled benefit claimants living in fear of the arrival of their appointment for the WCA, as conducted by Atos Healthcare, and the endless incorrect decisions regarding future benefit entitlement by DWP ‘Decision Makers.’(17)
The main influence of the Green Paper content was The Scientific & Conceptual Basis of Incapacity Benefits, TSO 2005(14), as authored by Professors Mansel Aylward and Gordon Waddell and published by the UnumProvident Centre for Psychosocial and Disability Research, Cardiff University. Research evidence has confirmed the profound influence of a discredited American corporate insurance giant with the DWP since 1994 and the most damaging reports, used to influence and inform government policy on welfare, have been produced via a research centre who have adopted the Unum philosophy and cannot possibly be considered to be ‘independent’ research evidence.
On 17th April 2013 the United Kingdom honoured Baroness Thatcher with a ceremonial funeral at an admitted cost of £3.6million, to acknowledge the nation’s first female Prime Minister, whilst her lasting legacy to the British people will be the successful destruction of the welfare state.
(16) Green Paper: A New Deal for Welfare: empowering people to work. 2006
– an independent assessment of the arguments for proposed Incapacity Benefit reform http://disability-studies.leeds.ac.uk/files/library/ravetz-Green-Paper-IB-critique.pdf
GOVERNMENT USE MIGHT OF AMERICAN INSURANCE GIANT TO DESTROY UK SAFETY NET – UPDATE
Whilst the Prime Minister employs talented script writers, and waxes lyrically about the nation’s concerns for our most vulnerable people, the reality is that the medical tyranny used to assess anyone claiming sickness or disability benefits has, by the Department for Work and Pension’s(DWP) own admission, resulted in 1100 deaths between January – August 2011.** Significantly, more recent death totals are not yet available from the DWP…
These genuine benefit claimants were removed from Incapacity Benefit and placed into the ‘work related activity group’ following a ‘medical assessment’ as exclusively conducted by Atos Healthcare – a subsidiary of the IT giant Atos Origin, who were awarded the very lucrative IT contract for the recent Olympic Games. The ongoing human tragedy is that, regardless of diagnosis, prognosis or treatments, these victims were removed from the safety net of the welfare state by under-qualified DWP staff, following a totally inadequate medical assessment by Atos Healthcare, forced to prepare for work and then died trying.**
This ongoing, relentless sinister attack on the welfare state was planned by the Thatcher
government in 1994(1), with successive governments contributing to the fear now faced by over three million chronically sick and disabled people. The Prime Minister announced last year that disability benefits should only be available to those whose reduced health was due to ‘no fault of their own.’* Playing ‘the blame game’ whilst demonstrating his very dangerous lack of comprehension of the sinister implications of all serious addiction was thought at the time to be extreme comments by the Prime Minister, but it was only ever the tip of the iceberg. The reality is that every chronically sick and disabled person in the UK, in receipt of disability benefits, has learned to live in fear of their own government that is shared by the claimed ‘moderate’ political party; namely the Liberal Democrats.
Most civil servants and MPs are able bodied, with very few having any detailed personal knowledge about the vast subject of chronic illness or disability, so sweeping generalisations feed the national press whilst one particular man, with a past history in finance, was given unlimited authority. He was ennobled to permit his appointed to government, and he was never elected, but his opinions are never challenged by government so Lord Freud, as the Minister for Welfare Reform, enjoys unprecedented authority about a subject that he demonstrably knows nothing about. With a past history in the world of finance Lord Freud only knows about budgets, and he engaged with the insurance industry to reduce the burden of government funded welfare.(2) In his own words(3), Lord Freud admitted that he knew nothing about welfare or disability. Yet, three weeks following his
appointment, he produced a report that was adopted by government and now the weakest in society live in fear of frequent obligatory government medical assessments, as conducted by Atos Healthcare, that have been demonstrated to be totally ‘unfit for purpose’ by the President of the Appeal Tribunals, national front-line charities, welfare agencies and concerned high calibre professionals. The government ignores them all.(1)(4)(5)
Atos Healthcare (AH) are engaged to undertake all medical assessments on behalf of the DWP for anyone in receipt of Incapacity Benefit – now changed to the new Employment Support Allowance(ESA) – but the AH assessments remain totally free from all public accountability according to the General Medical Council and the Care Quality Commission.(1) Undeterred by public concern, the £multi million contract between the DWP and AH was recently extended(6), whilst countless numbers of our most vulnerable citizens testify to this bogus medical assessment, that remains as far away from genuine medical evaluation as it’s possible to be.(1) In reality, the Atos assessment is a limited non-medical assessment, that discounts all input from the patients’ GP and Consultants, and remains very high risk as it is based on the totally discredited Bio-Psychosocial Model(BPS) of disability(7) that totally disregards the diagnosis and prognosis of the benefit claimant.
However, behind the might of Atos Healthcare(AH) are government advisers Unum Insurance, introduced to the UK government in 1994 by Professor Mansel Aylward when Chief Medical Officer at the DWP, and who was to leave the DWP to become the first Director of the Unum Centre for Psychosocial Disability Assessment. Some years later, mounting public criticism forced the removal of Unum from the title of the Centre, but the Professor remains unrepentant. When known as Unum Provident Insurance, the company were identified as one of the most discredited corporate insurance giants in the United States(US)(8), and the ‘medical assessments’ undertaken by AH are alarmingly similar to those used by Unum for the assessments and denial of income protection insurance claims, as the Atos assessments also use the totally unacceptable and highly discredited BPS model of disability assessment.(8)
The US courts discredited Unum Provident’s “non-medical” model for assessing medical
conditions(8) yet successive UK governments adopted it to reduce the welfare budget, regardless of the human cost of this imported US medical tyranny. Now known as Unum Insurance, the company have rebranded periodically over the years, depending on the numbers of $multi-million fines imposed due to unacceptable medical assessment practice(9), and they offer income protection (disability) insurance but, as a company, have a disturbing past history of resisting paying out when an insured person hits hard times with illness, or the onset of a disability, and needs to make a claim.(8)(9)(10)(11)
Previously known as Unum Provident or First Unum, the company have been advising successive British governments since Thatcher was Prime Minister and this corporate giant, described as operating ‘disability denial factories’ inspired the research report: Atos Healthcare or Disability Denial Factories(1), as now accessed by welfare professionals throughout the UK. Indeed, Unum Insurance were identified in 2009, by the American Association for Justice, as being ‘one of the top two worst insurance companies in America’(8) yet have been involved, behind the scenes, with the DWP for almost 20 years.(9)(12)(14)(15)
Disturbing evidence of the eventual planned move from the British welfare state to the US style of welfare, to be funded by private insurance, was first exposed in the House of Lords during the welfare reform debates last year. Members of the noble House quoted from the detailed research report: Welfare Reform – Redress for the Disabled(9) as written at the request of noble members. Unsurprisingly, the government decided that all suggested amendments to the Welfare Reform Bill, hard won in the House of Lords, were to be disregarded due to the use of Financial Privilege(16) – an ancient authority of the House of Commons. Hence, this coalition government’s contempt for any challenge was complete, unstoppable, and demonstrably dangerous for the nation’s chronically sick and disabled population.(8)(9)
One of the reasons for Professor Aylward inviting the involvement of Unum Insurance was the DWP’s ultimate plan to follow the American lead in welfare, to identify such conditions as Chronic Fatigue Syndrome as a ‘psychological condition’ by using the BPS model of disability assessment and thus to, eventually, justify not funding welfare benefits for sufferers, as in the US.(17)(18)(19) Considering that, at the time of the introduction of Unum (Provident) Insurance to the British government by Professor Aylward, in 1994, Unum already had an atrocious reputation in the US for failing to fund payouts from the insurance policies they sold, one must wonder as to why their advice was so willingly accepted and adopted by all successive UK governments ever since… (1)(9)(17)(19)(20)
Within three months of leaving the DWP Professor Aylward, recently rewarded with a Knighthood for services to disability assessment, was appointed as the Director of the then named Unum Centre for Psychosocial Disability Research at Cardiff University and his appointment as the Centre’s Director led to the Professor’s appointment as the first ever Chair of Public Health in Wales.
Professor Sir Mansel Aylward is also a Director of the Health Claims Bureau(13), a private company involving Unum Insurance with the ‘medical assessment’ for claimants of income protection or disability insurance for industry. Yet, this assessment is virtually identical to the tyranny used by Unum (Provident) Insurance, as exposed by the Yale School of Law(21) when identified as the Unum Provident Scandal, and now copied by the UK government to remove helpless victims from State financial support.
To guarantee that Atos Healthcare remained confident about their purpose, Unum’s former Chief Medical Officer Mike O’Donnell crossed the Atlantic Ocean and was appointed as the new Chief Medical Officer for Atos Healthcare but, of course, both companies deny that there is any professional relationship between them.
None of this news will disturb a UK government that has now been warned against more benefit cuts by the United Nations(22) and who appear to be trying very hard to be removed from all responsibility under the European Court for Human Rights(23). Meanwhile, the Professor recently denied any knowledge of this medical tyranny when confronted by disability activists outside a lecture hall where he had been advising representatives from the insurance industry…..(24)
When previously known as Unum Provident Insurance, this US corporate insurance giant were actually banned from 15 States in America and 6 countries, worldwide, until 2008(1), when they again changed their name to become known simply as Unum Insurance. Someone, somewhere surely now needs to be asking the question as to why was this highly discredited corporate insurance giant ever invited to advise the British government about welfare reforms….?? Someone, other than investigative TV journalists(25), needs to be asking what was the ultimate goal, and who were to be the undoubted beneficiaries of this government funded medical tyranny, imported from America, against the most vulnerable people in our society?
Unum’s unacceptable influence with successive UK governments was recently exposed at the
Liberal Democrat Conference by the courageous young Mr George Potter.(26) If only the political leaders of the Liberal Democrats enjoyed some of the courage displayed by George Potter, millions of chronically sick and disabled people would no longer need to live in fear of this coalition government, that has totally failed to protect them, despite claims by Liberal Democrat leaders.
And here’s George Potter speaking out at the LibDem Conference last year. I’m not a supporter of the LibDems but I take my hat off to him for having the bravery to criticise his own party at their own conference.
The report reproduced (with kind permission) below is a short summary of the vitally important research into the origin of the current government’s campaign against disability and incapacity benefits and the involvement of Unum (formerly UnumProvident) and ATOS. This remarkably detailed work was carried out over the last three years by former healthcare professional and disabled veteran, Mo Stewart*. Mo has worked relentlessly and determinedly, despite her own pain and fatigue, to bring together a vast amount of damning evidence against this cruel system which has and continues to bring misery and even death to people whose only ‘crime’ is to be chronically sick or disabled. What you are about to read below is but a tiny example of far, far more material some of which can be found on her website here or by following the links she provides in her reference list at the end of the articles.
*(Mo Stewart is a former healthcare professional, a disabled female veteran and, for the last 3 years, has researched the links between the DWP, Atos Healthcare & Unum Insurance. To date, the research evidence has been quoted during welfare debates in the House of Lords, the House of Commons and in Westminster Hall. Mo routinely shares all research evidence with academics, medical and healthcare professionals, frontline national charities, selected
politicians and service users.)
THE HIDDEN AGENDA: a research summary by Mo Stewart
The Work Capability Assessment (WCA) is exclusively conducted on behalf of the Department for Work and Pensions (DWP) by the corporate giant Atos Origin IT Ltd Medical Services, better known as Atos Healthcare. This ‘non-medical assessment’ was introduced in 2008 by the Labour government, and was identified as a ‘medical examination’ to be used to identify genuine claimants for long term sickness and disability benefit. However, what was unknown at the time was the fact that the WCA was a continuation of the planned agenda of the previous Thatcher government, whose ultimate goal was the destruction of the Welfare State.(1) The WCA was promoted as a ‘fitness for work’ assessment for claimants of what was once known as Incapacity Benefit, now re-named as the Employment and Support Allowance.(ESA) In reality, in order to reduce the welfare budget, the WCA was designed to resist as many sickness benefit claims as possible regardless of confirmed and identified permanent illness or disability. By 2010 the planned DWP welfare budget reduction was deemed to be
too slow. The new Coalition Government enhanced the WCA and, following the previous Labour Government’s lead, it became much more difficult to qualify for the ESA(2) as the WCA totally disregarded diagnosis, prognosis or limited life expectancy.
Aided and abetted by the national press, using insidious press headlines to manipulate public opinion(3)(3b), the Coalition Government successfully introduced tyranny, fear and despair to the nation’s most vulnerable people, using a disability assessment model as designed in consultation with Unum [Provident] Insurance; one of the most discredited corporate insurance giants in the world.(4)(4b) At the same time, reported disability hate crimes in the United Kingdom(UK) were rising to record levels.(5) The first two years of independent research into the WCA concluded at the end of November 2011 with the
exposure of two government memorandums provided by Unum Provident Insurance.(6) Initially, the link between the UK welfare reforms and the likely move to an insurance based benefits system was identified by Baroness Tanni Gray-Thompson during the welfare reform debates in the House of Lords.(7) Nine months later, the link between Atos Healthcare and Unum Insurance was exposed by Kevin Brennan MP during debate in Westminster Hall(8) and, more recently, during an emergency Backbench Business debate in the House of Commons(HOC), Michael Meacher MP identified the possible influence of Unum Insurance with the UK Government.(9)
Of course, this destruction of the welfare state could never have been so readily achieved without the unelected former Labour adviser, David Freud. He was ennobled to permit appointment initially to the Shadow Cabinet but, following the 2010 General Election, he was appointed as the Minister for Welfare Reform for the Coalition where he has excelled. Indeed, one of Lord Freud’s most recent claims was that: “Poor people should be prepared to take more risks because they have the least to lose…”(11) Clearly, this man is yet another millionaire Minister who demonstrates no concern, and no comprehension, of human need.
The ongoing DWP medical tyranny, masquerading as welfare reform, has permitted Atos Healthcare to conduct the WCA by employing the totally discredited Bio-Psychosocial(BPS) model of disability assessment that remains free from all public accountability according to the General Medical Council and the Care Quality Commission. The BPS is the assessment model as used by Unum Insurance when assessing healthcare insurance claims, and it is also the assessment model enthusiastically promoted by Professor Sir Mansel Aylward. The Professor is the Director of the Centre for Psychosocial and Disability Research at Cardiff University, initially sponsored by Unum Insurance from its inception in 2003 to 2009.
However, prior to his move to the Centre, the Professor was the DWP’s Chief Medical Officer who, in 1994, was in post when Unum Insurance was invited to become corporate ‘advisers’ to the UK government.(12) Whilst the BPS model is an interesting theory, the selective use of the BPS model of disability assessment, as used by both Unum Insurance and Atos Healthcare, was exposed long ago as an invention of the insurance industry.(13)(14) By concentrating on the psychological model of disability, to the detriment of the social model, the WCA was always destined to promote unacceptable results for many thousands of ESA claimants. In one six month period alone 37,100 people had waited up to a year to have their ESA benefit reinstated following appeal, yet no-one is asking what would have happened to these genuinely sick and disabled people if they had not had the strength to pursue their claim to appeal?(10)
Indeed, a recent Panorama documentary: ‘Disabled or Faking It’,(15) demonstrated quite categorically the dangers of the WCA with seriously ill patients, diagnosed with life threatening conditions such as heart failure and end stage emphysema, being found fit for work.(15) However, with the national press still refusing to expose the identified influence of Unum Insurance with the DWP welfare reforms, the British public remain in ignorance as the government covertly convert the UK welfare state into the American healthcare system, ultimately to be funded by private insurance.(12)(13)(14) Meanwhile, Unum Insurance is happy to continue to offer new careers to former government ‘advisers’. (16) The WCA is an American imported ‘disability assessment model’ and has no medical credibility whatsoever, as confirmed by the British Medical Association(17), yet it is enthusiastically employed by the DWP and causes devastation to those least able to protest. This ‘medical assessment’ is working very well as the thousands of genuine claimants that have either died, committed suicide, been forced into poverty due to mounting debt, or who have developed a mental health problem due to anxiety are now the disregarded victims.(10)
Many had been in receipt of Incapacity Benefit before being re-assessed by Atos Healthcare, using the fatally flawed WCA, only to fail to qualify for benefit following ‘assessment’. The Internet provides evidence to this government imposed suffering at a cost to the tax-payer of £110million per annum for the confidential Atos contract and an estimated £60 million pounds per annum, and rising, for the costs of the appeal tribunals. Yet, still, Members of Parliament (MP) continue with their very courteous and diplomatic debates(8)(9) as the Prime Minister, the Cabinet and, especially, their corporate partners all celebrate the ongoing planned destruction of the welfare state that appears to be unstoppable.
What is still disregarded is the fact that Professor Sir Mansel Aylward’s research activities were funded for six years by Unum Insurance.(12) Indeed, due to his significant contribution to the future reduction of the DWP welfare budget by promoting the use of a ‘non-medical’ assessment, the Professor was rewarded with a Knighthood for “services to disability assessment.” Therefore, his support for the BPS disability assessment model was presumed to be guaranteed. Yet, when confronted six months ago, the Professor actually confirmed that he now considered the BPS model to be “unsatisfactory” and that he believed it “no longer addresses the real needs of disabled people and the exclusion of disabled people from society”.(18) Of course, the question remains as to why there was no official DWP announcement following this amazing change of ‘expert’ professional opinion, as the entire national press totally disregarded the press release that was distributed last September following Sir Mansel’s unexpected statement. Perhaps the Professor was safe in the
knowledge that the press release would be ignored, and perhaps this is why he continues to travel widely, still lecturing about the virtues of the totally discredited BPS model of disability assessment? The most recent lecture was at the Health and Wellbeing at Work Conference in Birmingham, from 5th-6th March 2013,(19) where Professor Sir Mansel Aylward was listed as a keynote speaker on the subject of: The New Public Health Agenda: Its Impact on Health and Wellbeing at Work. Given the title of his speech, one can only presume that the Professor has yet to advise other professionals of his reported change of expert opinion.(18)
This is how the UK welfare state will be destroyed. There is a BPS ‘expert’ in place, and an American corporate insurance giant has influenced the UK Government to totally disregard human suffering, in favour of a reduced welfare budget, using an identified bogus ‘medical assessment’. Unum Insurance have begun their mass marketing to encourage able bodied members of the British public to invest in their ‘Income Protection Insurance’ or their ‘Back-up Plan,’ that’s only available via the workplace, and these are the healthcare insurance policies that the company has historically tried very hard to resist funding when a claim is made.(20)(21) Given that the unacceptable practice of Unum Insurance was previously exposed by MPs during a House of Commons debate in 1999(22), the question remains as to why was this highly discredited American corporate insurance giant ever permitted to influence UK welfare reforms and why the national press, en masse, refuse to expose this insurance company’s confirmed influence despite it being identified by a BBC News report in 2007?(23)
The recent exposure of a 2005 internal Unum report, that actively boasted that the company was ‘driving government thinking’ regarding the reform of Incapacity Benefit (24) leads to the much more sinister possibility that the DWP are simply administrators of these brutal welfare reforms, and that the perpetrators of the devastation caused to the victims of this UK government funded medical tyranny are, in fact, Unum Insurance. Michael O’Donnell was the author of the 2005 internal Unum report that was written when he was the Chief Medical Officer (CMO) for Unum Insurance. Michael O’Donnell is now the CMO for Atos Healthcare…..
The difficulty remains that no-one is asking the relevant questions. Perhaps MPs should be asking the Prime Minister why he’s been funded by ‘healthcare companies’ to the value of £750,000(27) since he became Prime Minister (25) or why every report produced by the President of the Appeal Tribunals, all of which identified the Atos Healthcare WCA assessments as “failing to coincide with reality”, was totally disregarded by the DWP? (12)
Until and unless more significant questions are asked in the House of Commons, victims of this government funded medical nightmare will be forced to turn to the law for help, just as in America.(26)
Until and unless the national press demonstrate that the UK really does benefit from a free press, and not a government controlled press, the most vulnerable of all British people will continue to suffer and the British public will continue to be deceived.(12)
Iain Duncan Smith has spoken a number of times about his pride in the welfare reforms he’s presided over. He’s dismissed all criticisms and poo-pooed all the evidence that these reforms are causing hardship.
Imagine that IDS could be put on trial for the harm he’s done (I wish) and evidence was presented for the prosecution. What would that evidence be? Where would we begin to start? Well, here’s an interesting video from February this year. It shows three well educated, articulate people appearing before the Scottish Parliament’s Welfare Reform Committee, telling how they suffered at the hands of Atos. Its a long video, over an hour and a half, but its well worth watching.
Here’s more evidence for the prosecution in the form of a conversation on LBC radio. A caller, Sally, who claims to be a former nurse assessor at ATOS gives Petrie Hosken an uncomfortable insight into how assessments are made.
So, anyone going to present any evidence for the defence?
We’ve all heard about the enormous number of appeals made against the outcome of Work Capability Assessments resulting from Atos’ completely unfit for purpose methodology.We’re all aware of the immense cost this has resulted in and the huge number of successful appeals which have overturned DWP decisions and caused embarrassment for the government. And I’m sure , like me, no-one has been too surprised by the attempts by DWP ministers to put a positive spin on the statistics in order to minimise this embarrassment by emphasising the numbers of unsuccessful appeals and playing down the successes.
What we have a right to expect, though, from a government department, is that they at least stick to the truth. Sadly, we’ve seen that this particular batch of DWP overlords seem to have big problems when it comes down to telling it like it really is. They have a truth deficit bigger than that of Osborne’s budget and it seems their version of what the appeals statistics mean is no exception.
According to an excellent website called ilegal the DWP ‘s presentation of statistics on all aspects of WCAs is full of omissions and obfuscations leading to a completely false picture of the performance of this crucial part of their attack on the welfare state. The article presented on ilegal’s website is far too long to reproduce in full here so I want to simply focus on the section on appeals. If you want to read a very detailed account of all the DWP statistics on this subject which explains the figures in a way that even a mathematically challenged dunce like me could understand then you need to go here:-
According to nickd who wrote the article on ilegal the DWP are claiming that 85% of ESA decisions are correct, but this is based on incomplete information. The figures he quotes are as follows:-
Overall number of appeals/ reconsiderations against ESA decisions: 793,700
Of which there are –
Appeals/ reconsiderations with a known outcome: 312,100
Appeals/ reconsiderations where outcome not yet known: 481,700
Of those 312,100where the outcome is known –
Appeals (Tribunal) where DWP decision overturned: 116,700
Reconsiderations where claimant moved back to WRAG: 73,300
TOTAL successes for claimants: 190,000
TOTAL successes for DWP: 122,100
These figures couldn’t be clearer and nickd extrapolated them from the DWP’s own fact sheets after close examination. The key figure we need to concentrate on is the one relating to cases the DWP can claim as successes in terms of making an ESA decision that wasn’t challenged by the claimant. This figure, as we can see is 122,100.
So when the DWP claims it has got things right in 85% of decisions then we can reasonably expect them to be referring to this figure. But its pretty obvious that 122,100 is not 85% of either the overall number of appeals/ reconsiderations applied for i.e 793,700 of which it is a mere 15% or of the number of appeals/reconsiderations for which the out come is known, 312,100 of which it is a somewhat better 39%. It is, though, a long way short of the claimed 85%.
So where have the DWP’s devious spinners of tangled webs of deception got this amazing statistic from? As far as I can see the following calculation is the only way they can have done it.
First of all its important to note that they are saying that 85% of ESA decisions appealed against are correct. They don’t mention reconsiderations by the DWP specifically.
So if you take the figure for successful Tribunal appeals – 116,700 –and express it as a percentage of the overall number of appeals i.e. both those whose outcome is known and those whose outcome is not yet known, 793,700, you get 15%.
So, if 15% are successful using this overall figure you can then claim, by a simple subtraction, that 85% of appeals at Tribunal must be unsuccessful for claimants.
By conveniently failing to include the other 73,300 positive outcomes for claimants – the successful reconsiderations – and then expressing the smaller number of successful outcomes as a percentage of a much bigger overall total of appeals over half of which have not yet produced a known outcome and could well contain many more successes the wily DWP has managed to totally rearrange reality to make itself look good. That’s pretty dishonest in my book when they have to hand further entirely relevant data that they could and should have included in their analysis if they were sincere in wanting to provide the public with a true and transparent picture of how their policies are working. The only conclusion to be taken from this can be that they don’t want to be that transparent government that Francis Maude is supposedly devoting his time to achieve.
This kind of dishonesty in government has now become the norm, it seems, with DWP ministers. When you think that someone working for this thoroughly corrupt department is being paid a wage with taxpayers’ money to produce this kind of propaganda in order to make ministers look good…and when you also think that the single underlying purpose of doing this is to give those ministers the means to justify being re-electing – basically for party political gain – when you consider this, you have to despair and wonder if we can ever rescue any kind of democratic process for our children and grandchildren.
So given this sorry state of affairs, I’d like to introduce a new term into our vocabulary to describe what is now happening ….. the Toryfying of statistics.
Just found this and couldn’t believe that in 21st century Britain people would be reduced to such dire circumstances. commonlyknownasmildred also has posts about a 60 year old man,George Rolph, an ATOS victim who has gone on hunger strike.We certainly do live in desperate times…this blog is well worth a visit.
This post moved me to tears by its eloquence and honesty. I’d like to think that if Ed Milliband read this he might change his mind about trying to follow the government’s approach to benefits and think again. The answers to the problem of poverty lie far deeper than blaming the poor and any solutions surely need to start with dismantling a system which assumes profit making is the ultimate human right and competition is good for all. The truth is that under the current system there can never be a level playing field on which to compete. And by their very nature human beings do not all have the same level of abilities. But a system whose basic underlying principle was the equality of value of humans rather than the right to make a profit no matter what would automatically ensure that we designed things so that everyone had the same basic income to guarantee them a life worth living.
A few days ago, I found myself involved in a twitter conversation about desperation. My impression of my fellow conversationalists is that they were mainly salariats (people receiving salaries) for whom, I imagine (because I don’t know), the austerity policies of the UK’s Coalition government have had some impact but have yet to undermine their foundations of existence. Participating as a precariat, my response was markedly different.