Vote for Corbyn to Stop the Work Capability Tests

This is the text of another of my table-top pamphlets, this time against the notorious Work Capability Tests. These were also introduced by New Labour at the behest of Unum and other private healthcare providers.

These are not objective tests to assess who is well enough to support themselves. They are simply a callous, bureaucratic mechanism for throwing people with disability off the benefits they need to support themselves. These have included severely disabled people, including terminal cancer patients in comas!

This iniquitous system has been retained and expanded by the Tories – David Cameron and his Lib Dem lackey, Nick Clegg, and now Theresa May.

It is killing people. As I’ve mentioned far too many times before, about 600 + people have died in misery and despair after having their benefit withdrawn due to these tests. Stilloaks, Johnny Void, Mike at Vox Political and DPAC have put together lists and videos putting names to faces, to show the human reality of these statistics – whose mothers, fathers, sons, daughters, brothers and sisters were killed thanks to the Thatcherite insistence of cutting down on welfare.

The number of people, who have died after having been assessed as ‘fit for work’ is well above ten thousand, though the true figure may never be known. Mike and the other disability activists, who tried to get the figures were blocked by IDS and the DWP at every turn when they tried to get them.

Jeremy Corbyn has also promised to end workfare.

So vote for him. Don’t let the Tories kill more disabled people under the pretence of saving money.

Stop the Work Capability Test –
Before More People Die

by David Sivier

One of the very worst policies introduced by various governments as part of their campaigns to dismantle the welfare state over the past decade has been the Work Capability Test. This was introduced by New Labour in October 2008 along with a new benefit for the disabled and long-term sick, the Employment Support Allowance, which replaced Incapacity Benefit. The Work Capability Test is intended to show if the person claiming benefit really cannot work. It consists of questionnaire, in which boxes are to be ticked in answer to particular questions about the claimant’s health and disability. 2Ten of these tests were on the claimant’s physical health, and another ten are on their ‘mental, cognitive and intellectual’ fitness. There may also be a brief physical examination. The tests are performed by medical doctors working on behalf of a government outsourcing company. This was given to the French company, Atos, but the company was forced to terminate its contract a year early in 2014 following public anger at the system’s incompetence and maladministration. The contract was then given to an American company, Maximus. The tests may be repeated as often as the JobCentre Plus decides. If the disabled person scores low in the tests, they are judged fit for work. They lose their ESA and are told to apply for Jobseeker’s Allowance.

The tests are based on a monograph, The Scientific and Conceptual Basis of Incapacity Beneft, by Gordon Waddell and Mansel Aylward, of 2005 and a succeeding work, Is Work Good for Your Health and Wellbeing? By Gordon Waddell and Kim Burton. They were also strongly influenced by a 2001 New Labour conference, in which Aylward was a contributor, Malingering and Illness Deception. These led in turn to the publication of a Green Paper in 2006, A New Deal for Welfare: empowering people to work – an independent assessment of the arguments for the proposed Incapacity Benefit reform. Both Waddell and Aylward were professors at the Unum Provident Centre for Psychosocial and Disability Research at Cardiff University, which was funded by the American insurance giant from 2004-9. The Work Capability Test uses a form of Bio-Psychosocial model of assessment, developed in America by Unum Provident. This model of assessment is considered to have been devised by George Engel in 1977. In 2006 a paper produced by Professor Christopher Butler and his colleagues attacked the model as ‘wanting’ and inadequate. Waddell and Aylward’s 2006 paper has also been attacked and discredited by Emeritus Professor Alison Ravetz.

Unum, and pseudo-medical testing actually became part of the disability benefits system twelve years or so prior to the Waddell and Aylward’s paper, in 1993, when the-then Conservative Health Secretary, Peter Lilley, introduced tougher testing designed to evaluate whether claimants were totally incapable of work. They had previously been awarded benefit if they were unable to do their job. Lilley considered that this approach was to open to sentimental interference by doctors, and so set up an ‘Incapacity benefit medical valuation group’, whose members included Dr John Le Cascio, the second vice-president of Unum Corporation. Lo Cascio had recently been seconded to its British branch, Unum Ltd, based in Dorking in Surrey. In 1994 Lo Cascio was appointed to train the British doctors charged with carrying out the tests by the Benefits Agency Medical Services. New Labour claimed that the purpose of the Work Capability Tests has been ‘to get people back into work’. This was always a misleading claim. New Labour had a ten-year plan to remove one million people from the 2.8 million receiving disability benefits. Their Secretary of State for Health declared ‘We know that being in work can be good for your wellbeing’, echoing the title of the paper by Waddell and Burton. 13 Years before that, Lilley introduced the tests with the aim of cutting £2 billion from the benefits bill.

And Unum itself regarded the benefit cuts as a great commercial opportunity. In their report in 1994, Chairman Ward E. Graffam was enthusiastic about ‘exciting developments in Britain’, saying ‘the impending changes to the State ill-health benefits system heralded in the November 1993 Budget will create unique sales opportunities across the entire disability market and we will be launching a concerted effort to harness the potential in these.’

Atos immediately decided that three-quarters of those in receipt of benefit were fit for work.16 Between the introduction of the tests in October 2008 and February 2012, the Department for Work and Pensions made over 1.36 million decisions on whether to award ESA following the administration of the tests on claimants. It declared 794,000 sick and disabled people ‘fit for work’. From the very beginning, the tests were criticised as being vastly inaccurate, and the treatment of claimants under it as cruel and degrading. ‘We Are
Spartacus’, a network of disability researchers and campaigners, denounced the way claimants were ‘wrongly assessed, humiliated and badly treated’. In response to repeated requests by disability campaigners, the DWP finally released the figures for the number of people dying over 11 months in 2011 while in receipt of ESA. 10,600 people in total had died. Of these, 1,300 had died after being taken off benefit following the decision that they were ‘fit to work’. Some of the people, who have died, committed suicide in despair at having their income terminated. One of these was a 47 year old man, who took a drug overdose. Others experienced a deterioration in their mental health due to the stress of assessment. Between 2008 and 2014, there were 600,000 appeals. This constitutes a third of all assessments, and in 2012-13 there were 465,000 appeals, with a success rate of 39 per cent. In some areas, lawyers had a success rate of over 80 per cent overturning decision by Atos against the claimant receiving benefits. 60 per cent of those, who had successfully appealed had scored zero. That is, Atos had declared them entirely fit for work. In 2013, however, the Conservative government took the decision to end legal aid for claims for welfare payment, which meant that fewer people would be able to afford to take the government to court.

In America, Unum Provident was fined $31.7 million in a class action lawsuit in California in 2003 for running ‘disability denial factories’. Two years later in 2005, John Garamendi, the California Department Insurance Commissioner, fined the company $15 million, declaring ‘Unum Provident is an outlaw company. It is a company that has operated in an illegal fashion for years’. The insurance commissioners of 48 American states had made a settlement with the company by 2006 that required it to review 200,000 claims and pay a $15 million fine. In 2008 the American Association of Justice declared that the company was the second most discredited insurance provider in America.

Despite public anger at Atos’ conduct of the Work Capability Test for ESA, the government in 2012 awarded the company another contract, worth over £400 million, for assessing whether disabled people were suitable for the Personal Independence Payment that was scheduled to replace the Disability Living Allowance in 2013. The Disability Living Allowance provided the handicapped with up to £130 per week to help them look after themselves. This was mostly awarded to help people cook, wash, and assist those with mobility problems. In the three years from April 2013 to 2016, this is to be phased out and replaced with the PIP, which is designed to get people back into work. The government was determined to cut spending on the PIP by twenty per cent during these three years, after the number claiming DLA rose by 30 per cent to 3.2 million people between 2002 and 2011. This was expected to throw 500,000 people off disability benefit.

As with their administration of the ESA fitness to work tests, Atos has proved to be less than efficient in its administration of the PIP. Those applying for the benefit may have to wait months before being notified that they are entitled. The cancer charity, MacMillan Cancer Support, stated that there were serious delays in the approval of payments. As well as leaving the terminally ill without this benefit, it also meant that they were unable to claim other vital benefits with which PIP was linked. As a result, some were forced in their desperation to take out loans from payday loan companies, which have a truly exorbitant interest rate. The number of problems with ESA dealt with by Citizens Advice rose by 54 per cent from 2011 to 2012, when the bureaux dealt with 450,000 of them.

Paul Farmer, the head of the mental health charity, Mind, criticised the tests for failing to consider the effects of mental health on people’s ability to work. In an interview with the Guardian in 2012, he said

The system is based on assumptions that claimants need to be forced back to work, rather than supported on their own terms, and that those not well enough to go back to work are somehow perceived as scroungers. These attitudes only serve to further damage individuals’ mental health and increase the time until they may be ready to return to work.

Richard Hawkes, the chief executive of Scope, another disability charity, stated that the tests ‘should be more than an exercise in getting people of benefits. It should make sure disabled people get the specialist, tailored and flexible support they need to find and keep a job.’ The House of Commons Work and Pensions Committee condemned the tests, stating that the system was so flawed it needed to be completely overhauled.

Guy Standing in his A Precariat Charter states that governments have been able to cut benefits for the disabled far more than for other groups, because they are a minority and so there is likely to be fewer objections to their treatment and lost votes. He also recommends that any firm hired by the government to provide services for the disabled should be bound by three commitments. The first should be to the disabled themselves; the second should be to the government; and the third should be to the whole of society, as the rest of us could be next. The employment contract awarded to such outsourcing firms should include penalty clauses requiring them to compensate the disabled claimant directly when they do not award them the correct benefits. This compensation should be much more than the benefits the disabled person did not receive. They should also be penalised for their mistakes. This would be a start, but it is not enough. The problem lies not with the companies administering the tests, but with the whole system of tests itself. The cause of the problem is attitude of successive governments, from John Major’s Conservatives, through Blair and Brown’s New Labour and then the Conservative-led governments of David Cameron, that the disabled should automatically have their benefits reduced, regardless of the poverty and hardship involved. The goal should be to provide benefits to support the poor and disabled, rather than cuts intended to reduce the tax burden for the rich. The Work Capability Test and the poverty and stress it inflicts should be stopped. Now.

Private Eye from 1995 on Unum and Peter Lilley in the Tory Government

As the left-wing blogs have repeatedly pointed out, the Tories’ welfare reforms, in which the disabled are assessed and routinely denied benefit for being supposedly ‘fit for work’, are based on the quack pseudoscience of the American insurance giant, Unum. It’s pet doctors dreamed up the profitable idea that any and every kind of work was useful in helping the sick and disabled to recover. This was enthusiastically taken over by the Tories and New Labour, as it justified throwing hundreds of thousands off disability benefit on the spurious grounds that they could work.

The results have been horrendous. Severely mentally ill people have been driven to the point of suicide by the threat of losing their benefits. Doctors and psychiatrists have seen increased numbers coming to them suffering from stress due to assessments. Critically ill people, including those dying of cancer, have been told that their benefits have been stopped, as they are well enough to work.

In his ‘Footnotes’ column in Private Eye’s issue for Friday, 16th June 1995, Paul Foot published this article on Unum, which had been brought into John Major’s Tory government by Peter Lilley. Here it is:

Doctor On Call

To help him in his bid to save £2 billion a year by slashing the benefits of disabled people, Peter Lilley, social services secretary, has hired the vice-president of a big multinational private insurance company which is using the benefit cuts to boost its sales.

Overcoming the xenophobia to which he so often gives voice at Tory party conferences, Mr Lilley has appointed an American.

Founded in Portland, Maine, in 1848, the Unum Corporation describes itself as “the world’s leading light in disability insurance”. Unum Ltd, its British arm, is based in Dorking, Surrey. It issued its annual report last September, when chairman Ward E. Graffam enthused about “exciting developments” in Britain.

He explained: “The impending changes to the State ill-health benefits system heralded in the November 1993 Budget will create unique sales opportunities across the entire disability market and we will be launching a concerted effort to harness the potential in these.” In January, the full extent of Lilley’s plans to replace invalidity benefit with incapacity benefit revealed to the Commons. Estimated “savings” for the year 1996-97 were £410 million; for 1996-97 £1.2 billion; and for 1997-98 an astonishing £1.7 billion.

Obviously, with so much less government money going to sick and disabled people, the opportunities for private disability insurance were enormous. No longer could people rely on benefit income if they became ill or disabled. They would have to fend for themselves. Accordingly, UNUM Ltd, as its chairman had promised, “launched a concerted effort to harness the potential”. In April this year, a glamorous and expensive advertising campaign coincided with the new rules for incapacity benefit.

One UNUM ad warned: “April 13, unlucky for some. Because tomorrow the new rules on state incapacity benefit announced in the 1993 autumn budget come into effect. Which means that if you fall ill and have to rely on state incapacity benefit, you could be in serious trouble”. Lurid tables estimating weekly outgoings for an average family at £276, and benefit under the new rules at £100, urged people to “protect yourself with a Long Term Disability policy from UNUM”.

Crucial to the new rules were tougher medical tests to find out if people really are incapacitated. The Benefits Agency Medical Services (BAMS) recruited a new corps of doctors to carry out new “all-work tests”. The basic change in the tests was simple. In the past, disabled or sick people were entitled to benefit if they could no longer do their job. From now on, people are entitled to benefit only if they can do no work at all.

The new medical tests were fundamental to the “savings” Lilley hoped for. If the tests were too lax – if doctors were allowed to slide into sentimental slackness in assessing peoples’ ability to do any work at all – the whole purpose of the tests would be thwarted. So Lilley’s department set up an “incapacity benefit medical valuation group” to “monitor and validate the quality standards for the doctors involved in the all-work assessments”.

The most famous member of the group is Dr John Le Cascio, second vice-p0resident of the Unum Corporation, who has recently be seconded to the company’s British arm. Dr Le Cascio was also invited last year by Lilley’s department to help in the extensive training of doctors in the new techniques of testing. The DSS stresses that “the doctors don’t decide the incapacity benefit – that is done by an adjudication officer”. No doubt; but the officer makes a decision on the expert medical information provided the tests.

No press release was issued about Dr Le Cascio’s appointment. No one told taxpayers that the DSS is shelling out £40,000 to Unum Ltd for Dr Le Cascio’s services in the year from October 1994 to September this year. A DSS spokeswoman explained: “This comes down basically to a daily rate of £440 a day. That’s cheap for a consultancy, actually”.

The Eye asked Dr Le Cascio if he agreed there was an absolutely obvious conflict of interest in his position as validator and monitor of tests for a benefit, the cutting of which was being exploited to the full by the advertisements for his company. He replied:

“Well, I don’t feel that way of course, and if I did I wouldn’t have accepted the job. I was brought in for a specific reason, and that is to teach some of the medical principles which are contained in the design of the new test – that’s what I do, that’s my area of expertise. I’m a technical person and I can do that. To me, there is no sort of conflict as long as I do that job. I feel comfortable doing it, and I assume that those in the department feel comfortable with my contribution. The reason they’ve turned to me is because the commercial insurers have been working with this sort of valuation system for a long time and that’s where the knowledge lies.’

It was thus Peter Lilley and the Tories, who introduced Unum and the wretched work capability assessment. New Labour retained and expanded them, but the ultimately responsibility lie with the Tories. And the results have been horrendous. Mike estimated that about 52,000 people a year have been killed through benefit sanctions.

All so Lilley could persecute the poor and sick, and his friends in private insurance could make a quick buck.