Why I blew the whistle on Atos fitness-for-work test

[Ria]

Why I blew the whistle on Atos fitness-for-work test
Greg Wood, a doctor employed to carry out the controversial test, explains what made him speak out
http://www.theguardian.com/society/2...test-greg-wood

Amelia Gentleman
The Guardian, Wednesday 31 July 2013


Greg Wood: 'I was told if you can press a button you get no points for manual dexterity, but it’s actually not what is in the regulations.' Photograph: Sarah Lee for the Guardian
Greg Wood decided that he could no longer tolerate working for the fitness-for-work assessment firm Atos earlier this year when he was asked, for perhaps the 10th time, to change a report he had made on a claimant, in this case making it unlikely that the individual would be eligible for sickness benefit.

He had harboured concerns about aspects of the work he was expected to perform for several months, but finally decided to leave because he felt the company was unethical to put pressure on a doctor to change the conclusions of an assessment.

His decision to blow the whistle on practices within Atos made headlines in May, because he was the first Atos-employed doctor to put his career on the line and articulate concerns about a system that has been criticised by charities and claimants for years. Wood gave strong evidence to the BBC to suggest that the methods used to assess whether individuals are eligible for the new incapacity benefit – employment and support allowance (ESA) – were "unfair" and "skewed against the claimant".

Last week, the government revealed that the quality of reports written by Atos assessors had fallen to "unacceptably poor" levels. Given the noise created by his act of whistleblowing, Wood thinks he can take a sliver of credit for the government's subsequent decision to retrain those Atos staff delivering the controversial fitness-for-work test and to start appointing new companies to take on the work, alongside Atos.

No ideological dispute

Wood joined Atos in 2010 after 16 years as a navy doctor. He saw the job of helping the government determine who was eligible for benefits as a respectable and important position, and wants to make it clear that he has no ideological dispute with the underlying principle of assessing people. He was paid about £60,000 a year for a 37-hour week.

"I'm not complaining about the function of what Atos does. I'm all for rational assessments. I've never liked the idea that people can just say that they've got something wrong with them and you just accept that. I think you do need an objective assessment," he says.

Atos was given the contract to perform the work capability assessment (WCA) by the last Labour government, and its team of doctors, nurses and physiotherapists are responsible for carrying out a computer-led test that looks at the claimant's ability to perform a range of functions (walk 200 metres, sit down for extended periods, use their hands, for example). In order to qualify for ESA, an individual needs to score 15 points. Since the company began reassessing former incapacity benefit claimants at a rate of around 11,000 people a week, very high numbers of people have been unhappy with the results, and have appealed against them. The total number of people appealing every year – both inside and outside of tribunals – has risen from 279,000 in 2009-10 to 465,000 in 2012‑13.

For the first two years, Wood had no complaints about his work, most of which was conducting less controversial assessments for a different benefit, the soon to be defunct disability living allowance. In May last year, however, he was sent on a one-day training course on how to carry out a slightly updated WCA, which had more stringent eligibility criteria, and several aspects of the training concerned him.

The trainer gave quick rule-of-thumb guidance on several areas of the test, which he believed deliberately traduced the more nuanced written instructions in the assessors' handbook on five critical areas, so that assessors were less likely to award points to claimants. He thinks the guidance is "plain wrong" in the five areas of: mobility, manual dexterity, continence, personal action, and risk.

"The trainer says: 'If they can walk from one room to another, they can walk 200 metres, which means they won't score any points [on that section of the assessment]'," he recalls. "I said: 'Well, one room to another is not 200 metres'. I wanted to know how they worked that out, and there was no explanation forthcoming."

"I was told, if you can press a button you get no points for manual dexterity – that's easy to remember – but it's actually not what is in the regulations," he says. The regulations set out a more nuanced set of tests that assess other manual skills, he argues, making it easier for claimants to be awarded points.

On another section of the test, he was also told: "If they can wash and get dressed, they have enough drive and concentration to do a job." He describes this logic as "medical nonsense". "That's true if you're two, and you wash and dress, then that probably requires some concentration. Anyone over the age of about five, doesn't need to concentrate," he says. Guidance from trainers encourages assessors to have a "cavalier" attitude to the difficulties of incontinence, he adds. He has written in detail about the five points in his blog.

When he pointed out that some of the guidance was "unmedical", his trainer responded with "irritation", he recalls, and shortly afterwards he was called out of the training room to talk to his line manager. He thinks that fellow trainees were "cowed" by the trainer and the process.

"I sensed that by questioning some of what I called bogus rules of thumb, I triggered a degree of irritation, if not hostility, in the trainer," he says. "I don't want to blame the trainers, because they were just obeying orders. The upshot is that there will be fewer points awarded. This is one of the reasons that there are so many successful appeals, because the tribunal judges read the manual."

In January, the quality of his reports began to be audited, for reasons that are not entirely clear to him. He understands the need for auditing and was happy to submit to the process, until line managers began to request that his reports were rewritten.

His patience ran out when he was instructed by his line manager – the clinical performance lead – to reduce the number of points awarded to a claimant with serious mental health problems.

"It was clearly wrong, medically," he says. "I had more mental health experience than most of the staff at Atos; I was supposed to be a lead on it. The two people who were telling me to change my report weren't. I had seen the person; they hadn't. She had chronic psychotic illness, going back about 20 years, in and out of hospital, on very strong medicines. Talking to her, she couldn't concentrate, she rambled, she had some odd ideas about things. A classic example of an only partially treated, chronic psychotic person. She fully deserved points. I was specifically told to amend the report. It wasn't: 'You ought to think about changing it'. I was sent two emails both telling me: 'You need to amend the report'," he says.

He resigned within the hour. He points out that the General Medical Council makes it clear that doctors must not change a report and risk being disciplined for unprofessional conduct if they do.

An Atos spokeswoman said that all training delivered to Atos practitioners was reviewed and approved by the Department for Work and Pensions. "A practitioner will only be asked to amend their report if there are quality problems identified within it. There is no ethical conflict in advising a doctor that aspects of their work require further attention to meet the standards expected; indeed, quality audit and feedback is a key aspect of all good medical practice."

Like all Atos employees, Wood was obliged to sign the Official Secrets Act when he joined the company. He thinks that this was a precaution more relevant to staff carrying out other, sensitive government contracts, and not a ruse to muzzle doctors employed to carry out the WCA. Since he is not revealing any official secrets, he has no qualms about speaking out, but he says becoming a whistleblower is not necessarily a positive move for a continued medical career. He is not currently working as a doctor, and is focusing on writing a book on Iraq.

He describes the whole assessment process as an "embarrassing shambles", but does not think Atos is necessarily to blame. He thinks a system whereby private companies are contracted in to perform sensitive tasks for the state is inherently risky.

"Atos is a business that makes money, as all good businesses do. If you're an Atos executive, what you're thinking about is the contract and getting a decent return. If you're a caring citizen, you worry about someone who is disabled and has had a stroke, and who has to come to this assessment thinking that they are going to lose some money or that someone is going to say, 'There's nothing wrong with you'. These are soft social judgments that the business model cannot handle," he says.

Curriculum vitae

Age 48.

Family Partner.

Lives Kennington, London.

Education Dulwich College; medical degree, University of London.

Career 2010-2013: Atos disability analyst; 2007-2010: not working; 1991-2007: Royal Navy medical officer (2005-06, senior medical officer, Maysan Province, Iraq; 2002‑05, principal medical officer, Faslane); 1988‑1991: NHS junior doctor in hospitals in Dartford, Chatham and Ashford, all in Kent.

[Ria]

There are so many cases that are ridiculous that problem, runs into the thousands

i.e. People with cancer receiving letter after their dead saying they are not eligible for sickness benefit and are fit and able for work.

A young woman with cerebral palsy with mantel age of three and a lack of coordination, needing her mother to guide her across roads. Apparently because she could walk even though she has no idea were she is, is deemed fit for work.

Also there is the liability for the employer, taking on people with mental illness can have quite wide implications. If you have a bad back there are days when you are immobilized, server migraines sufferers don't see the light of day for a week.
If you are a small company you cant afford to have absentee employees.

Would you feel safe if the bus driver, pilot was heavenly medicated. What if the truck in front is driven by a medicated person? You might be able to hold it together for a short spell, but after some hours?!?!

Heavily medicated people are recommended not to drive, because of impaired responses and actions. Yet be responsible with other machinery and equipment.!!!!

Other people are at risk and so is the employer.
Not all employers are bad people either.

[Keltikmuse]

I attended my test in a wheelchair last year...I have avascular necrosis in my right foot and my left Achilles tore due to pressure of walking one sided..I was waiting for that to come out of plaster to get the op on the right foot to have a dead bone removed..which I had done in May.
I was turned down and only now have I received a tribunal date..a year in and out of plaster and getting by on my own in a wheelchair..it bloody stinks.
I understand there are skivers who want to live on benefits but I am NOT ONE OF THEM. I want to work and have a nice life that money brings,,,I am living on 53£ a week due to now having to pay bedroom tax as well..and they think I want to live like this.? I could go on and on but will not bore you all with it.
Suffice to say when I go to the tribunal I will be armed with documents and paperwork and keep them there all bloody day .

P.S I was offered a job with ATOS as I am a nurse ,,lolololololol

[Sunny-side-up]

I've had to suffer the test!
"Test LOL"
To call it a Test is a farce!

I told the so called examining Doc that at my failed test!

Managed to get to tribunal and found a very professional and concerning judge and the same level a Doc.

I told them the test was a farce and that just getting to it meant you had Failed 0;o

I had to keep moving, getting up and down and at one point leaning over their desk during to tribunal.

I told them "Yes" I can do this and that for a minute or so but! each movement has a accumulative effect on me so I go into ACUTE pains. I'm in constant CHRONIC pains all the time..

I had great trouble and pains getting home '3 trains' which caused me a week of heavy acute pains and a great lowering of my mental strength to cope!

I'm heavily medicated and most waking time dizzy. I would love to work, i'm a team worker at heart and in the distant past over worked.

The other point is no jobs around anyway Doh

I passed and got reimbursed all costs and back dated payments, which was then used to pay back other family members the loan/gifts they gave me during my ordeal..

The whole process has made me iller as it has many other people who it was obvious they were in no way capable of constant work.
Very big waste of Tax payers money and a very damaging cruel way to treat ill people.

Yes there are people out there that are not ill and claiming benefits and should be found and stopped but go a bout it with concern that there are actually ill people as well.

Just be your self, be ill in front of them, don't be to organised and you will pass the tribunal if you are ill...

My dad fought in the second world war, a very decent upstanding man of great honor and responsibilities.
He did not have one ounce of respect for politicians and he used to say of them
"Give every politician a gun, let them shoot it out and when there is a survivor just shoot him as-well ! ! "

Oh nuff said,
Good post Ria and this is not your fault, but it has brought back a lot of mental pain and frustrated anger.
Stay true to your self, keep your head up and you will get through it all.

Love, Golden Healing Light and Hugs

[Ria]

http://johnnyvoid.wordpress.com/2013...sabled-people/

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Report Calls For Expansion Of Residential Workfare For Unemployed and Disabled People
Posted on July 31, 2013 by johnny void | 71 Comments
An independent report, commissioned by the DWP, has called for greater use of Residential Training for disabled people and an extension of the scheme to include long term unemployed non-disabled people.

The report also accepts that this kind of training, which can involve periods of workfare away from home, should be opened up to the market. This process may begin with a open tender exercise next year.

Residential Training is a little known scheme available for disabled people who are long term unemployed and in the words of Jobcentre Disability Employment Advisors, are the ‘hardest to help’.

The programme lasts a year and includes a mixture of residential and non-residential training, along with a period of up to three months workfare. Whilst the DWP’s guidance (PDF) states that this workfare should aim to take place in the participant’s local area, in some cases it can also be arranged on a residential basis.

Currently the scheme is entirely voluntary with no sanctions for refusing to take part or leaving the training. Of course this doesn’t mean that Jobcentre advisors may not pressurise claimants to take part. Often the most vulnerable claimants, who may be isolated, have learning disabilities, a mental health condition or face other significant difficulties are bullied onto non-mandatory schemes, with vague threats and over-optimistic promises of what is likely to be achieved. As the scheme is hugely expensive however, it is unlikely there is currently a large amount of pressure on staff to make referrals.

Like all DWP training, it’s mostly bollocks. As the Department says: “Training is not designed to train a Participant to the highest level available in their chosen vocation, but to equip an individual with the skills and knowledge that enable them to obtain and sustain employment.”*

Instead it appears to be the usual low level training for minimum wage work that will be familiar to any claimants who have experienced the Work Programme, the New Deal and the endless other schemes run by welfare-to-work parasites and inflicted on unemployed people. The true purpose of the training seems to be to operate as some kind of re-education camp for disabled people. This week’s report says that the residential element of the scheme enables “unemployed disabled people ‘think new thoughts’ about their life chances and their ability to work.”

The infamous review of training and employment provision for disabled people written by Liz Sayce recommend that the DWP stopped funding this kind of training and instead put the money into mainstream workfare such as “work experience, including internships, work placements and on-the-job learning.”

This consultation report is a response to these recommendations and strongly disagrees, calling for the scheme to be extended to non-disabled long term unemployed claimants.

This comes along with recommendations that this form of training be ‘integrated’ within the Work Programme and the acknowledgement that if these recommendations are implemented then Residential Training will be opened up to the market.

Currently there are nine Residential Training centres, all run by charities and which it is fair to say offer decent standard of accommodation – all residents have their own room for example. However, should this training be put out to competition, then this is certain to undermine these conditions as organisations compete to downgrade facilities and cut costs.

If the private sector is involved in this process, then the implications are even more concerning. It is chilling to imagine what an A4e or G4S run Residential Training facility would look like in practice.

And once the welfare-to-work companies get a taste of the pie, mandation – which means benefits being stopped for people who refuse to attend – is unlikely to be far away.

This of course is wild speculation. This report contains only recommendations which may well be ignored. Any attempt to introduce mandation into a residential scheme would almost certainly require new legislation, which isn’t happening this side of the next election. It would also be far too expensive to roll this out to all claimants, and however it evolves is likely to remain aimed at the so called ‘hardest to help’.

But this report shows a worrying direction being considered at the DWP. The potential for a charity run residential training facility to eventually become an A4e run workhouse is difficult to ignore.

Strangely the link to this report, which was published on the 29th July, seems to have disappeared from the DWP website, although it is still available on google cache and at: https://www.gov.uk/government/upload...ent-report.pdf

*This is a good example of the recently discussed principle of ‘less eligibility’. If any genuine training was available to unemployed people, then this may be a more attractive option than minimum wage work. Therefore it cannot be permitted.

[Violet]

Posted by Ria (here)
There are so many cases that are ridiculous that problem, runs into the thousands

i.e. People with cancer receiving letter after their dead saying they are not eligible for sickness benefit and are fit and able for work.

A young woman with cerebral palsy with mantel age of three and a lack of coordination, needing her mother to guide her across roads. Apparently because she could walk even though she has no idea were she is, is deemed fit for work.

Also there is the liability for the employer, taking on people with mental illness can have quite wide implications. If you have a bad back there are days when you are immobilized, server migraines sufferers don't see the light of day for a week.
If you are a small company you cant afford to have absentee employees.

Would you feel safe if the bus driver, pilot was heavenly medicated. What if the truck in front is driven by a medicated person? You might be able to hold it together for a short spell, but after some hours?!?!

Heavily medicated people are recommended not to drive, because of impaired responses and actions. Yet be responsible with other machinery and equipment.!!!!

Other people are at risk and so is the employer.
Not all employers are bad people either.

That's real bad. I've heard people complaining about a similar government body in our country. They have a complaint department that is said at times not even to respond to complaints at all. And when a decision has been taken, applicant always has the possibility to appeal in court. Strikingly enough, quite some cases appear to be eligible all of a sudden after that...

Unfortunately the class of people at stake here are often the ones that don't easily make it to the (pro-deo) lawyer.

Lol at "heavenly medicated" though.

[AriG]

This discrimination makes me furious. We all pay outrageous taxes so that those who need care, get care. Instead our dollars fund illegal wars and black ops. People, its time. Enough is enough.