It looks as if Channel 4 might be taking a step towards redemption, after inflicting Benefits Street upon us, with a piece of investigative journalism into the quality and ethics of medical assessments for the controversial Personal Independence Payments.
I've blogged previously about some of the failings with PIP although at that stage, the main complaint about assessments was that they weren't happening quickly enough. The C4 Dispatches programme highlights another problem - that they aren't being conducted properly. I doubt if there is a welfare rights adviser in the country who won't greet that news with the words 'No shit, Sherlock!' or similar. We've been struggling with slapdash so-called medicals for years, dating back way before Capita, long before Johnny-come-lately Maximus and even before Atos set to work.
It's also been an open secret for years that some people carrying out these medical assessments give not a jot for the people they see or their obligation to do a proper assessment for the sake of fairness to the broader society, but rush through them because, in doing so, they can make a shed-load of cash.
When people who were unfit for work still claimed Incapacity Benefit or Income Support and, before Atos took over the contract and introduced an IT system to make getting it all wrong even easier, we dealt with scores of appeals against 'fit for work' decisions at my CAB. We noticed that certain doctors' names turned up on the reports more than others. At this time, all the assessments were done by doctors, not miscellaneous 'HCPs'. Several had an apparently high rate of overturned decisions but one name stood out for both an extraordinarily high 'appeal allowed' rate and the number of people challenging his decisions. We'll call him Dr Branton, because that's his name.
In the beginning, the IB85 medical reports were hand-written, which was an extra challenge for advisers as the doctor's handwriting needed deciphering before the report could be assessed for accuracy and consistency. With Dr Branton, this took a little less time than usual because he rarely wrote much and almost all of his reports began in exactly the same way. The claimant was observed to be "a tidy man. Standing, walking and sitting normally. Talking in a clear voice with good eye-contact."
The odd exception arose when he had to describe "a tidy woman".
We lost this signature start when the IB85 was computerised though we gained a new piece of information at that stage - the duration of the assessment. The range was considerable, from well over an hour down to under ten minutes. For some years, Dr B held the record for both the fastest assessment and the fastest average overall. It was only after an acrimonious split from Atos, when he sold his side of the story to the Daily Mail (again, "No shit, Sherlock!"), that we appreciated that time was money - and vast amounts of it. He bragged about being able to make £450 per day - and that was eight years ago. Full-time skilled workers are still lucky to make that much a week around here. It's astonishing that the Dispatches report suggests the same level of profiteering is still going on and that it wasn't rooted out long ago.
Despite his perception of being an honest man in a cowardly culture, what my colleagues and I observed suggested quite the reverse about Dr Branton. We had started to keep a tally for each doctor, recording how
many people came to us to challenge their decisions and what percentage of those we
took to appeal we won. Branton's results were easily the worst, though many of the others hardly covered themselves in glory. At the Tribunals Service, 'Dr B' became widely recognised as a dubious authority. If you lost a case where the IB85 was Branton's work, you felt you should return to the office only to clear your desk. We shared our stats with the DWP, who took our concerns
seriously enough to send an officer out to hear more evidence, though by
then Dr Branton was already on his way out.
I hope, therefore, that tonight's documentary doesn't focus on Capita as the root of the problem. It's deeper than that and by no means unique to PIP. After all, Dr Branton's "tidy man" reports pre-dated Atos. Sadly, because the companies carrying out these contracts recruit people whose skills are in demand elsewhere, the relatively generous salary and bonus packages they offer can attract the crafty, greedy and lazy, as well as those genuinely struggling to get by on some NHS salaries. This story is a case in point.
Finally, I hope the programme points out the consequences for claimants and their families of getting the wrong decision on a disability benefit. Not everyone understands that they have the right to appeal and, of those that do, not all will be able to access support. Even those who win will have had to cope for months without vital funds, often contributing to a deterioration in both their physical and mental health. Many will have debts as a result, and seen family and other relationships put under additional pressure. We know that some people feel so worthless after having their health problems dismissed out of hand that they give up the struggle to go on living. Perhaps the prospect of corporate manslaughter charges is what's needed to ensure that those carrying out ESA and PIP assessments, and those responsible for them, work to the highest possible standards of fairness and accuracy, every single time.
