I've been working with my colleagues on a last ditch take-up campaign to ensure that as many disabled people as possible in our district claim legacy benefits with appropriate disability premiums before Universal Credit arrives next spring and sweeps all such things away. With this in mind, we've been putting a leaflet together on the severe disability premium.
For those of you not in the know, the severe disability premium, abbreviated to SDP (amusing if you're old enough to remember 1980s politics) is an extra element of means-tested benefit calculations for people receiving certain disability benefits (Attendance Allowance, PIP at either rate for daily living or DLA at the middle or higher rate for care) if they also a) live alone* and b) have no-one receiving Carer's Allowance for looking after them.
Well, that's what it always used to say. Since April 2016 b) should add that no-one must be receiving the Universal Credit Carer's Element for looking after them. This is a shift in policy since the Carer's Premium, included in the calculation of many legacy means-tested benefits, is not treated this way.
This is a more major change than seems to have been spotted at the time and one which could leave many disabled people significantly out of pocket as the UC full service rolls out and existing claims for means-tested benefits and tax credits transfer over. He's an example showing some potential problems:
Cynthia is a pensioner getting Attendance Allowance. Her income is above the basic Pension Credit level and her savings would usually exclude her from Housing or Council Tax Benefit but, because she lives alone and has no-one claiming Carer's Allowance for looking after her, her Pension Credit assessment includes an extra £62.45 per week SDP. This may only give her entitlement to a small amount of Pension Credit but this 'passports' her to maximum Housing and Council Tax Benefit.
Cynthia's daughter Joanna is her primary carer, spending over 35 hours per week looking after her. Joanna doesn't claim Carer's Allowance because she has a part-time job paying her more than the earnings limit for this benefit. She does, however, claim Housing Benefit and Child Tax Credit. Joanna's current situation does not impact on Cynthia's SDP.
Joanna has a change of circumstances - let's say she separates from a partner. She's in a full service UC area so now has to claim UC rather than legacy benefits. As part of this process, she discloses that she is a carer. This triggers a Carer Element with her UC award which will terminate her mother's entitlement to the SDP.
If Joanna knows this will happen (which suggests she works part-time as a benefits adviser, as no-one else is likely to know!) she has only two options; decrease the hours she spends caring for her mother to remove eligibility for this element or knowingly 'fail to disclose' the extent of her caring, which appears to put her on the wrong side of the law, especially as she is doing so specifically to gain extra benefit income for her mother (albeit at a financial loss to herself).
What she cannot do - the option open to potential Carer's Allowance claimants - is simply opt to carry on caring for her mother and not 'claim' the Carer's Element, as she cannot pick and choose which elements are included in her UC award. She can choose not to claim UC, but in that case she will get no support with raising her children or paying her rent.
The same predicament arises for many carers when they get 'migrated' to UC. The calculations - whether they stand to receive transitional protection as potential losers from the shift, or if they gain - will include a Carer's Element by default if they declare they are carers. Many of the carers won't know this could impact their 'caree's' entitlement - even those who did know about the Carer's Allowance prohibition. Most of the 'carees' will know even less.
The outcome can only be more financial losses for the most severely disabled people - including many of those whose benefits we are about to try and maximise - along with overpayments, prosecutions, family arguments and general misery.
Don't you just love it when they 'simplify' the benefits system?
*'live alone' in SDP terms means there is no other adult in the household who isn't either also receiving one of the disability benefit rates listed or registered blind.
Wednesday 8 November 2017
Tuesday 24 October 2017
#PauseAndFix - Why are we Waiting for Universal Credit?
Here's the text of an email I sent my MP ahead of last week's Opposition debate on Universal Credit. While there has, rightly, been increasing concern about the built-in six-week delay prior to the first payment, another waiting issue hasn't made the headlines...
I
am delighted that Labour have won a debate on a proposal to pause the roll-out
of Universal Credit. For the good of
millions of less well-off citizens, it is vital that this happens.
Personally,
I think Universal Credit is so flawed that it should be stopped in its tracks
and the whole project reworked, as it is simply not fit to be at the core of
our Social Security system for a generation or more. I’m sure others will have briefed you on the
many problems being encountered with UC.
Rightly, the long wait for the first payment has been grabbing the
headlines recently but there is another issue around ‘waiting’ that seems to
have slipped below the radar, and that is the seven ‘waiting days’ at the start
of new claims.
Since
2014, when the number was increased from three, the first seven days of your
claim for JSA or ESA have been ‘waiting days’ for which you receive no
benefit. If you lodged a claim today (13th
October), your payments would be based on entitlement from 20th
October. However, there are no waiting
days for Income Support and Tax Credits, while Housing Benefit awards are
usually calculated from the Monday following your date of claim. Someone claiming JSA or ESA for her/himself
and her/his partner therefore has seven days without payment of that benefit at
the start of their claim, but can get support for their children and housing
costs during that first week. Someone
claiming Income Support (usually a carer or lone parent) also receives their
earnings replacement benefit from their date of claim.
As
you know, Universal Credit rolls all of these benefits into one. It also counts the first seven days of the
claim as ‘waiting days’ in the majority of new claims. This means that a UC claimant not only misses
out on their earnings replacement benefit for seven days, they receive no
support for their children for that week, nor for their housing costs. For a jobless couple with two children and
rent of £100 per week, instead of missing out on around £115 due to waiting
days under the current regime, they would be over £300 down under UC. For larger families and where rents are
higher than they are in Stoke-on-Trent (ie. just about everywhere!) the losses
from extending the waiting day principle to children and housing costs can be
significantly higher.
The
higher this shortfall for the first week, the less chance there is of the
family affected being able to clear the debts built up as a result – especially
rent arrears – when their first payment eventually arrives. For those not working, UC gives them an
income set at no more than the minimum this Government believes they need to
live on; for families hit by the Benefit Cap, it is often very much less. They have no money to clear debts and pay
down rent arrears. By the time working
families have paid travelling costs and part of their childcare, they too are
unlikely to have spare cash.
I
do hope you will be able to support the call for a UC roll-out pause when it
comes to Parliament as I genuinely believe there is a chance to win this
vote. I hope you will also be able to
support your colleagues lobbying for further major reforms of UC; you might
urge a review of the ‘waiting days’ concept as one way to make it less
punishing.
Sunday 8 October 2017
A Typical Day
There is understandable outrage on social media today, regarding a post stating that the Tories are now denying people benefits for using foodbanks. It is illustrated with a photograph of a form on which a finding that a person has no problem with their lower limb function is justified by the statement: 'He walks to the foodbank when he needs to. This takes 30 minutes.'
With all due respect to whoever has posted this as an example of Conservative benefits cruelty, it absolutely isn't about having your benefits cut because you can use a foodbank. If this ESA claimant used to rely on points for mobility to qualify - the photo is clearly an extract from an ESA85 form, completed by a Health Professional (their phrase, not mine) at a face-to-face assessment for this benefit - he would have forfeited those points regardless of where his 30 minute walk took him, be it to the shops, to church or even to his local Conservative Club. If you can reliably walk 200 metres or more, you cannot score points for ESA activity 1. If you are walking for 30 minutes, you are, in all probability, walking more than 200 metres. Therefore, no points; not under the 2011 descriptors, nor under the original 2008 New Labour set.
So, has justice been done here? Despite what I have written above, the odds are that it has not. I've seen enough ESA85s to know that they frequently contain fewer hard, objective facts than The Chronicles of Narnia.
The reference to walking to the foodbank was almost certainly drawn from the part of the assessment in which the Health Professional discusses the claimant's "typical day" with them. It's possible that the HP and their "customer" had an in-depth chat about this journey but, unless the claimant's mobility really is too good to matter for ESA, it's far more likely that the conversation went something like this...
HP: Where do you do your shopping?
C: I haven't been able to do any shopping for the last couple of weeks. I don't have enough money. I've been going to the foodbank.
HP: How do you get there?
C: I walk.
HP: How long does it take you?
[Meaning 'how long is the walk there']
C: About half an hour [Meaning 'it takes me half an hour to get there, wait for my three day food parcel and walk back']
It's also possible that the claimant did walk for 30 minutes, going out with his voucher on a 'good day' after perhaps being stranded at home unable to make the journey for a few not-so-good days. Or that the journey was made in stages, stopping to recover after a few tens of metres before gamely pressing on. It's unlikely that the conversation between him and the HP went into anything like sufficient depth to establish this. It almost never does.
Whatever the case, it's disingenuous to suggest he has been refused benefit for using a foodbank or that this is the fault of the present Government. What we've got here is a problem that's existed for over a decade: a crazy assessment system where a health worker with no prior knowledge of a sick or disabled person - and usually no special insight into their specific health conditions - carries out a cursory examination, asks a set of standard questions from a computer system which offers all-too-easy-to-select standard answers, makes some informal observations, overlays a layer of subjective unconscious prejudices and recommends points to the DWP Decision Maker on this deeply unsatisfactory basis.
Meanwhile the claimant makes rough guess answers to badly-phrased questions about their typical day - where they like to go, what they watch on TV - that they haven't expected to be asked and haven't actually thought about, as they thought this was a medical, not a first date. The resulting ESA85 is inevitably a travesty of the truth, yet almost always the key item of evidence on which the Decision Maker bases the award/fit for work decision, often in defiance of other sound medical evidence.
We now know too, thanks to a freedom of information request, that the DWP are under pressure of internal targets to uphold these decisions if challenged, forcing people to struggle and starve while they wait for a tribunal to hear their case, or abandon their ESA claim and instead try to navigate their way through JSA or Universal Credit, built-in delays, sanctions and all.
There is more than enough real hardship and cruelty here without spinning it. Shamefully, most of it pre-dates IDS and his successors.
Friday 30 December 2016
A Bleaker Midwinter
On Monday 19th December, the Benefit Cap for unemployed families in Stoke-on-Trent fell to £20,000 per annum, or £384.62 per week. Whereas the original £26,000 Benefit Cap supposedly limited unemployed families to an income of no more than the average wage, the new cap seems to be entirely arbitrary. In effect, compared to the original Benefit Cap, the £20,000 one removes the equivalent of two more children's tax credits, if their parent(s) is/are unemployed.
In practice, this will mean two-parent, three-child families will get no more than £52 Housing Benefit per week, which is less than half the Local Housing Allowance for a three-bedroom home in this area. A lone parent raising four children gets no more than £25 Housing Benefit; larger families, only a token 50p. Neither social nor private tenancies are sustainable on that, not even in cheap-as-chips Stoke-on-Trent.
To which the answer from many is 'get a job' or 'don't have so many children' - as if poor families can somehow hand back the ones they can't afford. The Benefit Cap is, we're told, a popular measure. While Labour have slated the Bedroom Tax and pledged its abolition, there is no such promise when it comes to the Benefit Cap. Perhaps they believe that the range of exemptions protect those who genuinely can't work their way out of it?
If so, they are wrong.
The Benefit Cap clearly applies to two groups of people that benefit rules accept are in no position to find work and are not required to do so. The first is those who, after a tough medical assessment, have been put in the ESA 'work-related activity group', theoretically expected to be fit for work in the foreseeable future - but not yet. Included in this group are many profoundly sick and disabled people; I often cite as an example that you might have lost the use of your dominant arm and hand, or have actually lost them, and still not score enough 'points' to qualify for ESA even at this rate. Many have poor mental health. Few would be an employer's first choice; most could not take a job even if offered it.
The other group unable to work but still intentionally capped are women in the later stages of pregnancy, those who have recently given birth and the carers of very young children. There are no exemptions from the cap for women fleeing domestic violence, nor for recently bereaved parents. A family protected from the Benefit Cap while one parent is terminally ill and receiving PIP and/or Support Group ESA could be hit as soon as s/he dies, if their spouse hasn't been claiming Carer's Allowance, as might a family on the death of a disabled child. Even a claim for Carer's Allowance would earn no more than an eight week respite, the time for which it is payable after a death. It would take a heart of stone for a Local Authority not to allow a discretionary housing payment (DHP) in those circumstances but that needs an application, backed up with a detailed breakdown of the family's budget, at a time when extra distress is the last thing they should have to cope with.
Exemptions for families where either a parent or child is receiving a disability benefit ease the pressure on some of the most vulnerable but, with PIP and DLA regularly reassessed and often not fairly, the prospect of a horrific 'domino effect' of lost benefits is never far away. Take a lone parent getting DLA at the middle rate for care on the basis of supervision needs, perhaps for epilepsy, with grand mal fits too infrequent to meet the ESA criteria for 15 points and a place in the support group (weekly) but occurring often and without warning. While DLA might have accepted her need for continual supervision, there is no guarantee that s/he will score 8 PIP points for 'daily living'. S/he loses £55.10 per week, the DLA middle rate for care. In addition, losing DLA means no disability premium or severe disability premium - together worth £104 per week.
Ironically, losing all this could also means losing Housing Benefit, if the family was caught by the Benefit Cap. With so much other income gone, a family in these circumstances would perhaps be more likely to fall into rent arrears than one used to budgeting on less.
A similar nightmare results if a disabled child loses DLA, perhaps when transitioning to PIP at 16. Loss of a qualifying disability benefit - £21 to £82 per week - means loss too of the disabled child elements of Child Tax Credit, worth between £68 and £113 per week. A parent carer loses £34.20 'carer premium' from their means-tested benefit and may also have to take on the role of 'jobseeker' to get benefits. Then the Benefit Cap slices into their Housing Benefit.
You have the right to appeal the DLA/PIP decision but getting a decision on this, which may still not be favourable (although 63% of PIP appeals succeed) will take months. You can ask for a DHP, though you may have to keep asking, as most Councils time-limit awards - and you may be unlucky: 'discretionary' is the key word here.
Exempting carers is helpful though not without risk to people who were never supposed to be touched by the Benefit Cap - older people. Most people probably don't realise that a disabled person's benefits can be affected if they have a carer who claims Carer's Allowance. It's all down to that benefit geek's favourite, the severe disability premium, currently around £61 per week and included in the calculation of means-tested benefits where someone getting Attendance Allowance, PIP for daily living or DLA high or medium rate care i) is treated as living alone and ii) does not have a carer in receipt of Carer's Allowance.
For some pensioners, specifically those with capital of £16000 or above, the SDP is often their ticket to Guarantee Pension Credit, 'passporting' them to maximum Housing and Council Tax benefit when otherwise they would have no entitlement. Many people who get this have no idea how it works, nor that their carer claiming Carer's Allowance could bring the whole thing down like a house of cards. The loss isn't just the £61 SDP - it's all entitlement to HB and CTR, likely to exceed £100 per week. The carer might gain more, or possibly less - it's a £34 carer premium plus the reinstatement of HB lost to the Benefit Cap. In all likelihood, they too will have no idea how the disabled person's benefit will be affected, and that could set up a huge overpayment for the pensioner later.
In other cases, the pensioner might know the likely loss but agree to take it to save a trusted carer losing their home. Or the pensioner might be bullied by an unscrupulous carer into making up the Benefit Cap shortfall from his/her benefits. It's a troubling situation and one in which advisers will have to tread carefully, with potential conflicts of interest between, and within, families.
In practice, this will mean two-parent, three-child families will get no more than £52 Housing Benefit per week, which is less than half the Local Housing Allowance for a three-bedroom home in this area. A lone parent raising four children gets no more than £25 Housing Benefit; larger families, only a token 50p. Neither social nor private tenancies are sustainable on that, not even in cheap-as-chips Stoke-on-Trent.
To which the answer from many is 'get a job' or 'don't have so many children' - as if poor families can somehow hand back the ones they can't afford. The Benefit Cap is, we're told, a popular measure. While Labour have slated the Bedroom Tax and pledged its abolition, there is no such promise when it comes to the Benefit Cap. Perhaps they believe that the range of exemptions protect those who genuinely can't work their way out of it?
If so, they are wrong.
The Benefit Cap clearly applies to two groups of people that benefit rules accept are in no position to find work and are not required to do so. The first is those who, after a tough medical assessment, have been put in the ESA 'work-related activity group', theoretically expected to be fit for work in the foreseeable future - but not yet. Included in this group are many profoundly sick and disabled people; I often cite as an example that you might have lost the use of your dominant arm and hand, or have actually lost them, and still not score enough 'points' to qualify for ESA even at this rate. Many have poor mental health. Few would be an employer's first choice; most could not take a job even if offered it.
The other group unable to work but still intentionally capped are women in the later stages of pregnancy, those who have recently given birth and the carers of very young children. There are no exemptions from the cap for women fleeing domestic violence, nor for recently bereaved parents. A family protected from the Benefit Cap while one parent is terminally ill and receiving PIP and/or Support Group ESA could be hit as soon as s/he dies, if their spouse hasn't been claiming Carer's Allowance, as might a family on the death of a disabled child. Even a claim for Carer's Allowance would earn no more than an eight week respite, the time for which it is payable after a death. It would take a heart of stone for a Local Authority not to allow a discretionary housing payment (DHP) in those circumstances but that needs an application, backed up with a detailed breakdown of the family's budget, at a time when extra distress is the last thing they should have to cope with.
Exemptions for families where either a parent or child is receiving a disability benefit ease the pressure on some of the most vulnerable but, with PIP and DLA regularly reassessed and often not fairly, the prospect of a horrific 'domino effect' of lost benefits is never far away. Take a lone parent getting DLA at the middle rate for care on the basis of supervision needs, perhaps for epilepsy, with grand mal fits too infrequent to meet the ESA criteria for 15 points and a place in the support group (weekly) but occurring often and without warning. While DLA might have accepted her need for continual supervision, there is no guarantee that s/he will score 8 PIP points for 'daily living'. S/he loses £55.10 per week, the DLA middle rate for care. In addition, losing DLA means no disability premium or severe disability premium - together worth £104 per week.
Ironically, losing all this could also means losing Housing Benefit, if the family was caught by the Benefit Cap. With so much other income gone, a family in these circumstances would perhaps be more likely to fall into rent arrears than one used to budgeting on less.
A similar nightmare results if a disabled child loses DLA, perhaps when transitioning to PIP at 16. Loss of a qualifying disability benefit - £21 to £82 per week - means loss too of the disabled child elements of Child Tax Credit, worth between £68 and £113 per week. A parent carer loses £34.20 'carer premium' from their means-tested benefit and may also have to take on the role of 'jobseeker' to get benefits. Then the Benefit Cap slices into their Housing Benefit.
You have the right to appeal the DLA/PIP decision but getting a decision on this, which may still not be favourable (although 63% of PIP appeals succeed) will take months. You can ask for a DHP, though you may have to keep asking, as most Councils time-limit awards - and you may be unlucky: 'discretionary' is the key word here.
Exempting carers is helpful though not without risk to people who were never supposed to be touched by the Benefit Cap - older people. Most people probably don't realise that a disabled person's benefits can be affected if they have a carer who claims Carer's Allowance. It's all down to that benefit geek's favourite, the severe disability premium, currently around £61 per week and included in the calculation of means-tested benefits where someone getting Attendance Allowance, PIP for daily living or DLA high or medium rate care i) is treated as living alone and ii) does not have a carer in receipt of Carer's Allowance.
For some pensioners, specifically those with capital of £16000 or above, the SDP is often their ticket to Guarantee Pension Credit, 'passporting' them to maximum Housing and Council Tax benefit when otherwise they would have no entitlement. Many people who get this have no idea how it works, nor that their carer claiming Carer's Allowance could bring the whole thing down like a house of cards. The loss isn't just the £61 SDP - it's all entitlement to HB and CTR, likely to exceed £100 per week. The carer might gain more, or possibly less - it's a £34 carer premium plus the reinstatement of HB lost to the Benefit Cap. In all likelihood, they too will have no idea how the disabled person's benefit will be affected, and that could set up a huge overpayment for the pensioner later.
In other cases, the pensioner might know the likely loss but agree to take it to save a trusted carer losing their home. Or the pensioner might be bullied by an unscrupulous carer into making up the Benefit Cap shortfall from his/her benefits. It's a troubling situation and one in which advisers will have to tread carefully, with potential conflicts of interest between, and within, families.
Saturday 21 May 2016
Amicus Curiae
I unexpectedly found myself wearing my 'tribunal suit' yesterday,
appropriately (if accidentally) accessorised with a ladder up the left
leg of my tights much as my fictional alter ego Sally Archer. I don't rep for the CAB
in my current role and it must be at least five years since I was last
at our local venue; I was stepping into the breach as a favour for
another organisation and, to be totally honest, grabbing an opportunity
to see a PIP appeal in action. Confidentiality demands that I share no
more details and anyway, I don't know the result, though I'm cautiously
optimistic.
I had wondered whether there might be a Presenting Officer in attendance, since the rep who had asked me to help out with this case had encountered one at another recent PIP appeal. This was unusual as POs tend only to appear for especially contentious cases, although there was a recent DWP announcement of extra funding to provide them specifically for PIP appeals. Understandably, reaction from the broader welfare rights lobby was hostile - this article from the excellent Dr Frances Ryan encapsulating the general sense of unfairness.
I'm inclined to share this concern although, if these new Presenting Officers adopted the ethos once prevalent in the role, they could be more of a help than a hindrance to unrepresented appellants, denied properly-trained advocates by cuts to Legal Aid and advice service budgets. Although it suits my fictional stories to (minor spoiler) cast PO Tom Appleby as one of the DWP 'good guys', it involved no great leap of the imagination to do so. When I first started representing at appeals in the later 1980s, POs weren't simply the DWP's man (or woman) at the table. Their role was to be a 'friend of the Tribunal' and they could - and often did - speak up for the appellant's case, or at least concede their own gracefully.
In response to a comment I made on Dr Ryan's article that POs could be a force for good but I feared the new intake might be cut from rather different cloth than their predecessors, I was pleased to see the following:
"I was a PO in the 80s and my training stressed that the role was one of amicus curiae. I would review the papers for every case and if I was confident the law had been applied incorrectly to the facts I would tell the tribunal so, referring them to the appropriate law, including case law if necessary. If there was time I would speak to the original decision maker and ask them to revise their decision to save time. That's what POs were supposed to do. I'd probably be sacked for it these days."
The writer's nom de plume xck33l gives no clue as to his/her home town or gender but I couldn't help imagining that these might be the words of a softly-spoken Yorkshireman with a flare for interior decoration.
If the new breed of POs are to bring consistency and fairness to PIP hearings, it is vital that they be allowed to exercise the freedom and integrity of the old guard of POs and not be fettered by targets for tribunal 'wins'. On those terms, it would actually be rather a good job for some of the many benefits specialists thrown out of work by the loss of Legal Aid - as long as they could stay one step ahead of the Social Justice Ambassadors, of course!
I had wondered whether there might be a Presenting Officer in attendance, since the rep who had asked me to help out with this case had encountered one at another recent PIP appeal. This was unusual as POs tend only to appear for especially contentious cases, although there was a recent DWP announcement of extra funding to provide them specifically for PIP appeals. Understandably, reaction from the broader welfare rights lobby was hostile - this article from the excellent Dr Frances Ryan encapsulating the general sense of unfairness.
I'm inclined to share this concern although, if these new Presenting Officers adopted the ethos once prevalent in the role, they could be more of a help than a hindrance to unrepresented appellants, denied properly-trained advocates by cuts to Legal Aid and advice service budgets. Although it suits my fictional stories to (minor spoiler) cast PO Tom Appleby as one of the DWP 'good guys', it involved no great leap of the imagination to do so. When I first started representing at appeals in the later 1980s, POs weren't simply the DWP's man (or woman) at the table. Their role was to be a 'friend of the Tribunal' and they could - and often did - speak up for the appellant's case, or at least concede their own gracefully.
In response to a comment I made on Dr Ryan's article that POs could be a force for good but I feared the new intake might be cut from rather different cloth than their predecessors, I was pleased to see the following:
"I was a PO in the 80s and my training stressed that the role was one of amicus curiae. I would review the papers for every case and if I was confident the law had been applied incorrectly to the facts I would tell the tribunal so, referring them to the appropriate law, including case law if necessary. If there was time I would speak to the original decision maker and ask them to revise their decision to save time. That's what POs were supposed to do. I'd probably be sacked for it these days."
The writer's nom de plume xck33l gives no clue as to his/her home town or gender but I couldn't help imagining that these might be the words of a softly-spoken Yorkshireman with a flare for interior decoration.
If the new breed of POs are to bring consistency and fairness to PIP hearings, it is vital that they be allowed to exercise the freedom and integrity of the old guard of POs and not be fettered by targets for tribunal 'wins'. On those terms, it would actually be rather a good job for some of the many benefits specialists thrown out of work by the loss of Legal Aid - as long as they could stay one step ahead of the Social Justice Ambassadors, of course!
Monday 11 April 2016
Still Taking the PIP
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.
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.
Thursday 14 January 2016
A Striking Similarity
Until he retired, my father worked as a train driver.
A heart attack in about 1992 took him off the main line and into the
'depot' for the last few years of his employment, which had seen
both the advent and the demise of British Rail.
Even before the heart attack, Dad's work had brought him into fairly regular contact with the NHS. There were frequent trips to the old Southampton Eye Hospital in the early years of diesel propulsion, as the new locomotives chucked out tiny fragments of metal in their exhaust, which then required specialist removal if they got into your eyeball and rusted. That the same machines made such an unholy racket now means regular fitting and tweaking of hearing aids and, on several occasions in the last few years, he's been back in the Coronary Care Unit - most recently for the fitting of his second Implantable Cardioverter Defibulator.
Dad's working life and that of the doctors who've kept repairing him have always had one thing in common - a necessity to work unsocial hours. Recently, however, I've noticed another.
It was The Sun's stories about "Moet Medics" that triggered the deja vu moment. Of course I hadn't seen them in the actual paper - I wouldn't so much as wipe my backside on that rag - but I had laughed at the Junior Doctors' clever Instagram/Facebook parodies mocking allegations that they led the high life on inflated salaries. One of the joys of Social Media is that you can instantly strike back against the media establishment if you are misrepresented. In 1982, that wasn't so easy.
I mention 1982, because that was the year that Dad and his colleagues got the "Moet Medics" treatment from The Sun. There was a dispute in progress between BR and the drivers over something called 'flexible rostering'. Most people outside the industry thought this must be something quite positive, like 'flexitime' for office workers. For the drivers, it was a fundamental attack on their terms and conditions of employment since their work patterns were already pretty 'flexible', with the starting time of a shift able to be moved up to two hours between one day and the next. So a week of 2am shifts might start at that time on day one but at 00.01 the next night, back to 02.00 after that and then 03.50, depending on requirements, with the next shift's start time advised at booking off from the one before. If he was on nights, Dad would leave my mum a note when he came home and before he went to bed, to say what time he was due at work the following night and, on that basis, when he was likely to be up and about and what they could therefore do during the day.
The pay-off for that flexibility was, if the right guy was 'running foreman', a degree of goodwill in letting staff go home early if there wasn't work for the latter part of their shift and there was a bit of emergency cover. During the summer holidays we might get an odd day at the beach on the basis that Dad had been allowed to 'slide off' and so got a longer early morning sleep than usual. The same was true when booked on 'spare' - to cover for unexpected absences and emergencies - when some of the crews might get to 'slide off' early if everything was quiet. That goodwill was repaid by the drivers with great enthusiasm for their job and commitment to their industry, despite the diabolical hours and conditions - for example, many diesel locomotives' cabs were so poorly insulated that old newspapers had to be rolled up and stuffed into the gaps and cracks to stop the draughts. No fun at 100mph on a cold winter's night!
'Flexible rostering' meant further uncertainty, allowing the basic hours of a shift to last between 7 and 9 hours of standard time, rather than the basic 8. Operationally, you can see the sense of this; few shifts could be devised which neatly used eight hours work. However, with drivers' income heavily dependent on an arcane system of overtime and anti-social hours payments ('time-and-five-eighths' being one rate - train drivers were impressive mental mathematicians on payday), 'flexible rostering' threatened both their income and that last little bit of predictability in their working lives - a guaranteed eight hour day. That disputes like this were lost is arguably where the road to the 'zero-hours contract' begins.
In 1982, the train drivers - and their 'militant' union ASLEF - were very much a part of the 'Enemy Within' to the Tory establishment and it was therefore necessary to undermine their cause as thoroughly as possible. So when two young 'second men' from Dad's own depot were prepared to sell their story - of 'sliding off' to go to the disco in work time - to none other than The Sun, it did the drivers' cause no good at all. At no stage did any of the mainstream media properly explain the dispute and even the left-leaning Not the Nine o'clock News sketch-show couldn't resist a reference to the 'disco' story. By no means a communist, the only paper Dad said gave the drivers' case a fair airing was the Morning Star. (We had quite an eclectic mix of newspapers in the house when I was growing up, depending on what Dad found left behind by that day's commuters).
All this was going on when I was in my last year at sixth-form college and had a massive impact on my political outlook, not least through trying to explain the reality to fellow students who thought it was funny to ask if they should look out for my Dad at the disco that night. I saw how difficult it was to get fair coverage for your case and how quick politicians and the media were to condemn the 'selfishness' of workers supposedly 'holding the country to ransom' over something as trivial as fair pay and decent working conditions.
Today, I'd like to think it would be easier to fight back, with send-up Instagram pics of train drivers on the picket lines in their flares, open-necked satin shirts and medallions, and 'I'm in work, Peter'* Facebook posts. In some ways, though, looking at how meekly much of the media take the Government line on the current Junior Doctors' dispute, I fear it would be much the same. I can't help noticing that it's always "The Doctors' Union, The BMA" from our newsreaders these days (because Unions are a bad thing, of course, and God forbid that the general public mistake the BMA for anything legit), though we're never introduced to think-tank spokespeople as, for example, "Jack Slyme from The Centre for Social Justice, founded by Iain Duncan Smith to promote his personal agenda on Welfare."
At least in their dispute over pay and conditions the Junior Doctors do still have overwhelming public support - not least because a lot of people, like me, owe their lives or the lives of people they love to their dedication. I think most people understand that intelligent professionals don't take action lightly and that if they say this deal is bad for both their profession and their patients, they're more likely than a politician to know. Sadly, the opposite assumption tends to be made of blue-collar workers who, when they aren't simply being 'selfish', are still rarely portrayed as better than the dull-witted dupes of their unscrupulous, politically-motivated 'Union Bosses'. If you'd ever seen a train driver checking the sums on his payslip in his head, before quibbling with the pay clerk over whether he'd got time-and-five-eighths rather than time-and-three for the overtime last Sunday, you would never dare assume that blue-collar workers are easily bamboozled.
*Sir Peter Parker was Chairman of the British Railways Board in 1982.
Even before the heart attack, Dad's work had brought him into fairly regular contact with the NHS. There were frequent trips to the old Southampton Eye Hospital in the early years of diesel propulsion, as the new locomotives chucked out tiny fragments of metal in their exhaust, which then required specialist removal if they got into your eyeball and rusted. That the same machines made such an unholy racket now means regular fitting and tweaking of hearing aids and, on several occasions in the last few years, he's been back in the Coronary Care Unit - most recently for the fitting of his second Implantable Cardioverter Defibulator.
Dad's working life and that of the doctors who've kept repairing him have always had one thing in common - a necessity to work unsocial hours. Recently, however, I've noticed another.
It was The Sun's stories about "Moet Medics" that triggered the deja vu moment. Of course I hadn't seen them in the actual paper - I wouldn't so much as wipe my backside on that rag - but I had laughed at the Junior Doctors' clever Instagram/Facebook parodies mocking allegations that they led the high life on inflated salaries. One of the joys of Social Media is that you can instantly strike back against the media establishment if you are misrepresented. In 1982, that wasn't so easy.
I mention 1982, because that was the year that Dad and his colleagues got the "Moet Medics" treatment from The Sun. There was a dispute in progress between BR and the drivers over something called 'flexible rostering'. Most people outside the industry thought this must be something quite positive, like 'flexitime' for office workers. For the drivers, it was a fundamental attack on their terms and conditions of employment since their work patterns were already pretty 'flexible', with the starting time of a shift able to be moved up to two hours between one day and the next. So a week of 2am shifts might start at that time on day one but at 00.01 the next night, back to 02.00 after that and then 03.50, depending on requirements, with the next shift's start time advised at booking off from the one before. If he was on nights, Dad would leave my mum a note when he came home and before he went to bed, to say what time he was due at work the following night and, on that basis, when he was likely to be up and about and what they could therefore do during the day.
The pay-off for that flexibility was, if the right guy was 'running foreman', a degree of goodwill in letting staff go home early if there wasn't work for the latter part of their shift and there was a bit of emergency cover. During the summer holidays we might get an odd day at the beach on the basis that Dad had been allowed to 'slide off' and so got a longer early morning sleep than usual. The same was true when booked on 'spare' - to cover for unexpected absences and emergencies - when some of the crews might get to 'slide off' early if everything was quiet. That goodwill was repaid by the drivers with great enthusiasm for their job and commitment to their industry, despite the diabolical hours and conditions - for example, many diesel locomotives' cabs were so poorly insulated that old newspapers had to be rolled up and stuffed into the gaps and cracks to stop the draughts. No fun at 100mph on a cold winter's night!
'Flexible rostering' meant further uncertainty, allowing the basic hours of a shift to last between 7 and 9 hours of standard time, rather than the basic 8. Operationally, you can see the sense of this; few shifts could be devised which neatly used eight hours work. However, with drivers' income heavily dependent on an arcane system of overtime and anti-social hours payments ('time-and-five-eighths' being one rate - train drivers were impressive mental mathematicians on payday), 'flexible rostering' threatened both their income and that last little bit of predictability in their working lives - a guaranteed eight hour day. That disputes like this were lost is arguably where the road to the 'zero-hours contract' begins.
In 1982, the train drivers - and their 'militant' union ASLEF - were very much a part of the 'Enemy Within' to the Tory establishment and it was therefore necessary to undermine their cause as thoroughly as possible. So when two young 'second men' from Dad's own depot were prepared to sell their story - of 'sliding off' to go to the disco in work time - to none other than The Sun, it did the drivers' cause no good at all. At no stage did any of the mainstream media properly explain the dispute and even the left-leaning Not the Nine o'clock News sketch-show couldn't resist a reference to the 'disco' story. By no means a communist, the only paper Dad said gave the drivers' case a fair airing was the Morning Star. (We had quite an eclectic mix of newspapers in the house when I was growing up, depending on what Dad found left behind by that day's commuters).
All this was going on when I was in my last year at sixth-form college and had a massive impact on my political outlook, not least through trying to explain the reality to fellow students who thought it was funny to ask if they should look out for my Dad at the disco that night. I saw how difficult it was to get fair coverage for your case and how quick politicians and the media were to condemn the 'selfishness' of workers supposedly 'holding the country to ransom' over something as trivial as fair pay and decent working conditions.
Today, I'd like to think it would be easier to fight back, with send-up Instagram pics of train drivers on the picket lines in their flares, open-necked satin shirts and medallions, and 'I'm in work, Peter'* Facebook posts. In some ways, though, looking at how meekly much of the media take the Government line on the current Junior Doctors' dispute, I fear it would be much the same. I can't help noticing that it's always "The Doctors' Union, The BMA" from our newsreaders these days (because Unions are a bad thing, of course, and God forbid that the general public mistake the BMA for anything legit), though we're never introduced to think-tank spokespeople as, for example, "Jack Slyme from The Centre for Social Justice, founded by Iain Duncan Smith to promote his personal agenda on Welfare."
At least in their dispute over pay and conditions the Junior Doctors do still have overwhelming public support - not least because a lot of people, like me, owe their lives or the lives of people they love to their dedication. I think most people understand that intelligent professionals don't take action lightly and that if they say this deal is bad for both their profession and their patients, they're more likely than a politician to know. Sadly, the opposite assumption tends to be made of blue-collar workers who, when they aren't simply being 'selfish', are still rarely portrayed as better than the dull-witted dupes of their unscrupulous, politically-motivated 'Union Bosses'. If you'd ever seen a train driver checking the sums on his payslip in his head, before quibbling with the pay clerk over whether he'd got time-and-five-eighths rather than time-and-three for the overtime last Sunday, you would never dare assume that blue-collar workers are easily bamboozled.
*Sir Peter Parker was Chairman of the British Railways Board in 1982.
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