There has been an amusing Facebook post doing the rounds of my friends' pages concerning the recent confirmation that the skeleton found under the car park at Leicester Social Services is indeed most likely that of King Richard III. The joke being that, despite his deformed spine, numerous battle wounds and being dead for more than five hundred years, Atos would still find him 'fit for work' if he were sent to them for a medical. Indeed, I see the Prime Minister was mocked in Parliament with the same witty suggestion only yesterday.
I'm not at all sorry to see Atos finally being subjected to both gallows humour and serious journalistic scrutiny, but Atos are merely a symptom and not the disease. It would be extremely easy for this Government - or the next - to gain a quick fix of good press by unceremoniously terminating their contract at the next unsatisfactory audit of their performance. There would be a collective sigh of relief from many quarters were this to happen, but it would be of only limited benefit - no pun intended - to sick and disabled people.
The grim truth is that the problem with Employment and Support Allowance isn't Atos, it's the Work Capability Assessment for which they are employed to provide evidence. Sure, Atos often do a lamentably poor job of assessing the unfortunate claimants sent to them; in my work as a welfare rights adviser I saw some excruciatingly bad decisions often based on such stupidity as, for example, having a Registered Physiotherapist assigned the task of assessing someone with profound mental health problems. On other occasions, what proported to be a clinical judgment was very clearly influenced by negative value judgments about the claimant, especially where addiction played a part in his or her ill health. There were (and still are) errors, contradictions and outright lies in too many Atos-produced reports. And people have paid the price for this with their lives.
But while eliminating incompetence and unfairly subjective assessments would certainly save a great many seriously ill people the distress and anxiety of losing benefit and/or facing an appeal, and the 'taxpayer' the unnecessary costs of those appeals, it wouldn't leave us with a fair or logical system. The real flaws are within the ESA descriptors and, as with DLA, the sharp edges between entitlement and ineligibility, and between the two 'groups' into which ESA recipients are divided.
Admittedly, ESA does allow some room for the exercise of common sense by retaining an exceptional circumstances clause, allowing a claimant to be deemed unfit for work and unfit for work-related activity if necessary to prevent a serious risk to his or her physical or mental health, or to the physical or mental health of another person. Despite this, ESA remains a blunt instrument. Score 15 or more 'points' and you have 'limited capability for work' and entitlement to ESA. Score fewer and you are 'signing on' for Jobseekers Allowance, potentially even if you have completely lost the use of one arm and hand, or have no vision at all (but can get around familiar places with a guide-dog or cane) or even 'cannot learn anything beyond a simple task, such as setting an alarm clock'. While it would be unreasonable to argue that people with these disabilities are automatically unfit for any work, clearly the very term that describes their prospects is 'limited capability for work' - but in ESA law they have no such thing as these limitations each score a meagre 9 points.
A similar sharp edge divides the 'Work-related Activity Group', who receive a lower rate of benefit and are required to carry out 'work-related activity' as a condition of entitlement, from the more severely disabled and higher paid 'Support Group'. In ESA alone, the difference between the two components is up to £20 per week, but there can be other advantages - for example, in Stoke-on-Trent people in the 'Support Group' will potentially eligible for 100% Council Tax Support, while those in the 'Work-related Activity Group' will generally receive no more than 70%. The intention is to protect the most severely disabled, but the consequence is to put a greater financial burden on those with the lower income.
And the difference between the two groups, rather as with the components of DLA, can be miniscule. A claimant unable to lift a 0.5 litre carton of liquid goes into the Support Group. Someone who can, but couldn't manage to lift something fractionally heavier, does not. It's the Support Group if you have, on a daily basis, uncontrollable episodes of aggressive or disinhibited behaviour that would be unreasonable in any workplace, but although 'frequent' episodes of the same will also score 15 points, that puts you into the Work-related Activity Group. 'Occasional' episodes score 9 points and, unless supplemented by other point-scoring issues, will see you off to the Jobcentre to 'sign on'.
Is there a better way to support sick and disabled people? Prior to the introduction of the points-based predecessor of ESA, Incapacity Benefit, Invalidity Benefit treated each claimant as an individual and asked a simple question - what job is there within a reasonable daily journey, that this person could do? To answer it required a full appraisal of the claimant's capabilities so it was possible to differentiate between people with the same disabilities but different work experience and intellectual ability, and at different points in their working life. A points-based system that doesn't consider these issues effectively discriminates against older, unskilled workers by failing to recognise that even a relatively minor physical disability might make them unemployable. It also underplays the impact of variable conditions on employability.
The failing of the Invalidity Benefit principle was that there had to be a job the claimant could do, but not a vacancy for it. In my former home town, the job often cited as appropriate was 'lift attendant' while the one old-fashioned department store with a staffed lift remained, on the basis that the person so employed could readily move between sitting and standing, so could ease backpain, and needed only minimal upper limb strength to push buttons. The odds of there ever being an actual vacancy for the post were vanishingly small, but so long as the job existed, anyone fit to do it was theoretically fit for work.
So might the answer be a sliding-scale system, involving a Decision Maker with sound knowledge of local employment conditions making an assessment of the proportion of jobs in their area within the capacity of any given claimant, based on a full assessment of the claimant's health, skills, experience, education and re-training potential, and an 'employment disadvantage' percentage payment added to a new earnings-replacement benefit that would replace both ESA and JSA? And with similarly adjustable requirements to seek or prepare for work, based on the claimant's actually ability to cope with them and the probability of there being a job for them?
It would be tricky to assess, certainly, but arguably fairer than the present arrangements, and if you coupled it with access to good training, sound advice and compassionate support from properly skilled Jobcentre staff, it could do what ESA clearly fails to - namely, support people with limited capability for work into appropriate jobs, where those jobs actually exist, and provide an income applicable to the claimant's need where they do not.
