Correspondence in 2009

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

  0ffice address: NOTTINGHAM
                  Atos Healtheare
                  Summit House,
                  Nottingham Business Park
                  Orchard Place
                  Nottingham
                  NG8 6PX

       Reference: ...
    
            Date: 12th May 2009

WE NEED SOME INFORMATION

Dear Mr B...

We have sent you form ESA50 ESA QUESTIONNAIRE with the letter. This is to help us provide medical information that will assist the Department for Work and Pension (the DWP) when looking at your entitlement to benefit.

Please fill in the form so that we can see how your illness or disability affects your ability to work. Read the questions carefully. It will help us if you answer the questions as fully as possible.

The form also gives you the chance to tell us about your other health problems, including any mental health problems. We may also have to ask you to attend a medical assessment with an Approved Healthcare Professional at a later date.

Please only return the enclosed form ESA50 ESA QUESTIONNAIRE to the address at the top of this letter as soon as you can, but no later than 25th June 2009. Use the envelope we have sent you. It does not need a stamp. Please allow a few days for the form to reach us.

Medical certificates or any other documents must be sent directly to the office that deals with your claim. Do not enclose them with form ESA50.

If you want help filling in this form

You can ask someone to write down your answers for you. Ask a friend or relative to help you. Or get in touch with the office that deals with your claim. They will have a copy of the form and can go through the questions you are having trouble with over the phone. Sometimes they may be able to fill in a form for you. If they do this, they will send the form to you. You can the check, sign and send it back. They can send you a completed claim form in Braille or large print.

More information

If you want to know more about why we have sent you this form, or if you will be unable to complete the form by the required date, please contact the Jobcentre Plus office that deals with your claim. You can get the phone number by ringing 0800 0556688 and following the instructions.

Yours sincerely, 
Atos 0rigin 
Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

  0ffice address: NOTTINGHAM
                  Atos Healtheare
                  Summit House,
                  Nottingham Business Park
                  Orchard Place
                  Nottingham
                  NG8 6PX

       Reference: ...
    
             Date: 10th June 2009

WE NEED YOUR REPLY URGENTLY

Dear Mr B...

On 12th May 2009 we sent you form ESA50 ESA QUESTIONNAIRE. We need you to fill in this form so that we can see how your illness or disability affects your ability to work. We have not yet received your completed form.

What to do now

Please fill in the form and return it to the address at the top of this letter by 25th June 2009. Your benefit may be affected if you do not return the form ESA50 by the date shown without good reason. Please allow a few days for the form to reach us.

Medical certificates of any other documents must be sent directly to the office that deals with your claim. Do not enclose them with form ESA50.

Where to get help or more information

If you want to know more about why we have sent you form ESA50, or about how to complete it, or if you will be unable to complete it by the required date, please contact Jobcentre Plus office that deals with your claim. You can get the phone number by ringing 0800 055 6688 and following the instructions.

Yours sincerely, 
Atos 0rigin 
Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

        Office address:  Appointments Hepdesk
                         Block2, Government Buildin
                         Gabalfa,
                         Cardiff
                         CF14 4YJ
 Appointments help desk: 0800 2888777
                         if you have a textphone you can 
                         dial 18001 followed by the
                         number shown above

              Reference: ...
    
                   Date: 18th June 2009

Please contact us

Dear Mr B...

We have been asked by the Department for Work and Pensions (the DWP) to carry out a medical assessment in relation to your claim/appeal to Employment and Support Allowance/National Insurance Credits.

Please contact the appointments help desk on 0800 2888777 within two days of receipt of this letter so that we can arrange a convenient appointment for you. Our line are open from 8am to 8pm Monday to Friday and from 9am to 5 pm on Saturdays and Sundays.

Please only contact the appointments helpdesk in connection with your appointment. If you want to discuss your claim to benefit, or if you would like more information about why you need a medical assessment, please contact the office that deals with your claim.

If you have already agrees an appointment with us, please ignore this letter and keep the arranged appointment.

Yours sincerely, 
Atos 0rigin 
Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

        Office address:  Appointments Hepdesk
                         Block2, Government Buildin
                         Gabalfa,
                         Cardiff
                         CF14 4YJ
 Appointments help desk: 0800 2888777
                         if you have a textphone you can 
                         dial 18001 followed by the
                         number shown above

              Reference: ...
    
                   Date: 18th June 2009

Your appointment for a medical assessment

Dear Mr B...

We have been asked by the Department for Work and Pensions (the DWP) to carry out a medical assessment in relation to your claim/appeal to Employment and Support Allowance/National Insurance Credits. We have arranged an appointment for you at:

   2:40pm on Thursday 9th July 2009
              at:
   Highgate Medical Examination Centre
   lst Floor, 1, Elthorne Road, Upper Holloway, London N19 4AL

It is important that you attend. If you fail to attend, your benefit may be affected. If you are unable to attend, or if you need any help whilst you are at the examination centre, please inform the appointments help desk on 0800 2888777 as soon as possible.

Please only contact the appointments helpdesk in connection with your appointment. If you want to discuss your claim for benefit, or if you would like more information about why you need a medical assessment, please contact the office that deals with your claim.

Please arrive 10 minutes before your appointment time. You should bring this letter and proof of your identity with you. We have enclosed a leaflet containing important information about what to bring to the examination and how to claim expenses. We have enclosed a map and directions explaining how to get to the examination centre.

What to expect

An Approved Healthcare Professional will examine you and produce a medical report to help a decision-maker from the Department for Work and Pensions (DWP) when they consider your entitlement to benefit. The enclosed further information explains what will happen during your assessment.

Yours sincerely, 
Atos 0rigin 
Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

Suggested Journey Plan

                Date: Thursday 9th July 2009
      Departure time: 12:15
        Arrival time: 14:03
our appointment time: 14:40
           Travel by: Walk, Bus
   Number of changes: 7
    Journey duration: 1 hour & 48 minutes.
      

Suggested Journey Plan

Method	From	Depart	To	Arrive	Instructions	Duration
Walk	...	12:15pm	..., ... Avenue (opp)		Walk to ..., ... Avenue (opp)	6 mins
Bus	..., ... Avenue (opp)	12:21pm	..., Bus Station (adj)	12:45pm	Take Arriva the Shires & Essex/... towards ... Bus Station	24 mins
Walk	.. Bus Station.		..., Bus Station (Stop A)		Walk to ..., Bus Station (Stop A)	5mins
Bus	..., Bus Station (Stop A)	12:55pm	Turnpike Lane Station (Stop P)	01:35pm	Take Metroline Travel/217 towards West Green (London), Turnpike Lane Bus Station	20 mins
Walk	Turnpike Lane Station (Stop P)		Turnpike Lane Station (Stop Q)		Walk to Turnpike Lane Station (Stop Q)	2 mins
Bus	Turnpike Lane Station (Stop Q)	01:39pm	Upper Holloway, Archway Road / St John's Way (Stop N)	01:58pm	Take Arriva London/41 towards Upper Holloway, Archway Station / Macdonald Rd	19 mins
Walk	Upper Holloway, Archway Road / St John's Way (Stop N)		N19 4AL	02:03pm	Walk to N19 4AL	5 mins

Disclaimer

Please note that the above suggested journey plan is provided on an information basis only and should not be relied upon. We advise you to check information before you travel with the travel operator directly. Neither the Department for Work and Pensions nor Atos Origin warrant the accuracy of any data and can accept no liability in relation to the data including liability for errors or defects or for public transport delays.

Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

Regarding your letter dated 24 June, confirming a medical assessment arranged for 2:40pm Thursday 9 July. I have a number of questions:-

1. Can you advice me under which Statutory or Regulatory or other Authority you are undertaking this assessment and can you provide me with the terms of reference for the assessment?

2. What is the medical purpose of the assessment and what are the expected medical benefits of the assessment to the patient?

3. Can you confirm that the "Approved Healthcare Professional" as mentioned in your letter will have full access to the patient's medical record including the periods when emergency admitted to hospital on the 15 April, the results from the blood tests, XRays, CT Scans, MRI Scans, Echo Cardiograms, the prescriptions history including the recent changes to prescriptions and the forms and questionaires sent to the DWP and can you confirm who authorised this and confirm that human rights and doctor patient confidentiality considerations have been complied with?

4. Can you provide reasons why you are challenging the medical consensus of the GPs, hospital doctors and hospital consultants involved in this case to date and in particular challenging the doctor's statement in respect of ability to work?

5. Given that the DWP has received full information regarding the primary brain tumour and are aware that the patient is taking anti-fit medicine, has surrendered his driving licence to the DVLA and that stress such as long journeys may result in fits which in turn may require emergency admission back to hospital, what medical reasons do you have for arranging the assessment at a location that requires a roundtrip of around six (6) hours, at best, including fourteen (14) changes and six (6) bus journeys and a return in peak traffic times?

6. Can you confirm that the suggested journey plan, you provided, is one hundred and eight (108) minutes, and was expected to arrive thirty seven (37) minutes before the appointment, that no return journey plan was provided, and that this plan exceeds the maximum "ninety (90) minutes each way by public transport" allowed, as listed in your guidance booklet?

7. Do you think it is wise for a sick and vulnerable person, subject to intermittent and unpredictable periods of weakness and possible fits, to be required to carry important documents, such as a passport, through high crime areas for the extended roundtrip on public transport as you have recommended?

8. The need for an independent medical assessment impunes the abilities of the numerous medical practioners involved in the case so far. Can you recommend different local GPs, hospital doctors or hospital consultants that you feel are more capable and from whom I should ask for a second opinion?

9. Can you provide me a breakdown of the costs involved in this process?

My personal objective is to recover my strength and be able to get back to work as swiftly as I can. I have always worked in IT development. I want to do so again. I am waiting for an appointment with a neurologist to review my medication which may improve my strength and to clear me to work with computer screens full time as fits can in some cases be triggered by working with computer screens for long periods. My next appointment with the neuro surgeon is scheduled for 20 August.

I look forward to hearing from you. Thank you.

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

        Office address:  Appointments Hepdesk
                         Block2, Government Buildin
                         Gabalfa,
                         Cardiff
                         CF14 4YJ
 Appointments help desk: 0800 2888777
                         if you have a textphone you can 
                         dial 18001 followed by the
                         number shown above

              Reference: ...
    
                   Date: 3rd July 2009

Your appointment has been rescheduled

Dear Mr B...

As you know we need to examine you on behalf of the Department for Work and Pensions (the DWP) in relation to your claim/appeal to Employment and Support Allowance/National Insurance Credits. Your appointment at 2:40pm on Thursday 9th July 2009 has been rescheduled to:

   3:30pm on Friday 24th July 2009
              at:
   Highgate Medical Examination Centre
   lst Floor, 1, Elthorne Road, Upper Holloway, London N19 4AL

It is important that you attend. If you fail to attend, your benefit may be affected. If you are unable to attend, or if you need any help whilst you are at the examination centre, please inform the appointments help desk on 0800 2888777 as soon as possible.

Please only contact the appointments helpdesk in connection with your appointment. If you want to discuss your claim for benefit, or if you would like more information about why you need a medical assessment, please contact the office that deals with your claim.

Please arrive 10 minutes before your appointment time. You should bring this letter and proof of your identity with you. We have enclosed a leaflet containing important information about what to bring to the examination and how to claim expenses. We have enclosed a map and directions explaining how to get to the examination centre.

What to expect

An Approved Healthcare Professional will examine you and prodcue a medical report to help a decision-maker from the Department for Work and Pensions (DWP) when they consider your entitlement to benefit. The enclosed further information explains what will happen during your assessment.

Yours sincerely, 
Atos 0rigin 
Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

             MEDICAL SERVICES
Provided on behalf of the Department for Work and Pensions

Suggested Journey Plan

                 Date: Friday 24th July 2009
       Departure time: 13:25
         Arrival time: 14:39
Your appointment time: 15:30
            Travel by: Walk, Train, Underground
    Number of changes: 7
     Journey duration: 1 hour & 14 minutes.
      

Suggested Journey Plan

Method	From	Depart	To	Arrive	Instructions	Duration
Walk	...	01:25pm	... Rail Station		Walk to ...Rail Station	22 mins
Train	...	01:47pm	Tottenham Hale	02:00pm	Take National Express East Anglia towards London Liverpool Street	13 mins
Walk	Tottenham Hale Rail Station		Tottenham Hale Underground Station		Walk to ..., Bus Station (Stop A)	5mins
Underground	Tottenham Hale Underground Station	02:05pm	Euston Underground Station	02:19pm	Take London Underground/Victoria towards Brixton	14 mins
Walk	Euston Underground Station		Euston Underground Station		Walk to Euston Underground Station	4 mins
Underground	Euston Underground Station	02:24pm	Archway Underground Station	02:34pm	Take London Underground/Northern towards High Barnet	10 mins
Walk	Archway Underground Station		N19 4AL	02:39pm	Walk to N19 4AL	5 mins

Disclaimer

Please note that the above suggested journey plan is provided on an information basis only and should not be relied upon. We advise you to check information before you travel with the travel operator directly. Neither the Department for Work and Pensions nor Atos Origin warrant the accuracy of any data and can accept no liability in relation to the data including liability for errors or defects or for public transport delays.

Provided by Atos Origin on behalf of the Department for Work and Pensions 
Registered Number: 1245534 
Registered Address: Atos Origin IT Service UK Limited, 
                    4 Triton Square, Regent's Place, London NW1 3HG 
      

Date 10 July 2009

Dear Mr B...

YOUR CLAIM FOR EMPLOYMENT AND SUPPORT ALLOWANCE

I am writing to tell you that the medical certificate that you sent us, which covers the period from 18 April 2009 to 17 July 2009 is about to run out.

Please send us another medical certificate by 18 July 2009 if you are still sick and cannot work.

If you cannot get a medical certificate, a letter from a GP or hospital may be acceptable.

If you do not send us a medical certificate a letter from a GP or hospital this will result in your payment being stopped or suspended.

You can use the envelope sent with this letter. The envelope does not need a stamp.

If you want more information please get in touch with us. Your reference number plus our address and phone number are at the top of this letter.

Yours sincerely

Ms RB..., Manager, DWP Luton BDC, Jobcentre Plus

Following the medical examination I attended which was arranged for 3:30pm on Friday 24th July 2009. I would like to formally complain over the following:-

1. The doctor agreed that the procedure breaches medical ethics in that it was known, apriori, to be detrimental to the health of the patient nevertheless the doctor, against her best medical opinion, was obliged to comply with the procedures that you have implemented.

2. The doctor agreed it was obvious that, a patient with a brain tumour, who was on anti convulsion, high blood pressure and cholesterol lowering medicines which obliged the patient to rest and to visit the toilet frequently, who had been recently emergency admitted to hospital, who was waiting for an appointment to see a neurology consultant, who had surrendered his driving licence, and who was under treatment by a neuro-surgeon, was put at serious risk by the journey, involving 14 changes of train and underground and exposed to standing room only rush hour traffic on the return journey, and an extended long wait in a waiting room with other sick patients. In normal times this is bad but during a period of swine flu pandemic it is beyond belief.

   It should be noted that I was exhausted for two days and only now Wednesday have I recovered the energy to write this letter.

   My complaint is that the doctor was forced to operate in ways that are not in the best medical interest of the patient.

3. The meeting with the doctor commenced at 16:10pm and finished at 17:50. The doctor had no access to my patient history. All but ten minutes of this time were spent in me trying to remember medical events that are documented in my NHS medical patient history.

   The doctor drew conclusions as to when the medical condition started. This was a surprise and a worry as the specialists who have access to all the facts have not been able to come to such a conclusion.

   The medical tests were a measurement of blood pressure (high), a vision check and minor superfical muscle strength checks. This did seem to both the doctor and myself a waste of both our times.

   The doctor did not disagree with the consensus of the numerous GPs, hospital doctors and consultants involved in the case. The doctor did not disagree with the ongoing doctors statement that I was sick and unable to work at this time. The doctor agreed that I needed to see a neurologist to review the medicines I am taking and to consider the adverse impact they seem to have; in particular my intermittent periods of tiredness, vision issues and ability to walk. The doctor agreed fits can be triggered by my job in IT. The doctor sympathized with me that I have waited so long and continue to wait to see a consultant.

   My complaint is there is no medical benefit to me in following this procedure and that it just wastes medical resources that could be better deployed elsewhere.

4. The appointment should have commenced at 3:30pm. It was late and started at 16:10pm. I fail to see why an administration procedure with no medical merit cannot be run on time.

   My complaint is that the appointment was late and the explanation given at the time that my case needed to be seen by a doctor was not satisfactory. This requirement was clearly known at the time the appointment was made.

5. The suggested journey plan you provided, meant leaving home at 01:25pm, arriving at Highgate at 02:39pm, waiting until 03:30pm when the appointment was due to start.

   My complaint is that the suggested return journey plan was not provided. I left at 5:50pm and arrived home at 7:50pm. I had to stand on the underground and on the mainline train due to crowded. I was exhausted so much so that I could not eat and had to retire to bed at 8:30pm.

   My complaint is that making an appointment that obliges a sick patient to undertake a process which is tiring, takes over six hours without food or rest is inhuman, uncaring and callous in operation. It is shaming that we as a society allow this abuse of sick patients to be carried out.

6. The government has agreed that there is a swine flu pandemic in operation. They have asked people to minimise risks especially to groups such as the sick. My complaint is that you have ignored government advice and were negligent. You should have followed the advice, reviewed appointments, cancelled or rescheduled those which put patients at increased risks.

7. The waiting room does not have any hand cleaning creams and the cleansing gels which are usual in doctors' surgeries and hospitals. My complaint is that you allow offices to be used that are in breach of health and safety regulations in respect of premises that routinely deal with the sick.

8. The waiting room has minimal facilities, not a single picture on the walls, no reading material, no TV. It is bleak with nothing of interest on the walls. It feels like patients are being punished for being ill. It is brutal, stalinist and oppressive. My complain is that the waiting room treats the sick without dignity, respect or consideration.

9. Your guidance booklet suggests what is acceptable as proof of identity. My NHS prescription exemption card was accepted. My complaint is that this is not listed as acceptable in your booklet. Further, forcing a sick patient to carry a passport and bank details though high crime areas especially after a long and tiring journey is against Police advice to minimise crime.

10. My complaint is that you have still failed to reply to my letter of the 28 June 2009 (copy attached). I assumed you did receive it as the original appointment was changed to comply with the 90 minute journey time. I ask, once again, what Statute or Regulation authorises you to treat sick people so. I am sure your implementation and interpretation are against the intent if not the detail of relevant Health and Pension related legislation.

I attach my completed travel claim form which complies with the suggested journey plan that you supplied. I look forward to receiving the cheque.

I wait for a copy of the report. Please let me know when I can expect to receive a copy of it. Can you confirm copies will be sent to my GP and my consultants at the various hospitals?

I understand there may be circumstances whether the judgement of particular GPs is open to question in respect of frequency of doctors statements. If this is suspected the BMA could be asked to investigate. A patient could be asked to visit another local doctor. I suggest a maximum of 30 minutes outgoing travel time, 30 minutes wait and 30 minutes return travel time is reasonable. In rural areas the time could be extended to allow travel to the next nearest doctors' surgery.

In circumstances where multiple doctors have agreed, such as in my case, it is a waste of the large amount of taxes and NI contributions I have paid over the years to operate such a Kaffkaesque procedure.

Finally I have no complaints about the receptionist or the doctor I saw. They worked well in difficult circumstances.

I thought there was a bitter irony in that the doctor was from the Czech Republic. Her grandfather's generation and my father's generation fought long and hard against state tyrannies. A feature of these tyrannies, to put it mildly, was to force medical practitioners to undertake procedures that were not in the best interests of patients. The "minor" infringements in the early thirties resulted eventually in Nurnberg. Tempus omnia revelat.

Date 29 July 2009

Dear Mr B...

YOUR CLAIM FOR EMPLOYMENT AND SUPPORT ALLOWANCE

A CHANGE IN THE EMPLOYMENT AND SUPPORT ALLOWANCE

We have looked at your claim again following a recent change.

From 11 July 2009 your Employment and Support Allowance will be £89.80 a week.

This is because of:

a decision on your capability for work. You have been placed in the Work Related Activity Group

Customers with potential capability for work enter the work related activity group. This means them carrying out reasonable steps to manage their condition and to help move towards the workplace by undertaking any relevant activity, which will be developed with the support and encouragement of specialist Personal Advisors. Those who have limited or no capability for work-related activity enter the support group and are not required to take part in any work related activity.

We will credit you with National Insurance contributions while claiming Employment and Support Allowance.

The attached sheet shows how we worked out your money. lf you want more information please get in touch with us. Our phone number and address are at the top of this letter.

This assessment is based on your National Insurance Contribution Record.

HOW THE MONEY WILL BE PAID

The money will be paid every two weeks while you are still entitled to Employment and Support Allowance.

Bank/Building society: ... BANK PLC ...

We also hold an account number/sort code but for security reasons they have not been included in this letter.

We will pay your Employment and Support Allowance into the above account. The first payment includes arrears of £43.72 that are due from 11 July 2009 to 22 July 2009.

PAYMENT TO YOUR BANK/BUILDING SOCIETY

These notes are about allowance payments into a bank or building society account. Please make sure you read them.

You must tell us straight away if any details about the account change. Otherwise you may not be able to get your money.

You should check the account to see how much is paid in. We will tell you if your Employment and Support allowance is going to change.

If you think the payment is wrong, you should get in touch with us straight away. We will check your payment and tell you what will happen.

If your money is due on a Bank Holiday we will pay it into the account on the last weekday before the Bank Holiday.

If the account goes overdrawn, the bank or building society may not let you take any money out of the account. Talk to the bank or building society if this happens. You should also tell us as we can change how we pay you.

If you want a full explanation of why your Employment and Support Allowance has changed, please get in touch with us. Our phone number and address are at the top of this letter.

OTHER HELP YOU MAY BE ENTITLED TO

You may be entitled to other help. To find out more about this ask us for leaflet INF2 "Other help you may be entitled to".

HOUSING BENEFIT AND COUNCIL TAX BENEFIT

You could get Housing Benefit or Council Tax Benefit. Get in touch with your local council as soon as possible. If you are already getting Housing Benefit or Council Tax Benefit you should show them this letter.

If YOU WANT TO KNOW MORE ABOUT THIS DECISION OR IF YOU THINK IT iS WRONG

Please contact us and we will give an explanation. Our address and phone number are at the top of this letter. You should contact us within one month of the date of this letter, or we may not be able to consider any dispute.

WHAT HAPPENS AFTER THE DECISION IS LOOKED AT AGAIN

If the decision can be changed we will send you a new decision. If we cannot change the decision we will tell you why. You will still have the right of appeal against the decision.

HOW TO APPEAL To appeal , fill in the form in leaflet GL24 "If you think our decision is wrong". Please send it to us within one month of the date of this letter.

You can get this leaflet from your Jobcentre Plus Office. Your appeal will be heard by an independent appeal tribunal.

If the decision is wrong, the independent appeal tribunal can change it. But the independent appeal tribunal cannot:

• change the law that the decision is based on;
• pay more money than the law allows;
• check or change your contribution record.

If you disagree with our record of your contributions, please tell us at once. We will check your records and tell you the result. If you still disagree you can ask for a formal decision.

Jobcentre Plus staff work to offer a complete service through your Jobcentre. If you have an enquiry about your claim for Employment and Support Allowance you will be referred to the Decision Maker or appeals section.

PLEASE KEEP THIS LETTER FOR YOUR INFORMATION

It will help us if you have this letter when you make any enquiries or need an explanation about the decision.

How Employment and Support Allowance has been worked out

The Employment and Support Allowance Award

This payment of Employment and Support Allowance is based on your National Insurance Contribution record and any additional amount the law says you need to live on. We call this contribution-based and income related Employment and Support Allowance.

Your living expenses                                     £64.3O

Limited capability for work addition

Extra Money because you are in                           £25.50
the Work Related Activity Group

Which gives a total                                      £89.80
Employment and Support Allowance amount

Income and Benefits
No income will be taken off your Employment and Support Allowance

Your Employment and Support Allowance
amount of £89.80 less total income of £0.00

So your entitlement is                                   £89.80

The amounts on this page apply from 16 July 2009 to 22 July 2009.

Yours sincerely

Regarding your letter dated 29 July 2009, I would like to defer a decision to appeal, pending receipt of a copy of the medical report which was expected to be produced by Atos Healthcare following the appointment I attended on Friday 24th July 2009. My advisors and myself need to review this report before deciding my response.

I have formally requested a copy of the report by letter dated 29 July 2009. I have formally complained today by email that my complaints in letters dated 28 June 2009 and 29 July 2009 have neither been acknowledged within the two working days or have been responded to within the 20 working days. I accept for the 29 June 2009 letter there is still time for Atos Healthcare to meet the 20 working day deadline.

Please advise me of the complaint procedure to be followed if Atos Healthcare continues to ignore my letters of complaint, to refuse to provide me a copy of the report and refuse to pay me the travel expenses due.

Can you confirm that you are DWP Manager for my case and as such are fully responsible in law for the actions of your staff and third party contractors who you choose to employ? Assuming this is the case I would like you to provide me with all the information you hold about me and my case as you are required to do under the Data Protection Act. If you are not the person responsible can you forward this letter to the person responsible and inform me of that person's contact details.

Notwithstanding the above, without prejudice, I would like to defer any interview relating to a placement in a "Work Related Activity Group" on the grounds that it is not appropriate as I am a terminally ill claimant. In a recent (2 April 2008) written answer to a Parliamentary question, the survival rate for an adult patient diagnosed with a Primary Brain Tumour was stated by the Secretary of State for Health as twelve (12.3) percent survive five years e.g 87.7% will be dead within five years. If you believe I do not qualify as a terminally ill patient please provide me with the guidelines you apply. My advisors may decide to test this in law.

Notwithstanding the above, without prejudice, I would like to defer any interview relating to a placement in a "Work Related Activity Group" on the grounds that I am so sick or disabled that the interview would be of no assistance. My tumour is progressive. This is as good as it gets unless and until I have brain surgery and or radio-therapy. I have been subject to fits which I am told can be triggered by excessive use of working with a computer screen. As an IT manager, for years, I used to spend twelve hours a day on the computer screen, now I can only work a few hours before my body tells me to stop for a rest. After a couple of hours I am able to work again. I have periods of extreme weakness. I can walk locally but have to rest on benches for around 10 minutes before I can go on. I have intermittent vision issues. I surrendered my driving licence. I was exhausted for four days when you forced me to go to Highgate for the medical appointment.

Appointment scheduled for 3:30pm (but was forty minutes late and started at 4:10pm) on Friday 24th July 2009 at Highgate Medical Examination Centre, 1st Floor, 1 Elthorne Road, Upper Holloway, London N19 4AL.

I would like to complain that you have failed to either acknowledge my letter of complaint dated 28 June 2009, within two working days and you failed to reply to this letter. A reasonable person would conclude that you did receive this letter as you took action over item 6. This item pointed out that your suggested journey time of 108 minutes was outside the maximum allowed journey time of 90 minutes. I would like this complaint to be referred to The Independent Tier.

Further, I would like to complain that you have failed to acknowledge my letter of complaint dated 29 July 2009 within the two working days. I accept the twenty working days for you to respond have not yet expired. Please note I still have not received the medical report which I would like my GP, Neurologist and Neuro surgeon to review. I presume I need this to decide whether I will appeal any decision the DWP might make. I would be happy to receive the report in electronic form. Please note I still have not received my travel expenses.

I attach copies of the letters. I can provide you with an electronic image of my travel expenses claim.

Thank you for your email below. On the 10th August 2009, Customer Relations received your letters dated 28th June 2009 addressed to Medical Services in Cardiff and 29th July 2009 addressed to Highgate Medical Examination Centre. Unfortunately there was no indication on the letters where they had been forwarded from.

We acknowledged receipt of these letters on the 10th August 2009. An acknowledgement letter and a copy of our Comments, Complaint and Suggestions booklet was sent to your home address the same day. As advised in the acknowledgement letter, we will now conduct a full investigation into the issues that you have raised, along with why your initial correspondence was not addressed sooner. We aim to complete our investigation within 20 working days and as soon as we have all the information we require, we will write out to you with our findings.

In your email below, you make a request for your complaint to be referred to the Independent Tier. I would advise that a referral to the Independent Tier at this stage is not possible until your complaint has been investigated through the stages of Customer Relations' complaints process, as explained in the Comments, Complaints and Suggestions booklet.

With regard to your travel expenses, your original claim form was enclosed with the letters which were sent to our office. As advised in our acknowledgement letter, we have forwarded your claim form to our office in Nottingham for them to authorise and arrange payment.

With reference to my letter of complaint dated 28th June 2009. Your Customer Relations Manager did not acknowledge the complaint within 2 days. This Manager apparently operating in line with your complaints procedure, within the 20 working days, took action on item 6 and sent out a letter dated 3rd July resolving this item but failed to respond to me on any of the other items or even to contact me and send me a copy of the complaints booklet. I have no knowledge whether the Customer Relations Manager arranged for a senior manager to personally review the investigation. The 20 working days ended in July which by definition means the investigations undertaken by Atos Healthcare on this matter were complete. I would like my letter of complaint dated 28th June 2009 to be immediately referred to The Independent Tier. I would like them to review your actions in this matter.

With reference to my letter of complaint dated 29 July 2009, I expect to receive your written response by the 27 August 2009 which is the date 20 working days expired. I take your email dated 12 August as a belated acknowledgment that you have received my complaint and are investigating. After the 27 August 2009 my advisors and myself will consider whether this second complaint should also be referred to The Independent Tier.

I have no complaint relating to 10 August 2009. I have not raised any new issues. A correction to your email, on the 10 August 2009 you received copies of letters that you have previously received.

In summary your investigations relating to matters related to my letter of complaint dated 28th June 2009 have been concluded by you and now should be referred to The Independent Tier. Your investigations relating to matters raised in my letter of complaint dated 29 July 2009 are ongoing by you.

As a point of information I have still not received my travel expenses.

I hope the above clarifies matters and is in line with your understanding of the situation. I would be pleased to discuss further. I look forward to hearing from The Independent Tier on the 28 June 2009 matter and from you on the 29 July 2009 matter.

I am sorry that you feel your letters (dated 28 June and 29 July) have not been acknowledged in an appropriate timescale.

As Ms B... explained, your letters were not received in the Customer Relation Team offices until 10th August and she acknowledged them immediately. I am afraid that I am unable explain why they were not delivered to our offices to investigate until the 10th August.

I can advise that Ms B... is currently investigating your complaint and will address all the issues you have raised in her response.

I would be grateful if you would refrain from sending any further emails enquiring about her progress to allow Ms B... time to conduct her investigation and obtain all the relevant information she requires as she will be unable to respond to each individual email.

Thank you for your letters dated 28th June 2009 addressed to Medical Services in Cardiff, and 29th July 2009 addressed to Highgate Medical Examination Centre. Your letters have been received in our office today.

l would like to begin by offering our sincere apologies that your letters have not been addressed sooner. Usually letters of this nature are forwarded to Customer Relations Team to address. I will make enquiries with the addressees of your letters as to why they were not sent to us sooner.

I can advise that a full investigation will now take place into the issues you have raised and I hope to be able to write to you with a full response shortly. However, if the investigation takes longer than anticipated I will continue to update you of our progress.

I have enclosed a copy of our Customer Relations booklet, which will explain how your complaint will be dealt with.

I can confirm that I have forwarded your travel expenses claim form to our Nottingham office for them to arrange payment. Once it has been authorised, you should receive payment within 2 weeks, Should you have any queries during this time, you can contact them on 0115 9758353.

About your appeal

I am writing about your letter dated 14/08/09 appealing against a decision on your ESA Claim.

We will look at the decision that you have appealed against and, if appropriate, we will revise the decision in your favour. In this case your appeal will lapse and will not be sent to the Tribunals Service. You can appeal against the new/revised decision if you think it is still wrong.

If we cannot revise the decision in your favour we will send your appeal letter and papers, giving our reasons and evidence for the decision, to the Tribunals Service. will send you a copy of these papers.

If someone is dealing with the appeal for you , we will send them a copy of the papers about the appeal.

The Tribunals Service will tell you where and when your appeal will be heard.

If you want more information, please get in touch with us. Our address and phone number are at the top of this letter. An advice centre like the Citizens Advice Bureau or a local law centre can also give you free advice. You can get a list of organisations in your area who can also give you free advice from your nearest DWP office at Luton. If you are a member of a trade union they may be able to give you help with your appeal.

If you ask someone for help and advice you should take this letter with you.

Regarding your letter dated 14 August 2009 which followed my letter to Ms RB... dated 11 August 2009 which followed a letter from Ms RB... dated 29 July 2009, I do not believe there is much disagreement between us. Maybe the following points can help resolve the situation.

My claim is for ESA(C). I have assets and savings over the £15,000 limit. I am 52 and have worked all my life paying tax and NI. I have a primary brain tumour which makes me periodically very tired and unable to do IT development work, which is my profession. I think my claim is valid. I am happy for the DWP to decide what I am entitled to.

I still have not received a copy of the medical report. I am not in a position to decide whether an appeal should be made until I have received the medical report and had time to review it. Unfortunately the letter from Ms RB... dated 29 July instructed that an appeal requires the form in leaflet GL24 to be completed within one month of 29 July. Please can you supply a copy of the medical report, together with leaflet GL24 as I have restricted mobility and have difficulties attending a JobCentre Plus office or a Post Office, and then give me one month from that time to decide whether to appeal.

If you refuse to provide me a copy of the medical report, can you advise me on what legal grounds you are taking this action.

Regarding Atos Healthcare arranging Work Related Activity Group interviews in line with the 29 July letter, please can you ensure that Atos Healthcare records are updated to reflect that Work Related Activity Group interviews are deferred indefinitely on the grounds that I am terminally ill and so sick that any such interview would be of no assistance in the treatment of my brain tumour which is progressive. Naturally if circumstances change, hopefully for the better, I will let the DWP know.

I look forward to receiving a copy of the medical report (an email to ...@... would be fine) and receiving form GL24.

Finally my view is that the DWP has operated correctly in this matter. The DWP is reliant on Atos Origin to provide correct medical opinion. The medical opinion that the DWP should have received is that I should be placed in a Work Related Activity Group and that interviews are of no assistance and may harm me. This status should continue until the tumour is treated by surgery or radiotherapy. Following treatment the situation should be reviewed. If able, I am happy to keep the DWP informed after every consultation with my Neuro Surgeon. The next consultation is scheduled for 10 September.

Please can you inform Ms B... that I have just received a letter from Atos Healthcare dated 16th August 2009 informing me that an appointment has been arranged at Highgate for Monday 24 August 2009. Please could you ask Ms B... to cancel this appointment and ask her to update my record so that no further similar letters are sent out in error.

Ms B... has advised me in a letter dated 10 August that she is conducting a full investigation. I have not yet received a progress report. The matters she is investigating are pertinent to whether or not future interviews are to take place and the location of any such interviews.

Ms B... may wish to confirm with Ms RB... and Mr AR... of the DWP... that all further interviews are deferred indefinitely on the grounds that I am terminally ill and so sick that any such interview would be of no assistance and likely to be detrimental in the treatment of my progressive brain tumour.

Please note I have still not received a copy of the medical report expected to be produced following the 24 July appointment. The thirty days, allowed to decide whether an appeal to the DWP will be made, can only start following receipt of this report. Looking ahead, if the medical facts are disputed it may be necessary to take this matter to the High Court who might need to appoint an independent medical authority to provide clarification. The court may call the Doctor who carried out the appointment on 24 July as a witness.

Please note I have still not received my travel expenses for the 24 July.

I am afraid that the Customer Relations Team are unable to cancel an appointment on your behalf. You will need to telephone the contact centre on 0800 2888 777 to discuss your appointment. If you are disputing the need to attend an appointment, you may wish to contact the benefit office dealing with your claim as they have sent your file to Atos Healthcare for advice/assessment.

With regard to your travel expenses, I can confirm that Ms B... forwarded your completed form to our Nottingham office for payment and you should receive this shortly.

I would once again ask that you refrain from sending Ms B... e-mails and allow her time in which to investigate your complaint and provide you with a full response.

Both the DWP and yourself have been informed. I am confirming to you that you have made a mistake in making a new appointment. It is immaterial whether the DWP has not updated you or more likely whether, judging by the poor service I have seen, you have mislaid the information that the DWP has given you. What you both decide to do with this information is up to you. As a tax payer for over 30 years I am appalled that you would stand by and take no action and waste a doctor's time I presume. I will continue to wait for the DWP to come back to me as the DWP has asked me to and I will wait for Ms B.... Other than this I am pleased not to have to take any more action in this matter.

I would appreciate it if you could arrange for the time being that the only correspondence I received from Atos Origin is from Ms B.... Other correspondence sent out by Atos Origin such as additional appointments made in error will be retained and be put aside pending future High Court action.

Further to Atos Healthcare's most recent Ietter, I am now able to respond to the concerns which you raised regarding your attendance at Highgate Medical Examination Centre (MEC) on the 24 July 2009 for your Employment and Support Allowance (ESA) assessment. l am now also able to respond to your concerns regarding the suggested journey planner.

I would like to apologise for the delay in responding. Unfortunately it took longer than anticipated to obtain all the necessary information to enable me to fully respond to your concerns.

During the investigation into your concerns, I have obtained comments from the Site Manager responsible for Highgate MEC and also input from the Atos Healthcare offices to where your correspondence was addressed.

With regard to our corresondence dated 28 June 2009, addressed to the Appointments Helpdesk in Cardiff and dated 29 July 2009, addressed to Highgate MEC, I can confirm that neither of these letters reached the correct destination of our office in Leeds for which I must offer you our sincere apologies. Both addressees have advised that any correspondence relating to concerns from a customer would be forwarded on to the Customer Relations Team in Leeds, however they have no record of doing so.

I have noted your concern that the journey planner supplied with your appointment letter, advised that your journey from your home to Highgate MEC was over 90 minutes.

Atos Healthcare tries to arrange an appointment at your nearest MEC. Unless agreed with yourself, you are not expected to travel more than 90 minutes (each way) by pubIic transport bemeen your home and the examination centre. The appointment letter also contains information regarding how to contact Atos Healthcare should a customer have any queries about their appointment, including travelling to their appointment. If our Helpdesk contacted by a customer who has been asked to travel more than 90 minutes to a MEC, other options can be explored such as the consideration of travel by taxi or to be visited at home.

I can confirm that according to Transport Direct, a government website providing suggested journey planners, the journey from your home to Highgate MEC shows a duration of 1 hour 48 minutes. Two of our alternative MEC's in the surrounding area would be Romford MEC (a journey of 1 hour 34 minutes) and Luton MEC (a journey of 2 hours 5 minutes).

Moving on now to your concerns regarding your attendance at Highgate MEC , the waiting time that you experienced before being seen and the facilities available at the MEC.

The Site Manager responsible for Highgate MEC has advised that at the time of your scheduled appointment of 3.30pm, a health care professional looked at your paperwork and advised that you needed to be assessed by a doctor rather than a health care professional due to your neurologicaI conditions, an issue which had unfortunately not been highlighted and for which I would like to apologise, as I understand that you then experienced a delay in waiting for a doctor to become available. The Site Manager has advised that the receptionist explained the situation to you and that there would be a delay.

With regard to your concerns about the facilities at Highgate MEC, the Site Manager has advised that as the MEC is not a GP surgey or hospital, it does not have alcohol rubs for people to use in the waiting room , but soap and washing facilities are available in the toilets. She adds that the waiting room does not have any pictures or a teIevision, but does have some leaflets and reading material provided from the Department for Work and Pensions regarding benefits. I can however advise that providing televisions for the waiting areas at the MEC's is something which is currently under consideration.

When asking for proof of identity from customers, the Site Manager has advised that reception staff always ask the customer for identification if they have any. Where the customer does not have a suitable form of identity, this is noted on the Proof of Identity slip and signed by the customer. It is then the responsibility of the examining practitioner to establish the customer's correct identity.

In response to your concern regarding your travel expense claim, as I advised in my acknowledgement letter to you of the 10 August 2009, I forwarded your claim form to our Nottingham office in order for them to authorise and arrange payment for your travel. A Team Leader from our Nottingham office has confirmed that payment was authorised on the 13 August and that you should have received payment approximately 1 week Iater. However, if for any reason you have not yet received payment, you can contact our Nottingham office on 0115 9758353.

I have noted from your letter that you have no complaints regarding the receptionist or the doctor who you saw, and that you thought that they worked well under difficult circumstances. l would like to thank you for this feedback.

It may however be helpful if I explain that the examining practitioner would not have access to a customer's NHS medical patient history. The only information available to the examining practitioner is provided to us by the Department for Work and Pensions and may include information from your GP and an ESA questionnaire if you had completed one.

You have advised in your letter that you are waiting for a copy of the report. I would advise that a request for a copy of your report should be made to your local Department for Work and Pensions' office. I believe that your local office is Luton who can be contacted on 0845 6088627.

I have noted from our records that you did not attend your scheduled appointment on the 24 August 2009 at Highgate MEC. I can confirm that your paperwork was returned to Luton Benefit office the same day, where it remains.

As part of Atos Healthcare's commitment to provide a service of the highest standard, it is important that we continue to be open and receptive to the views of those whose lives are affected by the service that we provide. I am, therefore, grateful for your feedback, which has given me the opponunity to investigate your concerns and make the Site Manager aware of them.

Atos Healthcare strives to provide all customers for whom we are asked to arrange an examination in respect of a benefit claim with a professional and courteous service. I am sorry for the upset that you have experienced on this occasion and hope that any future dealings that you may have with our service will not give you cause for concern.

Regarding your letter dated 22 September 2009 which followed your letter dated 10 August 2009. I am taking advice on your response and will write more fully in due course.

Regarding the 24 August 2009 Highgate MEC appointment, I would like to formally complain that you took no action regarding a request by me to cancel the appointment in an email sent to Customer Relations dated 18 August 2009 11:29. Customer Relations replied in an email dated 18 August 2009 12:10. I further replied in an email dated 18 August 18:12. I can provide copies of these emails at your request.

My email of the 18 August 2009 11:29 clearly explained the reasons why the appointment should be cancelled. You failed to cancel the appointment. You failed to address these reasons I gave in your responses to date.

A reasonable person might conclude that it is an abuse of process to continue with a procedure whilst a complaints and appeals process has not concluded. It seems especially pertinent that substantive items in the letters of complaints include the validity of the medical examination process and in particular the location and accessibility of the Highgate MEC and the gross lack of care in consideration of the medical state of the patient.

I delayed raising this complaint in line with your instruction in your email dated 18 August 2009 12:10 "... refrain ... allow her time ...provide you with a full response."

I look forward to receiving acknowledgement of my complaint within two days and your full response thereafter.

Regarding your letter dated 22 September 2009 which followed your letter dated 10 August 2009 and my letters of complaint the latest of which is dated 24 September 2009. In the email I received from Customer Relations, dated 18 August 2009 11:29, I was told I would be provided with a full response. To date, I have not received a full response. Please can you now, immediately, refer my complaints and all correspondence to The Independent Tier for their consideration.

I would like the Independent Tier to consider the following:

1. Did the Medical Examination that was carried out, conform to statutes "Welfare Reform Act 2007" etc and conform to relevant case Law and so was it valid?

   In particular, is it acceptable, other than in a medical emergency, for a doctor to make a diagnosis without access to the patients' medical history or without access to consultation notes from specialist consultants if appropriate? Case law suggests that this is not acceptable in the legal or engineering fields and so as a general principle is not acceptable in the medical field.

   Ms B... has stated that "...the examining practitioner would not have access to a customer's NHS medical patient history". The doctor I saw agreed that in my case the medical examination process that she was compelled to undertake was unnecessary and put me at risk. She confirmed that if she had seen my original letter of the 28 June 2009 that it would have been unethical to undertake the medical examination as the long journey, lack of toilets, lack of food, increased likelihood of fitting, especially in the Tube , was potentially harmful to myself as the patient. She further confirmed the process was not a valid medical examination but she was compelled to complete the on line questionnaire which took most of the 1 hour 50 minute duration even though this had the same information as the ESA form completed and given previously to the DWP. It is clear a trained clerk could have completed the process as no medical expertise was required. It is clear a valid medical examination was not carried out.

2. Was there a breach of duty (tort of negligence) in that the appointment process did not allow the medical state of the patient to be taken into account even when a verbal and an, a priori, written request to take this into account was made?

   The result was four days of illness, confined to home, able only to get up for a few hours a day and weeks to recover to the state of strength prior to the appointment. What compensation for damages is appropriate in this case?

3. Was there under Administrative Law, an abuse of process in that the recommendation given to the DWP assigned the patient, myself, to a Work Related Support Group but appears to have failed to defer further interviews on the grounds of either terminal illness or the fact that further interviews would be of no assistance in the treatment of a progressive brain tumour?

   As stated in the ESA form and in my letter dated 28 June 2009, my GP is unable to assist medically. A Neurologist is needed to decide the level of medication to keep the symptoms under control. A Neuro-Surgeon is required to deal with the brain tumour. On what medical grounds was it felt necessary to insist on a further medical appointment at the Highgate MEC on 24 August 2009 and back this up once again by the direct threat of cancellation of allowance? Is this not shameful? How can such gross negligence and dereliction from duty of care occur whilst a complaints and appeals procedure is underway?

4. Are the long travel distances required by a patient to travel consistent with a Medical Examination as defined by statutes "Welfare Reform Act 2007" etc and Case Law?

   It seems reasonable to suggest that the intention of Parliament is for the Medical Examination to be consistent with existing Medical Examinations and in quality to be as good as or better than existing.

   NHS Medical Examinations are carried out at the local GP surgery or hospital, by qualified medical practitioners with access to the patient's history, in locations that meet Health and Safety Rules for such places and take into account difficulties in travel and accessibility. Parliament has not clearly expressed a wish that lesser standards should apply.

   Ms B... confirmed the journey times to the nearest MECs; Highgate 108 minutes, Romford 94 minutes and Luton 125 minutes. All three times breach the maximum 90 minutes set out in Atos Healthcare literature. Are these times acceptable given that patients are ill and no account is taken of the conditions of the patient? Is it acceptable that these times do not include waiting times or return times?

   My GP surgery is a walk of 10 minutes. My local hospital is 20 minutes by car. My local JobCentrePlus is 15 minutes by car. Parliament has not stated that lesser standards in journey times than those of NHS Medical Examinations should apply. Is setting a maximum journey time of 30 minutes more in line with the intent of Parliament?

5. Atos Healthcare have confirmed that the Highgate MEC is not a GP Surgery or a hospital. Is this, under Administrative Law, an abuse of process given that Parliament has not stated that lesser standards than those of NHS Medical Examinations should apply?

   Ms B... states paragraph 10 "...the Site Manager has advised that as the MEC is not a GP surgery or hospital, it does not have alcohol rubs for people to use in the waiting room, but soap and washing facilities are available in the toilets...".

   Please note the Health and Safety Executive is taking Health and Safety issues forward and has raised Case No 4177247.

6. Is there sufficient evidence to suggest there is systematic failure in the services provided by Atos Healthcare in that three offices have failed jointly and severally?

   1. Atos Healthcare jointly fails to comply with the Welfare Reform Act 2007 and with Health and Safety legislation.

   2. Atos Healthcare in their literature and communications appear to confuse the concept of a customer and a patient. The customer is the DWP. I am the patient. Their duty to DWP is defined by contract. Their duty to the patient is defined by their duty of care as defined by legislation and statute. Training appears to be insufficient in this regard.

   3. Of the three letters of complaint, none have been acknowledged within the two days as in the literature.

   4. Cardiff and Highgate failed to respond to letters of complaint.

   5. Cardiff cancelled an appointment with two days notice in breach of the published seven day notice period. This proves the 28 June 2009 letter of complaint was received. Ms B... confirms it was not forwarded to Leeds as it should have been.

   6. Highgate failed to schedule a qualified medical practitioner to be available at the appointment time. No explanation was given for this failure.

   7. Ms B... in Leeds failed to action a request to cancel an appointment scheduled for the 24 August 2009 at Highgate MEC despite being requested to do so on the 18 August 2009 and after acknowledgment of the request.

   8. Ms B... in Leeds failed to respond fully to the letters of complaint and partially responded just under three months after the original letter of complaint in breach of the published time period for dealing with complaints.

   9. Ms B... in Leeds refused to forward the original complaint to The Independent Tier when requested to do so.

   10. Atos Healthcare, at times, has been unprofessional and discourteous and has failed to demonstrate that it is capable of providing services that address the health care needs of patients.

7. Is the DWP, as the customer of Atos Healthcare receiving value for money when the DWP ie being charged for unnecessary and invalid medical examinations which do not appear to comply with legislation?

8. Is the patient receiving the duty of care that is consistent with legislation?

I look forward to receiving the adjudication of The Independent Tier on the above and their considerations on the details of my complaints.

The Welfare Reform Act 2007 legislation is clear. I hope The Independent Tier will instruct Atos Healthcare to comply with the legislation. Hopefully Atos Healthcare will comply and it will not be necessary to place a case before the High Court to rule on whether, under Administrative Law, an abuse of process has taken place and as remedy to seek an order of mandamus to compel Atos Healthcare to comply with the legisation.

I hope recommendations arise from this case that will improve patient care and bring the standards of Medical Examinations carried out by Atos Healthcare up to or better than existing NHS standards for Medical Examinations.

Please can you confirm, by return, that you have forwarded this matter to The Independent Tier.

Your appointment details for your Pathways to Work Interview on 12 October 2009 10:45.... A threat that you must attend ... the usual bullying. ... you must contact us.

Regarding your letter dated 2 October 2009. Please can you cancel the "Pathways to Work" Interview with "D..." that you have scheduled, in error, for 12 October 2009 at 10:45 in ....

The position is as stated in my letter dated 15 August 2009 to Mr AR... BDC... which followed my letter dated 11 August 2009 sent to Ms RB... at the same address.

Your records should reflect the substantive point:- "...Regarding ... arranging Work Related Activity Group interviews ..., please can you ensure that ...records are updated to reflect that Work Related Activity Group interviews are deferred indefinitely on the grounds that I am terminally ill and so sick that any such interview would be of no assistance in the treatment of my brain tumour which is progressive. Naturally if circumstances change, hopefully for the better, I will let the DWP know...."

I am concerned your records are in error. I hope this clarifies matters and you can ensure your records are corrected.

Please can you update me with progress in respect of a letter dated 24 September 2009 regarding a complaint and a letter dated 28 September 2009 regarding a request that the matter is referred to the "The Independent Tier". These letters were sent to Ms B..., Customer Relations Manager, Atos Healthcare in response to the letter received from Ms B... dated 22 September 2009. I was expecting a written acknowledgment within two working days as specified in your "Caring about customer service" booklet.

I attach copies of the original letters.

I write in response to your letters of 24 and 28 September 2009, which were received in this office on 28 and 30 September. Please accept my apologies for the delay in doing so. I also acknowledge receipt of your e-mail of 6 October 2009.

I can advise that I am currently considering the content of your letters and I hope to be in a position to provide you with a response shortly.

If I can be of any further assistance in the meantime however, please do not hesitate to contact me.

I write further to my letter of 6 October 2009. I can advise that in accordance with our complaints process, which has been contractually agreed with the Department for Work and Pensions (DWP), your complaint can only be referred to the Independent Tier when all issues of complaint have been addressed.

Your letter of 26 September 2009 raises new issues that we should have the opportunity to address further in accordance with our complaints procedure.

In view of the above, I can advise that your complaint will be reviewed by a Senior Medical Advisor in the tight of the comments you have made in your letter.

I hope to be able to provide you with a response to your continuing concerns in the near future. If, in the meantime, l can be of any further assistance, please do not hesitate to contact me.

Regarding your letters dated 7 October 2009 and 6 October 2009 which followed my email dated 6 October 2009. Thank you for responding so quickly. It is a pleasant contrast with the tardiness, poor customer service and systematic failure I have experienced to date from Atos Healthcare.

In line with your "Caring about customer service" booklet, I expect to hear from you within 20 working days.

Thank you for confirming that Atos Healthcare has a contractual relationship with the Department for Work and Pensions (DWP). Under case law and in particular cases that set precedents with respect to "Delegatus non potest delegare", Atos Healthcare is under the same legal obligations as the DWP in respect of the DWP contracted for services. Under the rights given to me by the Freedom of Information Act 2000, please can you provide me with a copy of the contract between the DWP and Atos Healthcare or provide me with a public website address where I can access a copy. In particular, I am interested in the contractual clauses that relate to the Medical Examination and associated processes. I would like to know who, against the intent of Parliament, has decided that lesser standards should apply to Medical Examinations carried out by Atos Healthcare. There are set time periods for providing this information. There are legal remedies and penalties for not supplying this information.

We wrote to you ...blah blah blah... help we offer ... Pathways to Work service ...blah blah blah... interview has been arranged.... it is a condition for receiving the full amount of your benefit that you attend ...blah blah blah....

Regarding the telephone message, from "C...", left before lunch today and your letter dated 12 October 2009 which followed my letter dated 5 October 2009.

I am pleased that you have spoken to the DWP in ... and have been advised by them to defer any further interviews until such time as they have addressed the outstanding matters detailed in my letters dated 15 August 2009 and 11 August 2009.

I trust that you have updated your records and that this means that you will not send me any more correspondence which are in error.

I would like to make it clear that should this matter be put before a High Court, I would be asking the judge to consider your motives in sending out your letters of the 2 October and of the 12 October. I would be asking whether these constituted under Administrative Law an abuse of process; deliberate unlawful harassment, neglect, incompetence et al. A judge might consider these actions of yours breach sections of the Human Rights Act 1998. I should not need to remind you that you have a duty of care to the dying, the sick and the disabled.

Thank you for your letter of 8 October 2009, which was received in this office on 12 October.

I can advise I can confirm that your request for information under the Freedom of Information Act has been passed to the Department for Work and Pensions, Medical Services Contract Management Team (MSCMT) who are responsible for dealing with such requests. They will be in contact with you in due course.

Further to my letter of 7 October 2009 I can advise that I am stlll in the process of investigating your continuing concerns, which has invoIved requesting a copy of your self assessment questionnaire (ESA50) from the Department for Work and Pensions, which l have yet to receive.

I can confirm that once I receive a copy of your ESA50, my investigations will continue and I will be in a position to provide you with a response once they are completed.

I am sorry for the delay in providing you with a response to your concerns and I thank you for your patience.

Regarding your letter dated 11 November 2009 which I received on 14 November 2009.

Please can you provide me with the name of the Health Care Professional who reviewed the information provided and decided a face to face meeting was necessary in my case.

Please can you provide me with the name of the Health Care Professional who undertook my medical examination in Highgate.

I refer you to the Contract between the Department for Work and Pensions and Atos Healthcare.

I refer you to the above Contract, in particular Schedule 4, Section 4.1 Part 2, 1. General, 1.1 Medical Recruitment Standards. Please can you confirm that the use of the above Health Care Professionals by Atos Healthcare complies with paragraph 1.1.1.1 in that, at the time they carried out the above actions, they were "...fully registered, without restrictions or conditions, on the Principal List of the General Medical Council; and in addition...". Please provide me with sufficient information that I can independently check these facts with the GMC.

I refer you to the above Contract, in particular Schedule 4, Section 4.1 Part 2, 5. Medical Quality Assurance. For each of the above Health Care Professional, please can you supply me with a copy of the information Atos Healthcare is contractually obliged to hold in respect of 5.1. "Systems for recording ...".

A reasonable person would regard your further delays in resolving this matter as obstruction. As provided for in the Contract, and taking into account the time scales set out in the Contract, please forward this case immediately to the Independent Tier and provide me with contact details so I can contact the Independent Tier directly. If you, once again, decline to do this, please provide me with the legal grounds for your refusal. A further failure to comply might be regarded by the Secretary of State for Work and Pensions as a breach of contract.

Understanding your experiences of applying for benefits

We are currently looking at ways to improve customers' experiences of sickness-related benefits, and hope you will heIp us in shaping policies on this important issue. We understand that you have recently made an application for a sickness-related benefit. It does not matter if you have not yet gone through the whole process, or have already withdrawn your application. We are still interested in hearing about your views.

We have commissioned Ipsos MORI and the Institute for Employment Studies (IES) to carry out this study on our behalf. Both organisations are completely independent of the Government and political parties.

In the next few weeks, an interviewer from Ipsos MORI will be calling you or visiting you at the above address Unfortunately, they can not arrange specific dates or times for interviews, but don't worry if you are not home when the interviewer calls or arrives. He or she will try again at another time.

All Ipsos MORI interviewers wear identification badges with their photo. Please only allow people who carry this official identification into your home. You may have a family member, friend or carer present during the interview if you wish.

Everything you tell Ipsos MORI will of course be treated in complete confidence - no personal views or information will be passed to anyone outside the research team without your prior approval. More importantly, nothing you say will affect any current or future dealings you may have with the Department for Work and Pensions, Jobcentre Plus, or any other Government departments. Importantly, the information you provide will not affect the benefits you receive, either now or in the future.

I do hope that you feel able to take part in this survey. However, if you need assistance to help you take part, or feel that you do not want to be interviewed, please call J... from Ipsos MORI on the freephone number 0808 ... ... or email her at J... at ipsos.com. By giving us the reference number on this letter during the call or in the email, you will help us deal with your queries as quickly as possible.

We look forward to speaking to you.

Regarding your letter dated 20 November 2009 which I received on 25 November 2009.

First, may I respectfully correct you in your use of the term "customer", you should use the term patient or patient claimant. If you refer to the Welfare Reform Act and the Contract between the DWP and Atos Healthcare, a "customer", in respect of Employment and Support Allowance (ESA), is a defined term and has a specific legal meaning. Your use of "customer" in your letter is a misrepresentation. The state has a statutory duty of care to patients and claimants. The term "customer" implies subject to Contract Law. This is not the case in the context you use the word.

Further, my reading of the Welfare Reform Act is that it provides for allowances. The term benefits applies to prior legislation. Feel free to confirm my assertions with the Secretary of State for Work and Pensions. I would be willing to be corrected on this matter if you would draw my attention to the statute or regulation.

Following on from the above, I have a patient claimant experience of sickness related allowances. I do not have and never have had a customer experience of sickness related benefits whatever that might be.

The ignorance you have shown appears to be common throughout the DWP and Atos Healthcare. In my opinion, the misuse of the term "customer" contributes to the abuse of the dying, the sick, the disabled and their carers by the DWP and Atos Healthcare. History tells us the concept of a sick person in Stalin's labour camps or in Nazi concentration camps was not allowed. These regimes preferred to use the term "worker" and similar. It seems to me there is an echo of history when the DWP and Atos Healthcare prefer the term customer or worker or jobseeker instead of the correct term patient or patient claimant.

I have published my abuse at the hands of the DWP and Atos Healthcare on my website "http://www.whywaitforever.com/dwpatos.html". I am willing for anyone including Ipsos MORI to use this information. This web page contains links to my written submission to the House of Commons inquiry and contains links to extracts of relevant correspondence.

I am never at home to pollsters, hawkers or other such callers. I am even more disinclined now that I am terminally ill and of less than robust constitution.

Notwithstanding, if there is additional information that Ipsos MORI requires, I will respond to questions submitted in writing, providing, of course, that the symptoms of my terminal primary brain tumour allows me to. I have periods of weakness and extreme tiredness so how quickly I can respond is not certain.

I would appreciate a reply that you have received this letter and confirmation of my understanding of the term "customer" and "benefits".

... I hope you are independent, honest etc. Frankly my experience of the DWP and Atos Healthcare suggests that you are another shill.

Feel free to publish this as part of the report. I am not concerned about complete confidence...publish away. I am dying what more harm can you guys do to me. In time injustice will be overcome. Maybe a future Nurmberg Doctors type trial will hang the abusers of the dying, the sick, the disabled and their carers. ...

Thank you for contacting me. I am very sorry that you have had such a terrible experience, and I will remove your name from our contact list and ensure that none of our interviewers disturb you at your home.

I would like to clarify that Ipsos MORI is entirely independent of government - we were commissioned by DWP to conduct the survey but otherwise we are not connected with the Department. We do not have personal information about your condition or your medical or benefit records. We also have no connection with Atos Healthcare.

Thank you for replying. I have updated my web page with extracts of our correspondence. The sections that refer to the survey are located subsequent to .... http://www.whywaitforever.com/dwpatosletters.html#DWP20091125F If you feel I have made a factual error please let me know. If you would like me to publish a further comment from you or Ipsos MORI, I will consider and try and oblige.

I think you can demonstrate your independence if you confirm that you will both include me in the survey and you agree to publish in an explanatory note to the report the above web page address annotating this note as a particular (maybe atypical) response.

I write in response to your letter of 18 November 2009, which was received in this office on 20 November.

Firstly, I can confirm that your request for information under the Freedom of Information Act has been passed to the Department for Work and Pensions (DWP), Medical Services Contract Management Team (MSCMT) who are responsible for dealing with such requests. They will be in contact with you in due course.

In response to your request that your case be forwarded immediately to the Independent Tier (IT), I can advise that in accordance with Atos Healthcare's Complaint Procedure, which has been contractually agreed with the DWP, complaints can only be referred to the IT (which is the final stage of the process) when all issues of complaint have been addressed. As your letter of 26 September 2009 raises further issues, they are currently being investigated.

As mentioned in my letter of 11 November 2009, I am sorry for the delay in providing you with a response to your continuing concerns but hope to be in a position to do so very shortly.

Thank you for your Freedom of Information request which was received 20 November 2009.

You asked for:- Healthcare Professional's name and Qualifications + information about schedute 4 section 4. 1 part 2, 5. 1

You can therefore expect a reply by 18 December 2009 unless I need to come back to you to clarify your request or the balance of the public interest test needs to be considered.

If you have any queries about this letter please contact me quoting the reference number above.

Ref: FOI:... Atos Healthcare names et al

Thank you for providing me the edited copy of the Medical Services Contract in my request your reference FOI:.... The information has proved very useful. There is one outstanding point relating to this request, I asked if this information could be made available on line. I believe it is a Government aspiration that as much information as possible is made available on the web. The DWP website would be an ideal location. Can you provide me with your position on publication on the web of the edited copy?

Further to your letter dated 25 November 2009, your reference FOI:... which followed up a request to Atos Healthcare for the names and qualifications of the healthcare professionals involved in my case. I am confused as to why this is a FOI matter. I may have misunderstood the Contract between the DWP and Atos Healthcare. My understanding is that the Contract suggests that Atos Healthcare should supply this case specific information direct to a claimant.

Notwithstanding, I would like to clarify that I am requesting information about the three main individuals involved in my case and others. Mr Jonathan Shaw MP, the Minister for Disabled People has assured me in a letter that the information provided is screened before deciding on a face to face examination.

Person 1. is the person who screened the information I provided. I have been told by Atos Healthcare that this person was not a Doctor. I have been told this person requested that the information should be screened by a Doctor and that this request was refused.

Person 2. is the person advised by Person 1 that a Doctor should review the information I provided. I understand this person ignored the advice and decided a medical examination was required. I do not know whether this person is a Doctor.

Person 3. is, I believe, Dr Ludmila Semetillo, a C... national. I do not know if this person is registered with the GMC. In particular, I would like evidence on her competence in spoken and written English. She undertook my medical examination at Highgate, the quality of which is under dispute.

For the three persons above, I would like the names, qualifications and GMC registration information and for these individuals, and as you mentioned in your letter, in compliance with the Contract, Schedule 4, Section 4.1 Part 2, 5. Medical Quality Assurance, copies of the information Atos Healthcare is contractually obliged to hold in respect of 5.1. "Systems for recording ...".

For Person 1 and Person 2, the date when and the location where they screened the information that I supplied in respect of ESA.

For the three persons, I would like the names, titles and qualifications of the managers directly responsible for the quality of the work of these individuals.

In a letter from Ms C... dated 10 October 2009, I was advised that my complaint will be reviewed by a Senior Medical Advisor. I would like the name, qualifications, GMC registration information and location of this individual. I would like the name, title and contact information of the manager of Ms C... responsible for the quality of work undertaken by Ms C....

For all the individuals referred to above I would like full contact information in the form that is acceptable should this matter be put before the High Court.

Atos Healthcare have refused repeatedly to refer my case to the Independent Tier. Under the Freedom of Information Act, I would like information on the Independent Tier who are defined in the Contract. For the Independent Tier I would like, the terms of reference for this body, the names and qualifications of the members of this body and information on how and where the adjudications of this body are published. I would like summary information comprising the number of cases that have been referred to this body and of these cases how many rulings were made in favour of Atos Healthcare. The figures for the most recent year available is sufficient. I presume this body takes the form of a judicial tribunal, in which case I would just need to be given the web site address for where the activities of this body are published.

I appreciate your efforts. I look forward to hearing from you. Thank you.