Government Correspondence

Re: Welfare Reform Act 2007

I have concerns over the way the Medical Examination as required by the Welfare Reform Act 2007 has been implemented. I do not believe it was the intent of Parliament that lesser standards should apply to these medical examinations compared to the standards that apply to those carried out by the NHS. I believe it was the intent of Parliament that standards as good as or better should apply.

The Department for Work and Pensions (DWP) has contracted out services to Atos Healthcare. Atos Healthcare in a written reply has stated that "...the examining practioner would not have access to a customer's NHS medical patient history". Atos Healthcare has stated in a written reply to the Health and Safety Executive (case reference 4177247 handled by Mr J...) that "...The Medical Examination Centre assesses people's functional ability through consultation, discussion and simple physical tests(e.g. reflex)...".

In my case, I would be pleased to see the DWP medical expert if that expert had consultant level knowledge of my condition and who could provide me with a better view on the steps needed to stabilise my condition and turn me around so that I get well and back to work. In deciding whether a medical examination is necessary, I would like a specialist to review and decide on medical grounds whether there is a medical benefit to the patient in attending the medical examination.

I believe there would be a major cost saving in screening the ESA forms and only examining those who were not terminally ill or those whose medical conditions are stable. My condition is terminal and not stable yet I was compelled to attend an unnecessary medical examination. As a tax payer for 30 years I feel the money would be better spent on those cases where success is more likely.

Please can you confirm that you believe the standards should be as good as or better than those applied in NHS GP surgeries and NHS hospitals. Please can you take the steps necessary to ensure that the will of Parliament is complied with.

I look forward to hearing from you. Thank you.

Thank you for your letter of 14 October to the Secretary of State on behalf of ... of ... who has expressed concerns about the new medical examination known as the Work Capability Assessment. The Secretary of State has asked me to reply in my role as Minister for Disabled PeopIe.

It may be helpful to explain that people receiving Employment and Support Allowance are required to attend a Work Capability Assessment which is designed to help establish whether there is entitlement to the benefit and their level of work capability. The assessment also determines which group the individual should join (the work-related activity group which has mandatory requirements to attend work-focused interviews attached, or the support group, which does not).

Healthcare professionals employed by Atos Healthcare, the private company contracted to provide medical services for Jobcentre Plus, receive speciaIist training before undertaking these assessments. The maintenance of high standards of medical practice is enforced through monitoring and evaluation of the healthcare professionals, including random audits by the Medical Service's quality monitoring and auditing system. Approval to carry out the assessment can be removed if a healthcare professional's work does not continue at the required standard.

... may be pleased to learn that we already screen the information provided by customers before deciding whether a face to face examination is required. The precise circumstances for exemption are prescribed in the regulations and include terminally ill people who are fast-tracked onto the higher rate of benefit. Every effort is made to identify potentially exempt cases by liaising with the GP or specialist before contacting the claimant. This ensures that where at all possible, severely ill peopIe are not troubled by the assessment and in particular do not have to undergo a medical examination unnecessarily.

It is important to recognise that assessment looks at what an individual can do, rather than simply making a diagnosis of their medical condition. It is function-based, rather than condition-based and focuses on a person's ability to perform work-related activities, rather than on their particular illness or disability.

I trust this reply is helpful to ...

Regarding your reply to ... MP dated 28 October 2009 following his letter of the 14 October 2009 on my behalf.

I have concerns over how the medical examination has been implemented by Atos Healthcare in my case and in others. I am in favour of valid medical examinations carried by competent qualified medical practitioners who have access to full medical records.

I attach my letter of complaint to the GMC in respect of negligent, neglectful and or incompetent actions by Mr David Wright, Chief Medical Officer, Atos Healthcare. I appreciate your comments, which have assisted my case.

In summary, the information I provided was not screened before deciding on a face to face examination and the medical examination was not carried out by a competent qualified medical practitioner.

Please can you investigate why I have still not received a reply from the DWP to my letter of the 15 August, why I have still not received a copy of the medical report and why I have still not received a reply to my letter to Atos Healthcare dated 28 September 2009.

The Care Quality Commission has informed me that Atos Healthcare is outside the scope of their responsibilities. Can you confirm this is your understanding? If this is so, can you inform me which independent body is responsible for the regulation of the quality of care provided by Atos Healthcare who is a customer of the DWP? In addition, can you confirm that Atos Healthcare is also outside the scope of responsibility of PALS?

You mentioned "the Medical Service's quality monitoring and auditing system" in your letter. Can you provide me with contact information and where reports are published?

I draw your attention to the legal case mentioned in my letter to the GMC. "...to review and apply current medical opinion in respect of "...assessment looks at what an individual can do, rather than simply making a diagnosis of their medical condition...". I refer you to the legal case involving the United States of America, State of California, Department of Insurance and their 2005 settlement with the UnumProvident Corporation. This agreement settles disputes over thousands of claims filed by California policy holders who were unfairly denied benefits by the insurance carrier during the time period between January 1, 1997 and September 30, 2005...".

I presume that, in my case, Atos Healthcare has charged the DWP for a service that they did not carry out. In my case, Atos Healthcare did not comply with the Welfare Reform Act, the Regulations and the principles you outlined in your letter. I respectfully request you to ask the National Audit Office to audit my case, to audit similar cases where potentially large numbers of patients and their carers have been unfairly denied benefits and to obtain financial recompense from Atos Healthcare. I do not see why tax payers have to pay for services not received. It would be better to address this injustice now before future costly litigation occurs.

I look forward to hearing from you.

Thank you for your further letters of 17 November and 8 December 2009 on behalf of Mr B... of ... concerning the Work Capability Assessment and Atos Healthcare I apologise for the delay in replying.

I am sorry that it has been necessary for you to write again but thank you for doing so.

I am unable to offer a full response at present as we are still considering this issue and enquiries are taking longer than anticipated. I will, of course, send you one as soon as possible.

Thank you for your further letters of 17 November and 8 December 2009 on behalf of Mr B... of ... concerning the Work Capability Assessment and Atos Healthcare.

Following my letter of 6 January, I understand an official from this Department wrote to Mr B... on 7 January.

I have attached a copy of her reply for ease of reference.

I hope this matter has now been resolved to Mr B...'s satisfaction.

Dear Mr ...

Last year you progressed my letter dated 9 October 2009 to the Secretary of State for Work and Pensions. You obtained a reply dated 28 October 2009 from Jonathan Shaw MP, the then Minister for Disabled People, Department for Work and Pensions. The Minister was misled by the DWP and Atos Healthcare, evidence of which I have subsequently obtained, unfortunately matters are still outstanding.

I wrote to the DWP on the 4 August 2010 see attached. I have neither received an acknowledgement or a response to this letter. Please could you request the Secretary of State for Work and Pensions to review the contents of this letter, to explain why my letter has, so far, been ignored and obtain a detailed response to each of the 14 points raised in the letter.

In addition, please could you write to the Minister of Justice on my behalf, provide him with a copy of this letter and the attached 4 August 2010 letter and ask him to launch an investigation into whether individuals working for the DWP are subject to undue influence by Atos Origin and as a result do not enforce the Contract between the DWP and Atos. Atos has implicitly agreed it has committed multiple breaches of Contract and has implicitly agreed it has mislead the former Minister for Disabled People and thus Parliament.

The Minister of Justice could ask, as a start, the NAO to independently audit my case to see whether Atos have refunded the taxpayer for failing to engage a qualified medical professional in deciding whether a face to face assessment was necessary, for producing an unsound ESA85 and for producing an unsound IB59. I have published, desensitized where appropriate, all correspondence and additional information on my website http://www.whywaitforever.com/dwpatos.html. The Minister of Justice could ask the NAO to investigate how extensive are the failures, maladministration and mismanagement.

In November 2001, there was a Labour conference near Oxford on 'Malingering and Illness Deception'. It was attended by Malcolm Wicks, the then Parliamentary Under Secretary of State for Work, and Mansel Aylward, his Chief Medical Officer at the Department of Work and Pensions (DWP). Unum (previously UnumProvident) was the driving force and was represented by John LoCascio. Unum in 2002 in the US faced a multi-million class action lawsuit for operating "disability denial factories". In January 2003, a California jury reached a 1.7 million USD settlement against UnumProvident and two years later, the California Department of Insurance fined the company 8 million USD because it "misinterpreted job classifications, improperly overruled doctors' opinions and knowingly used incorrect insurance definitions to avoid paying benefits". Other states received compensation from Unum. Unum allocated between 325m USD and 415m USD to cover the likely costs.

The work of this 2001 Labour conference resulted in the UK Welfare Reform Act 2007. In 2006 Unum helped to draw up the rules and regulations of this Act. UnumProvident Centre provides funding for Psychosocial and Disability Research based at Cardiff University. The Director of the Centre is Professor Mansel Aylward. Please could you ask the Minister for Justice to investigate whether Professor Aylward acted properly while working for the DWP when awarding contracts to Unum and whether his actions conformed to the Civil Service Code.

Unum refunded millions in the US. Atos follows the same unsound and possibly illegal in the UK approach that Unum and Atos included in the regulations relating to the Welfare Reform Act 2007. Please could you ask the Minister of Justice to investigate whether Atos Origin have acted illegally, by implementing the Act apparently deliberately breaching the Contract between the DWP and Atos, the NAO can provide the evidence, and to investigate whether Atos should refund the UK taxpayer millions GBP and compensate the individuals denied benefits on unsound grounds? It should be noted that the medical conditions and the medical professional who undertook each process should be noted on all forms. The GMC can tell whether the individual is qualified to carry out a medical assessment for the particular medical condition as set out in the Contract. In my case Atos used unqualified healthcare professionals on three separate occasions. They have not refunded the taxpayer for providing three unsound medical assessments. My case is not unique.

Please could you request the Minister responsible to remove Atos Origin from the shortlist of companies eligible for Government work related to the DoH Additional Supply Capability and Capacity (ASCC) framework catalogue and to remove Atos Origin from being eligible for any new Government work. The grounds for this action are the repeated breaches of Contract with the DWP by Atos Origin and the gross errors made by Atos Origin e.g. loss of confidential data, patients recalled for scans, clinic faces second investigation et al. More details are listed on my website. http://www.whywaitforever.com/dwpatosbusiness.html

Finally could you request the Minister responsible either to expel Atos Healthcare (Atos Origin) from Commercial Occupational Health Providers Association (COHPA) www.cohpa.co.uk or to withdraw all Government contacts with COHPA. COHPA appears to be a front organisation for Atos and Unum. The grounds for this action are the repeated breaches of Contract with the DWP by Atos Origin. Senior individuals from the DoH and the DWP attend the COHPA AGM and other events and thus may be subject to undue influence. Please could you ask the Minister of Justice to investigate the individuals who attend COHPA events and receive benefits from COHPA to ensure their actions conform to the Civil Service Code.

I appreciate your assistance in this matter

Thank you.

HOUSE OF COMMONS
LONDON SWlA 0AA
Tel: 020 7219 3000

The Rt Hon Iain Duncan Smith MP
Secretary of State for Work & Pensions
Department for Work & Pensions
Caxton House
Tothill Street
London SWlH 2NS

26th August 2010

Dear Private Secretary,

Re:- Mr B... of ... 

Please find attached a copy of my letter addressed to Mr Darra Singh, Chief Executive of Jobcentre Plus, on behalf of my above-named constituent regarding his ongoing concern about Atos Healthcare.

Mr B... has requested that you also review the contents of his letter and would be grateful for any comments you may like to make in response to the general issues raised.

Thank you for your assistance and I look forward to hearing from you.

Yours sincerely,

... MP

Att.

HOUSE OF COMMONS
LONDON SWlA 0AA
Tel: 020 7219 3000

Mr Darra Singh
Chief Executive
Jobcentre Plus
Caxton House
Room 607, Level 6
London SWlH 9NA

26th August 2010

Dear Mr Singh,

Re:- Mr B... of ...

Please find attached a copy of correspondence recently received from my constituent, Mr B..., regarding his ongoing concerns about Atos Healthcare, which I understand you may have already received directly.

I would be grateful if you could respond specifically to each of Mr B...'s 14 points and send me a copy.

Thank you for your assistance and I look forward to hearing from you.

Yours sincerely,

... MP

Att.

Re:- The Rt Hon Iain Duncan Smith MP, Secretary of State for Work and Pensions

HOUSE OF COMMONS
LONDON SWlA 0AA
Tel: 020 7219 3000

The Rt Hon Kenneth Clarke QC MP
Lord Chancellor & Secretary of State for Justice
Ministry of Justice
102 Petty France
London SW1H 9AJ

26th August 2010

Dear Private Secretary,

Re:- Atos Healthcare

Please find attached a copy of correspondence recently received from my constituent, Mr B... (...), who would like the Ministry of Justice "to launch an investigation into whether individuals working for the Department for Work and Pensions are subject to undue influence by Atos Origin and as a result do not enforce the Contract between the DWP and Atos".

For your information, I also attach a copy of the letters I have sent to the Secretary of State for Work and Pensions and the Chief Executive of Jobcentre Plus.

Thank you for your assistance and I look forward to hearing from you.

Yours sincerely,

... MP

Att.

1 November 2010

Re:- Atos Healthcare and the DWP

Please find attached a copy of corresspondence recently received from the Rt Hon Chris Grayling MP, Minister of State at the Department for Work and Pensions, in response to representations made on your behalf regarding your experience or Atos Healthcare. I am still awaiting a response from the Secretary of State for Justice but have today sent him a further letter as a chase-up.

Furthermore, please find attached a copy of the Minister's response to the Parliamentary Question I recently tabled on your behalf.

Yours sincerely,

... MP

Department for Work and Pensions
Caxton House, Tothill Stree, London SW1H 9DA

Our ref: ...
October 2010

...MP

As you may be aware, your letter of 26 August to the Secretary of State for Justice on behalf of Mr B... of ... has been passed to this DeparUnent for reply. I am sorry for the delay that this caused. Mr B... wrote about his experience of Atos Healthcare. I am replying as the Minister with responsibility for the Work Capability Assessment.

Hilary Brierley of the Department's Commercial Management Directorate wrote to Mr B... on 3 September offering an extensive reply to the outstanding issues which he had raised in his letter of 4 August. I enclose a copy of Ms Brierley's letter for your reference.

I do not feel there is anything I can add to Ms Brierley's letter. However, should Mr B... wish to raise any additional issues I would, of course, be happy to look into them.

With best wishes,

Rt Hon Chris Grayling MP Minister for Employment

Dear Mr ... MP,

... The Right Honourable Iain Duncan Smith yesterday stated that there were 5.5 million unemployed and 500,000 jobs available through Jobcentre Plus (JCP). I just watched on a business media channel a CEO of a JCP contract employment agency crowing about profits and future prospects from the DWP. It reminded me of Atos Origin stating in their annual report the highest margin in Europe was from the DWP. As a high rate tax payer for thirty years this concerns me. So how are some profits for the employment agency achieved?

I believe the JCP pays the external agency for placements on success. A driver is placed and works for no salary for a period. The driver is then taken on and retained, on minimum wage, for just the period of time needed for the bounty to be paid. Some of this bounty, allegedly, is paid as a "sweetener" to the transport company. The driver is then made redundant.

Clearly the nil costs for the initial period of a driver and driver no promotion prospects to the transport company outweighs redundancy costs as the driver has worked for such a short period. Other alleged methods of "creative" dismissal I mentioned in my previous letter. There has never been a suggestion of payments to JCP staff. The JCP is happy as they have met their targets. The Government is happy at their success. Taxpayers and people desperate for work lose out. I am not sure of the time periods involved but "the six month JCP chop" was a phrase I heard.

People travelled from all over the country to work in London and the South East and feel betrayed. I know this is legal but is it moral? Is it consistent with the Big Society? I realise this was introduced during the thirteen years of Labour incompetence and it makes the figures look better but I look to this Government to improve matters.

So here are some suggestion for improvements. The employment agency should pay the driver during the initial period. The employment agency should only receive the bounty if the driver is retained for three years. Their duty is to the driver and they should audit the companies taking placements.

As the overall jobless falls the retention period can be reduced as it will be harder to place individuals. At the moment, for the employment agencies, it is like taking "candy from a baby". The "baby" is the taxpayer. The HMRC can audit staff turnover in the companies' annual return. I think it may be there already. If turnover is above a certain level the company will be put on a JCP watch list and bounties will not be paid to employment agencies that place people with these companies.

You will be aware major employers, allegedly, such as DHL, UPS have made redundant all their drivers. I am in favour of capitalism. I am in favour of free markets. I am not in favour of monopolies or foolish legislation that distorts markets and drives down the wages of the poorest in society. Part of the Government's job is to ensure transparency, to audit and to regulate. Maybe what is needed is a levy on companies who enjoy monopolies in supplying the Government with goods and services rather than wasting banks' resources and energy minimising the impact of the banking levy when the banks should be better employed as the engine of growth.

I hope you are in agreement with the sentiment if not the detail of the above.

Some minor corrections:-

I refer to employment and training companies. Where I say turnover I mean staff turnover. An employee is entitled to one week's pay for each year of service so by sacking an employee before the year is up saves the employer money. Once sacked there is a period before Jobseeker's allowance can be claimed. This forces the poor into the arms of loan sharks. I suggest the employment and training company pay minimum wage for all the weeks the employee is without work during the three years. This will concentrate their minds as they claim they place job seekers in "real" jobs. This should be no risk to the employment and training companies if they live up to the promises they give Jobcentre Plus.

Finally why not privatize each Jobcentre Plus employment activity as a separate company? Why must they be subsidised by the state and compete with the private sector? I believe the profits of employment companies are down. Private companies can never compete with a competitor offering staff for free. It is not just in logistics and distribution. The retail sector and others are getting in on the "too good to miss" deal.

Employment last month is down. Not surprising as Jobcentre Plus decimates employment in sector after sector. When was the last time you saw a major retailer job advert? I suggest they now get their "employees" through Jobcentre Plus. No pension. No perks. No security. Reduced employee costs.

	Department for Work and Penslons

	Caxton House
	Tothill Street
	London
	SW1H 9DA
	Telephone
	020 7340 4000
	Email
	ministers@dwp.gsi.gov.uk
	www.dwp.gov.uk

Our ref: POS(2)11058/190

... MP
14 March 2011

Thank you for your letter of February 24 to the Secretary of State on behalf of Mr ... of ... regarding employment programmes in Jobcentre Plus. I am replying as the Minister responsible for this area of the Department's work.

The range of current provision for supporting people into work tends to be confusing and inflexible. The focus on specifying particular types of support for particular groups constrains providers and reduces value for money. The Work Programme will be different. Providers will be free to design support based on the needs of individuals and target the right support at the right time - not waste time delivering centrally-specified support that will not provide the help a person needs.

The Work Programme will help people with a wide variety of needs. We will offer providers higher rewards for supporting harder-to-help customers into employment to ensure that it is worthwhile for providers to help all customer groups. This Department is designing a coherent package of support, not just a single programme. Alongside the Work Programme we will deliver a more flexible advisory service in Jobcentre Plus. giving local offices more control and allowing them to deliver in a way that is responsive to local needs, and focusing on results rather than process.

The Work Programme will be the biggest single welfare to work programme this county has ever seen. It is the centrepiece of the Government's plans to reform welfare-to-work provision in the UK and ensure people have the right support as the economy moves out of recession and into recovery.

It will be built around the needs of individuals, providing the support they need when they need it. The Work Programme will be delivered by the best of the private, public and voluntary sector and will focus on helping people into sustained jobs, with in-work sustainment payments available for substantially longer than under current programmes. Providers will be given the freedom to innovate and do what works, rather than follow a top-down Whitehall-knows- best approach. In return they will be paid by results.

I hope this reply is helpful to Mr ....

With best wishes,

Rt Hon Chris Grayling MP, Minister for Employment

From: Mr B... 
To: DWP WCA Evidence 
Sent: Tuesday, July 19, 2011 11:01 AM
Subject: Re: WCA independent review - Call for Evidence launched 14th July

Dear Prof. Malcolm Harrington CBE,
 
First, may I say, I appreciate your efforts in addressing the failings in the 
implementation of the Welfare Reform Act and of predecessor Statutes, Rules and 
Regulations.  I would like to submit the following in respect of your Call for 
Evidence for your DWP WCA independent review.  I am willing for my evidence to 
be published in full on all media channels without reservations.

1. My Medical Status

I have worked full time in the the IT industry at a senior level for 30 years 
prior to my first admission to hospital.

I was emergency admitted to hospital in April 2009 (a ten day stay) after being 
revived from a fit. I was diagnosed with a brain tumour and given anti-convulsant 
medication. My condition deteriorated. I was an acute admission for a biopsy in 
October 2010 (a stay of 16 days). I was treated with six weeks of radio-therapy 
which completed in December 2010. I was so weak I needed patient transport and 
was allowed an escort due to my condition. I declined the offer of an escort 
after the first day as there was insufficient space on that first day and I saw 
others whose need was greater than mine. The radio-therapy has stabilised my 
condition. I am always weak and many days very tired or extremely tired. 
This is due to the number and dosage of medication I have been prescribed. 
My next MRI scan is scheduled for September 2011.

My condition allows me a few hours some days when I can use the computer. Daily 
physio-therapy exercises is slowly returning function to my right side. Handwriting 
is still problematic. 

2. My Feeling on an Annual Assessment

I am in favour of an annual assessment for everyone but it is a waste of resources 
to require all to attend a face to face assessment especially for those medical 
conditions for which the Contract states no face to face assessment is required. 
I am happy for the DWP to contact my GP or Consultants every three months if they 
feel so inclined. I have sent the DWP copies of my medical status after every MRI 
scan and treatment. What is the sense in harrassing me with an ESA50 form every 
year when the DWP the previous year has agreed to complete it for me due to my 
handwriting issues? It is crass waste of resources and just puts more profits 
into Atos coffers.

3. Contacting the DWP and Atos

The DWP and Atos prefer contact by phone. The DWP does not, against my understanding 
of Government objectives, provide email addresses except when a case is referred to 
a supervisor. My experience of phone messages is at best that there has been a 
misunderstanding of what has been agreed and at worst dishonesty. My experience leads 
me to suggest that the DWP and Atos should record every call and send the recording 
as an attachment to an email to every patient. This would concentrate the mind of the 
DWP and Atos and force them to be less cavalier with the truth over the phone. 
Alternatively the recordings should be kept until the patient has exhausted all 
avenues of appeal. Tribunals considering appeals should be able to access these 
recordings. 

4. Evidence (My correspondence in full to date) 

I submitted evidence to a Parliamentary Inquiry and have published ALL correspondence 
(desensitized) on my website http://www.whywaitforever.com/dwpatos.html. 

5. My view of the DWP and Atos

I was shocked to discover the lack of transparency, the duplicity and the evasion of 
the DWP and Atos.

- Why is it necessary to hide which medical conditions mean a face to face assessment 
  is not required and which, like mine, need to be referred to a GP or consultant? 

- Why is it necessary to hide which Parliamentary constituencies are not within the 
  90 minutes travel time?

- Why is continence or mobility not taken into account in the travel time? Hospital 
  patient transport provides bed pans. Look at the journey times, outside the maximum 
  90 minutes, and the changes that I was instructed to take; all in breach of the Contract.

- Why is travel time not audited and the results published? 

6. The Contract between the DWP and Atos

I have published major parts of the Contract between the DWP and Atos obtained under the 
Freedom of Information Act. 

- Why is the publication of this important document left to concerned individuals such as I?

It is a low cost option for the DWP to publish on the DWP website such information. 
Patients, advisors, Atos and the DWP could help reduce the Kaffkaesque waste of the 
current approach as demonstrated by the large number of appeals won by patients.

7. The DWP and Atos mislead Parliament

- Why did the DWP mislead the Secretary of State in claiming a competent medical authority 
  decides whether a face to face assessment is necessary?

8. The DWP and Atos fail to audit

- Why does the DWP fail to audit Atos?

In every private company I have worked for, the importance of internal and external audit 
means that reports are handled at board level. "Who did what, when, to whom" underpins 
every improvement. In my case, kindly review the correspondence to see how long it took 
to find the nurse who took a decision that only a qualified doctor should have taken. 
The NMC stated that she failed to read but as she can now read they cannot take the matter 
further as they are constrained in what they can investigate and what they cannot.

9. DWP and Atos deception

I was deceived by the DWP and Atos and duped into attending the illegal WCA. At that time 
there was no access to the Contract. I assumed that the DWP and Atos would put my interests 
as a patient first. The result was a shock. To compound the failings the refusal to provide 
me with the report despite repeated requests. 

10. DWP and Atos ignores the NAO

The Atos Independent Tier process was a farce. Please see the correspondence. Why, despite 
the specific recommendation by the NAO, was Atos allowed to investigate themselves? Why does 
the DWP and Atos suppress or lose evidence? How can evidence be found eventually if the 
patient is persistent. The DWP have declined to comment. 

11. My Atos report is a libel

The report itself is a libel. Why did the assessment start so late in clear breach of the 
Contract? Why did the assessment take so long? Why is there no mention of my black outs, 
memory loss, near falls and pain? In this electronic age why is the assessment not video 
recorded and a copy given to the patient? Alternatively why is the recording not retained 
pending appeal. How can the competence or lack thereof of the doctor be assessed? How many 
other libellous assessments have their been? I suggest the level of successful appeals 
speaks volumes.

12. Doctors and nurses fail to speak and write English

In the Contract knowledge by doctors and nurses of English, both written and spoken, is 
mandatory. Please read the reports written by the two doctors as published on my website. 
Their command of English is poor. The GMC say, due to Maastrict, doctors in the EU without 
any English can practice in the UK. The GMC further say it is up to the employer, DWP and 
Atos in this case. 

Patients describe their symptoms in idiomatic language. I recall describing the intensity 
of my constant weakness as "I feel like a limp wet fish" or "movement is like constantly 
wearing a diving suit with lead boots". Diving? Aqualung? was the broken reply by the doctor. 
I vaguely remember struggling in my mind to remember snippets of Latin, French and German 
but my overwhelming tiredness made the struggle futile. Clearly Atos should have supplied 
an interpreter for the doctor and due to medical confidentiality rules this should have 
been a doctor. Clearly if an English speaking doctor is available than one who was not 
competent would not be used. The DWP Contract specifies the English competency requirement 
but does not audit that Atos is "passing off" doctors and nurses who are not competent and 
profiting greatly by this. Remember the NMC found that the nurse in my case "failed to read".

13. Cleanliness of Atos doctors and nurses

I was concerned about the cleanliness of the doctor. She wore no gloves yet she squeezed 
my hands and manipulated my limbs. I was so close to blacking out I was barely able to 
keep myself together so I did not question at the time. There was no place in the assessment 
room for her or me to wash. I do recall a previous patient who had soiled himself but was 
handled by someone other than the doctor who handled me. Other patients were bleeding.  
It was Dickensian.  The GMC, CQC et al have stated this is an assessment, it is NOT a medical 
matter and therefore it is outside their remit. This is not the third world. We have access 
to first class medical equipment and plumbing. Atos penny pinching may cause illness but as 
their assessment is not a medical matter the costs will be born by the NHS.

14. Attitude of Atos doctors and nurses

I was hurried and hustled out of the secure door by the doctor despite my loss of balance. 
I was using the walls to keep upright. I got through the door and collapsed on the seat by 
the door. Doctors and nurses do not behave like this and after weeks when I had recovered 
a little I realised that Atos were operating a scam. Atos are fraudulently providing 
services to the DWP, at great profit to Atos, and the DWP are allowing this by failing to 
enforce the contract. 

Consider again my case. The Contract states that it is not possible for my condition to 
produce an assessment without access to my medical history. The DWP and Atos have 
repeatedly asserted that my assessment was valid. The DWP and Atos have not explained why, 
without the benefit of more medical information, months later they changed their mind. 
As part of your investigations it would be useful to find out how many assessment 
recommendations were overturned and for what reason.

15. Atos and travel expenses

The Contract states that travel expenses will be paid. Why did I, with my law legal 
knowledge have such difficulties in obtaining my expenses?

16. The DWP and Atos and preferential treatment

The Contract clearly states that patients who refer to their MPs are treated differently. 
This is outrageous. The Police would not act differently if a suspect contacted their MP. 
The implication for me is that the DWP and Atos feel they are operating in a way that 
would not stand up to close scrutiny.

17. DWP Senior Staff evasion

I refer you to the correspondence I have had with Darra Singh and other senior executives.  
I would like you to consider whether his answers address the issues I have raised or 
whether he is evasive and unwilling to investigate whether there is substance to my assertions.

18. "Delay, Defer, Deny"

Look at the volumes of correspondence in my case. The DWP should publish figures for each 
area as to how long the average process takes and the average items of correspondence. 

My recommendation to you is to demand copies of all the reports specified by the Contract 
for the most recent time period for each report; daily, weekly, monthly and annually. 
You should obtain and organisation tree for the individuals that receive these reports 
and ask what actions have been required as a consequence of the information in the reports. 
The DWP has been evasive in this area. 

I can sum up my experience of the DWP and their subcontractor Atos by three words; 
"Delay, Defer, Deny". The DWP is a secretive and evasive organisation. It refuses to 
publish information that would reduce costs to the taxpayer. It is profligate with 
resources; see the correspondence of my case. It is organised so that DWP Decision 
Makers have deniability. If there are no meaningful audits and challenges are not 
accounted for, the DWP Decision Maker has an easy time since they are not competent 
in medical matters. Atos has an easy time as Atos does not make decisions. This 
results in a cosy time for the DWP and Atos. The Atos annual report crows it makes 
the biggest margin from the DWP in Europe. A reasonable person might suspect neglect 
or incompetence or corruption is at play.

19. The DWP and Atos and patients, claimants, customers and clients

- Why is it necessary for a lay knowledge of the law to obtain benefits?

- Why are there errors and inconsistences in the forms and documents?

- Who are the Benefits Agency and why do they send me forms?

- Why does the DWP and Atos use customers, clients and claiments freely without rhyme nor 
  reason?  To paraphrase the explanation I have received the "lesser" educated are familiar 
  with the word "customer" but would be confused by the word "claimant".  This is despite 
  Parliament, media channels and independent advice agencies using "claimant".  If I am 
  confused by this usage, especially "client" then I suggest many others are.  My 
  understanding is that the DWP is a customer of Atos.  In your review can you consider 
  this patronising and confusing approach to a "claimant" or patient and recommend accordingly.

NB Employment Support Allowance (C or I) Support Group actually means Unemployment Allowance 
(C or I) Work Incapable. Employment Support Allowance (C or I) Work Capable actually 
means Unemployment Allowance (C or I) Work Capable and should have categories such as 
part time, work from home, local travel etc.  These categories should allow employers 
to evaluate and shortlist without interview costs and without causing distress to applicants.  
Jobcentre staff would send fewer applicants to try for patently unsuitable jobs.

20. Speculation on why the DWP and Atos abuse patients

Finally perhaps you could investigate the underlying drivers for this situation. Is 
this the utilitarian political philosophy setting aside the moral imperative? If so 
an honest Government would say so. Assuming that patients do matter, is there a darker 
motive at play? Unum and Atos host many PR and marketing events either directly or mostly 
through front organisations. Are the "benefits" fully disclosed?

You are aware of the CV of Prof Mansel Aylward. You will have noticed that the pictures 
of the champagne and caviar events have been removed from many web sites attended by Unum, 
Atos and DWP senior staff. I am in contact with a photographer of such an event. Atos 
hold the copyright but I am sure the photographer would release them to a Police investigation.

==============================================================================================
Date: 21 July 2011 15:35

Subject: Re: WCA independent review - Call for Evidence launched 14th July - Supplemental Evidence

Dear Prof. Malcolm Harrington CBE,
 
Further to my evidence in my email dated 19 July, I would like to supply the WCA independent 
review with the attached documents that support my assertions.  I am happy these documents 
are published in full as they are on my website.

The originals can be obtained from the DWP.
 
1. I attach a series of recent correspondence with the DWP.  I contend that the DWP is 
   evasive in that it claims to have previously addressed each issue in previous 
   correspondence but fails to address the substantive matters raised; failure to correct 
   the Parliamentary record, failure to audit, failure to comply with NAO procedures 
   (in respect of the Independent Tier).
 
2. I attach my ESA50 form dated 15 June 2009, the ESA85 report dated 24 July 2009 by Atos 
   to the DWP decision maker (a copy of which I received I presume November 2009 after 
   intervention from the Secretary of State), the Atos independent tier report dated 
   15 February 2010 and the IB59 report dated 23 April 2010 which changed my status 
   from "work capable" to "support group (a copy of which I received I presume after 
   intervention again from the Secretary of State).
 
At the introduction of the Atos independent tier (Medical Issues) report is stated 
"I have read all the documents supplied by the Customer Relations Team".  These are 
not listed or made available that I can challenge veracity and completeness.  
How is it that an "independent" review fails to list evidence considered?  
I suggest this is unheard of.  The abuse of process is one of the reasons that 
the NAO have set down recommendations that the DWP and Atos continue to ignore.
 
In the Atos independent tier (Medical Issues) report when on page 4 of page 7 is 
stated "Certainly Mr B... seems to have accepted the report in its entirety".  This 
cannot be sustantiated.  Please review all the correspondence and review how such an 
assertion can be made.  The Atos independent tier process is summed up by the statement 
in the report "I must confirm that a good deal of what he asks for is beyond the remit 
of the Medical section of the Tier".  The key issue of who decided that a the face to 
face assessment was not addressed. On 11 January 2010 I was told that a Nurse decided 
a face to face assessment was necessary.  That this is in breach of the Contract has 
never been disputed.  Her defence made to the NMC investigating panel was that she 
failed to read!  Why did the Atos independent tier highlight this "medical" failing?
 
Finally I suggest part of the problem is that senior personnel in the DWP and Atos do 
not carry out random spot checks on individual cases.  If the details, such as I have 
provided you, are reviewed, desensitized and published by the DWP, it would concentrate 
the minds of the operational staff to improve.  The culture of obfustication, evasion 
and waste at the DWP and Atos is so clear.  I suggest if you request all the ESA85 
reports produced by a random centre on a random day, desensitize and publish as an 
addenda to your report you would shame the senior personnel to do better.
 
Yours sincerely

Attachments:
   DWP ESA Atos ESA50 - 15 June 2009
   DWP ESA Atos ESA85 - 24 July 2009
   DWP ESA Atos IB59 - 23 April 2010
   DWP ESA Atos Independent Tier Report - 15 February 2010
   Extract from Email to the DWP BDC - 1 February 2011 13:00
   Extract from Letter from Matthew Nicholas, Director - 21 February 2011
   Extract from Email to Darra Singh, Chief Executive - 15 March 2011
   Extract from Letter from DWP - 18 April 2011
   Email to DWP - 27 May 2011
   Letter from DWP - 25 July 2011
   Email to DWP - 31 July 2011
      

To:      WORKPENCOM@parliament.uk
Date:    7 November 2011 11:56  
Subject: Proposal to replace DLA with PIP

Dear Clerk of the Committee,

Please could you be so kind as to forward my comments, as below, to the Chair of the Work and Pensions Committee. My comments relate to the Committee meeting held on Wednesday 19 October 2011 at 9:30am, Subject: Proposal to replace Disability Living Allowance with Personal Independence Payment. I watched the proceedings on Parliament TV. A transcript of the meeting is not yet available so forgive me if I have misunderstood.

I believe at one point the Chair asked a question as to who could replace Atos in undertaking medical examinations or as commonly known assessments. I would like the Committee to consider if "locums" in the claimants own GP surgery could replace Atos. In GP surgeries, as now, "contentious" examinations are usually carried out by "locums". The many advantages of using the GP surgery include access to the claimant's full medical history and reduction in administrative and logistics costs. The "locums" both nurses and doctors could be the same qualified pool that are currently employed by Atos but I do not think this is necessary as occupational therapists could easily cover the current work capable assessment. An alternative could be the nearest physiotherapy or occupational health therapy centre these, like GP surgeries, are trusted by patients.

The DWP has stated that "as of 31 August 2011 Atos Healthcare has 847.24 (full time equivalent) Healthcare Professionals (HCP) undertaking medical assessments". This seems very few to undertake so many and complex assessments especially without access to the patient's medical history. The "Assessment of whether a claimant has limited capability for work" (points) and the "Assessment of whether a claimant has limited capability for work related activity" are straight forward forms to complete if and only if access to a full medical history is available. As a layman, but with expert IT knowledge, complex error prone tick box software (Lima) seems to be unnecessary.

As you are aware the original DWP and Atos contract was valued at £80m per year but in 2009/2010 the DWP paid £150.8m (DWP top-100-commercial-suppliers.pdf). The reasons for this increase, vastly in excess of inflation, have not been made clear. If the DWP paid the NHS PCT's £150m a year, I am sure the results of the assessments would result in far fewer appeals and this matter would be less contentious. As you are aware when the results of appeals are so many in favour of the patient and the DWP concedes so many before appeal there is a major problem in the assessment process.

As support to the approach I advocate above, I would like the Committee to consider "EXPLANATORY MEMORANDUM TO THE EMPLOYMENT AND SUPPORT ALLOWANCE REGULATIONS 2008, 2008 No. 794 AND THE EMPLOYMENT AND SUPPORT ALLOWANCE (TRANSITIONAL PROVISIONS) REGULATIONS 2008, 2008 No. 795" in which is stated "the annual net benefit will be £215m (by year10) and the total benefit £1.1bn (10years)". I suggest comparing these figures with actuals suggests that the changes, such as I have proposed, would be a better way to move forward. It seems foolish, irrational and arbitrary to continue with the Atos "not fit for purpose" approach.

Finally I would like to declare my interest. I am still in the ESA(C) Support Group but all the weekly income I would receive from the DWP is withheld as my company pension scheme, due to my exceptional medical circumstances, has agreed to award me a pension. I only receive the £10 Christmas payment. In my case an unqualified HCP, a nurse "failed to read my ESA50" and ordered me to attend a face to face assessment. This decision, as defined by the Contract, should only have been taken by a doctor. I was defamed by libel by the doctor who undertook my assessment and produced the ESA85. She failed to understand the Contract in that my GP and or Consultants should have been consulted prior to my assessment. It has taken two years and two months for the DWP to concede all points I have raised including misleading the then Secretary of State. The case is with the Independent Case Examiner who I have left to decide the appropriate level of compensation.

I look forward to hearing from you. Thank you.

From:    Inquiry Manager
Date:    10 November 2011 16:23 
Subject: Proposal to replace DLA with PIP

Dear Mr B...

Thank you for your email of 7 November. The Chair has asked me to reply.

We have noted your comments about the delivery of PIP assessments in the future. The Committee understands your concerns about PIP being delivered in the same way as the WCA for ESA and will be exploring this issue on 23 November with witnesses from disability representative organisations.

The transcript of 19 October should have been put on our website by now – I will chase this up, please check again in a day or two.

Thank you for your interest in the Committee’s inquiry.

Kind regards,