Memorandum submitted by Mr B...

I emailed Mr Roger Pugh on the 15 February notifying him of the following error and asking him to reissue a corrected document and extend the time allowed for submission of evidence.

In "Background" clause 8. on page 12, the statement "There are three possible outcomes:" is false. This should be replaced with "There are four possible outcomes:". In addition to the first and last, as listed, there are two other outcomes:

The DWP has clearly defined that there is a major difference between "limited capability for work" and "limited capability for work related activity". I believe "work" is self explanatory. I believe "work related activity" means involvement by specialists familiar with the claimants medical condition and able to assist the claimant to, in time, become capable for work.

In my case, brain tumour, my progression should be from support group, to capable for work related activity, to capable for work and then work.

Mr Pugh replied:

I have discussed this with colleagues on the consultation team, and they are content that the 'outcomes', as described in the document, accurately reflect the high-level WCA outcomes. We do not, therefore, intend to revise the document at this stage.

I replied:

Please can you provide me in plain English the meaning of "high-level" WCA outcomes. It is jargon that I am not familiar with. I would appreciate if you can provide me the actual definition of "high-level" WCA outcomes as defined by Statute, Regulation, Contract or DWP document. The document does not state "high-level" outcomes. The document states outcomes. Thus the document needs amending and needs to be reissued with additional time made available for revised evidence. Any existing submitter of evidence should be advised of this falsehood and asked to resubmit. Can you confirm that you agree with the DWP documents especially those used by DWP Decision Makers and those provided by the DWP to Local Authorities that there are four outcomes and not three?

I regard the document as grossly misleading. It is four hoops not three that a patient has to jump through. The document implies that the process is less complex than it is. This appears to be wilfull blindness. The assessment points system is not mentioned. This is the most stressful and contentious hoop to jump through. It is the hoop that most patients are assigned to prior to appeal (DWP figures).

I will be providing extensive evidence to the Consultation. Can you confirm that all the evidence will be published alongside the Government response to the Consultation if the submitter of evidence does not require their evidence to be kept private?

Mr Pugh replied:

I am sorry if you found my response to contain jargon. I did not intend it to. I am not a technical person and was trying to use a non-technical description that I thought was plain English.

But we are satisfied that the description of the outcomes contained in the consultation document is fair, and do not intend to alter it, or the consultation period.

What we are seeking here is views on the proposals about placing people receiving certain cancer treatments in the support group. This is not a consultation about the whole WCA process.

I hope this is helpful.

My experience is that the DWP has difficulties understanding the complexities of the processes that they have a duty to administer. I believe Professor Harrington is reported as saying that there is "something wrong with every bit of the process". The terminology does not help. Is it sensible to call a "sickness benefit" or a "disabled benefit" an "employment benefit"? Is it sensible to use the demeaning "job" instead of "employment"? These terms echo class prejudices and serve only to confuse the DWP and the public.

People in work sign contracts of employment not contracts for jobs. People in work who are sick are, in the main, assessed by company doctors who consult with the patient's GP and in consequence may or may not receive company sick pay. Employer organisations have warned of the dangers of Unum's "back up plan". The employer is believed to be liable not Unum if Unum uses their "non medical" model for assessing medical conditions and in consequence denies payment. Atos uses the flawed (not fit for purpose) Unum "non medical" model.

People out of work seem to be regarded as part of the "fourth estate" (the undeserving). They seek for jobs. They are not accepted as sick or disabled. The sick and disabled are ludicrously labelled as needing employment support. Medical conditions are assessed using the discredited (see below) "non medical" model (UNUM) aka evidence based (excluding the patient's medical history - Dame Carole Black) aka bio-psycho-social-assessment (Lord Freud).

Imagine if a "non engineering" model was use in civil or mechanical or electrical or chemical engineering projects. It is true architects do apply an "artistic" model to engineering projects but sound proven engineering models are used to implement these projects by qualified engineers.

History has shown the folly of "non medical" models in considering medical matters. These "non medical" models are invariably overturned; taking mercury, comparative anatomy, phrenology, women's problems, mental conditions, psychoanalysis, autism, ME et al. This is a long list of infamy supported at the time by some of the "most qualified" or "company funded" medical opinion. We look back with amazement in the same way as future historians will look back at the foolishness of "non medical" models.

With Dame Carole Black proselytising her fit note (non medical) assessment, the age of rational thinking and applying strict scientific methods has been set back further. The total failure in the US and the UK of using the "non medical" model to assess medical conditions is excluded as evidence by the DWP and those who seem by their actions to further the commercial interests of Unum and Atos.

Science is about understanding the world and applying that knowledge to improve the world. Use of the "non medical" model is a betrayal of those who have struggled so hard against ignorance and superstition.

Question 5a: How important to you and/or your family was work during treatment for cancer or during recovery from that treatment?

Answer 5a: My brain tumour made work impossible both for me and for my wife. Since the time my wife called the emergency ambulance in April 2009 to the current time my wife provides me with full time care. When you are a "dead man walking" this question, the importance of work, is insulting, demeaning and patronising. As should be patently obvious, to any with the slightest empathy for those less fortunate than themselves, work is not at all important when at any second one might drop dead. My demise is not predictable and as the Secretary of State has reported the survival rate of those with brain tumours is getting worse.

Question 5b: If you are willing, please could you provide details about your treatment and the effects on your ability to work.

Answer 5b: The evidence that follows addresses this question.

I was emergency admitted to hospital in April 2009 and was diagnosed with a brain tumour the size of a squash ball. I was inoperable but treatable. The tumour grew to the size of a small orange. In October 2010, I was an acute admission for a biopsy. The diagnosis was anaplastic oligoastrocytoma (WHO grade III), epilepsy, focal fits, intractable painful partial seizures and right hemiparesis. I had an extended stay in hospital to address my symptoms with high doses of anticonvulsants and other medicines. These I continue to be prescribed. These are debilitating in their own right. These medicines are not suitable for taking over long periods of time.

The treatment was radical radiotherapy 54.9Gy in 30 fractions over six weeks completed 22 December 2010. The treatment reduced the intensity and size of the tumour. I have a MRI scan every four months. My current status is "stable appearance".

I am fortunate not yet to have required chemotherapy.

There are periods when I have to be house bound and bed ridden. My right leg and right arm can become ice cold. Heating needs to be both kept on longer and at higher temperatures. More heating plus extra clothes plus wearing coats in doors plus blankets are necessary at times and this does not mean that the discomfort is fully addressed.

I take medicines twice a day at 08:00 and 20:00. An hour or so after taking the medicine I am hit by a wave of fatigue. It is true that now this is not every day but there are still periods where for a few days in a row I have to return to bed from 09:00 to 10:30. This is not predictable. In the evening it is unusual if I am up after 22:00.

As I understand the situation at any time my tumour could rapidly grow or it could remain as it is and in either case I could just drop dead. It will not shrink without further treatment and while stable no further treatment is expected.

I am fortunate that I do not suffer the anxieties and mental torment that can occur in some cancer patients. During epileptic episodes, seizures and focal fits I have experienced such extreme pain that my mind appeared to disassociate from my body. My mind felt no pain and everything was getting brighter and brighter.

I was revived by a paramedic after around 20 minutes. The paramedic arrived in a fast car before the ambulance. I believe I am only alive now because of the incredible speed of response. I am not concerned about death either because I am an atheist or because at 55, especially after dealing with the "wear down" tactics of the DWP, I now feel very old.

In contrast to the excellent treatment I have received from the NHS, the treatment I have received from the DWP and Atos reveals them to be an inept, incompetent bunch of clowns. The DWP appears to use the case of Sisyphus as a model for dealing with patients. The DWP tactics are to delay, to defer and to deny. Even if after months and months the DWP concedes, within a couple of weeks, a new ESA 50 form appears and so it goes on ... and so it goes on ... and so it goes on...

The doctors and consultants involved in my case include my GP, neurologists, neuro-surgeons, neuro-oncologists, neuro-psychologists, physiotherapists and occupational therapists. At times my condition has been described as acute. My biopsy had to be scheduled for the first available bed. Because of my condition I was pushed to the top of the list for surgery. All regard my ongoing condition as very serious.

The Atos doctor thinks this medical opinion is worthless and states that I am work capable. She is a liar. The DWP and Atos have taken no action. She is free to lie and lie again.

I have mobility issues which physiotherapy exercises recommended to me by the hospital are helping to address. I returned my driving licence to the DVLA in May 2009. Occasionally I have other issues related to vision, memory and conceptual thinking.

It it the little things that can be so difficult and painful; getting up for a chair, putting and taking off clothes, putting on shoes, tieing shoe laces, washing, toilet, dropping things and picking them up trying to minimise pain, cutting nails (impossible), losing balance, the camber of payments, buying a rail ticket while holding a stick, stairs and public transport.

Ongoing concerns are going to sleep knowing an extremely painful focal fit and seizure could happen at any time (no longer taking diazepam), as I used to experience night after night and in the daytime. Any muscle twitch or twinge might be the start of an episode.

The Government in the form of the DWP and their contractor Atos found me work capable. Is it suggesting that I should only state to a prospective employer that I am work capable and not elaborate on my medical condition? Is it suggesting I should withhold information about my medical condition on the grounds that it is not pertinent to the considerations of an employer? Is it suggesting the DVLA should return my driving licence because I have been found work capable? Is it suggesting I could be placed in a position that would make me responsible for other people's lives such as a bus or train or tube driver? ESA is a fraud and a farce.

I was offered physiotherapy and occupational therapy at home on completion of the radiotherapy treatment. This I declined as I hoped my physiotherapy exercises would improve my physical condition.

Multiple daily focal fits and seizures for over two years meant my right arm and right leg muscles shrunk. It is now in February 2012 that the strength of my right side is back to 80 percent of what it was prior to initial focal fits in spring and summer 2008. I am right handed and I still use my left hand in preference when strength is required. My writing is improving. I tire very easily.

In early autumn 2008 I was asked to manage an IT development team (previously I had managed major IT development projects) at the company where I was working as a developer, I declined as I was not well. Every working day I would collapse at home, have a bite to eat and then sleep. Every weekend I was a little stronger. Originally I accepted a developer position as I knew something was not right. When I declined the management role, I was made redundant and the team I was due to set up was eventually set up in a different location.

I have worked at a senior level in IT with responsibilities for recruiting teams. I know I would not hire myself. I still receive a stream of job vacancy notices as my IT expertise is highly valued. If I could work I would work. I am not work capable now. I am unlikely to ever be work capable while the tumour remains and my body is declining due to the medication I must take.

My duty is to my family and this overrides personal considerations. If I did not have close family I would have taken my life by now. The major contributory factor would be the disgraceful actions of the DWP. The one hundred and twenty six (126) items of correspondence to date excluding FOI requests, correspondence with the DWP executive, with my MP, with the Secretary of State and with the medical regulatory bodies is sufficient to drive anyone deep into the slough of despond. See Annex A.

I have not applied for or receive DLA though I would be eligible. My intention was to apply for DLA after the ESA process was completed. My ESA process after nearly three years is not completed. I do not receive Carers Allowance or Attendance Allowance. I have applied and been found eligible for free prescriptions, a disabled bus pass, a disabled car parking pass and have purchased a disabled rail card.

Two company pension schemes, due to exceptional medical circumstances, have agreed to pay me a pension (from September 2011). These would normally be paid at the state retirement age. The companies' doctor contacted my consultant and confirmed the seriousness of my medical condition. I presume further support for this action is based on actuarial grounds.

My case is with the Independent Case Examiner who wrote at the end of January 2012 "We will write to you again in 13 weeks time to keep you advised of progress...". The questions I asked the ICE to address are listed in this evidence.

I am credited with National Insurance contributions while qualifying for ESA(C).

The amounts and dates of the benefit are as follows:

The company pension deduction calculation is not easy to understand. The following is from the DWP letter.

Monthly pension £1255.74 x 12 divided by 52 = £289.87
                                            - £ 85.00 disregard
                                              £204.87 x 50% = £102.39
 
Your pension income still exceeds your contributory ESA entitlement
and extinguishes your contributory ESA payments. 

I would like to draw attention to the use of the word "extinguishes". This is a sensitive word. I know and the DWP knows that I am a "dead man walking". There are so many less aggressive ways to express the same message.

If there is a life of luxury to be had by claiming benefits, I can't see how this is possible.

My correpondence is listed in Annex A below. The process will have taken three years in April and it still continues. My case seems to be the norm not the exception. The DWP does not provide statistics to prove otherwise. Clearly in my case the DWP met their objective to delay, to deny and to defer.

The Atos booking clerk said I must attend or lose my benefits. He claimed to be just a booking clerk and was not able to do any other action except book or report the claimant refused to attend. The option of being assessed at home was not offered. The threat and menace was explicit.

I was seriously ill. The phone conversations tired me. It was a brutal shock to be treated in such a dehumanising manner.

I was required to travel to an Atos medical centre with a travelling time far in excess of that specified in the contract. Multiple bus changes were required. The effect of my medical condition on continence was not considered.

The NMC found that the Atos nurse failed to read the ESA 50 and so did not pass it to a GMC registered doctor. An Atos doctor, not an Atos nurse, should have contacted my GP prior to agreeing a face to face assessment was necessary.

The Atos doctor kept me waiting for 45 minutes. The Contract states the maximum waiting time should be 10 minutes.

The Atos doctor did not display her credentials.

The Atos doctor did not wash her hands or rub them in alcohol before shaking my hand. She did not use gloves when she touched me. She could be passing infection from one patient to another. At the time I was too ill to realise. Now I am disgusted at her and at Atos.

The Atos doctor had difficulties reading, writing and comprehending English. In describing symptoms one needs to use metaphors to describe intensity of pain, tiredness etc. A doctor with a poor grasp of metaphor is as useless as a castrato in a brothel. A strong grasp of idiomatic English from the local area is a must.

I do not expect the Atos doctor to understand slang e.g. Tom Dick. I do expect an Atos doctor to understand "I am so weak most of the time it feels like I am wearing an old fashion diving suit, the ones with the lead boots". For the Atos doctor to follow up by asking with all seriousness whether I dived would in other circumstances be comic. My obvious distress and pain did cause the Atos doctor some concern. She did say in mitigation if she did not do as ordered she would be returned to her country. How can Atos be allowed to employ a doctor with such a poor grasp of English and flagrantly in breach of Contract? The DWP choose not to audit.

An Atos doctor's failure in her command of English appears not to be a problem for the tick box Atos software.

The Atos Lima software is so flawed it allowed the generated report to sometimes refer to me as male and sometimes as female. I am male.

The Atos doctor had not read the ESA 50.

The Atos doctor assaulted me because she should have known that the Contract is explicit that for cancer my GP should have been contacted. She asked me to move in ways that she knew caused me great pain. She caused me injury.

The Atos doctor defamed me by libel.

The assessment took one hour and fifty minutes during which I nearly blacked out a number of times. I was in pain and exhausted. She pushed me out of the locked door at the end despite my distress.

The Atos doctor produced a report that was fiction. She entered false readings for my blood pressure and heart rate. It was so glaringly obviously fiction that the DWP and Atos could not find it for months and it needed the intervention of the Secretary of State for it to be released to me.

I have published on my website all correspondence, desensitized where appropriate. This includes my ESA 50 and ESA 85. I am happy to provide copies for this consultation.

Atos delayed paying my travel expenses. Mine were paid after much correspondence on 20 August 2009.

It was only after I had obtained under the FOI the Contract between the DWP and Atos that I realised that Atos were in multiple breach of contract and that I had been assaulted by the Atos doctor. Before considering taking legal action, I need to wait until all remedies have been tried. The matter is currently with the Independent Case Examiner.

The Health and Safety Executive responded to my concerns about the Atos Medical Examination Centre that I attended.

"Following our enquiries about your concerns, we have received a response from the company's Regional Manager. With regards the disposal of clinical waste; we were advised that the Centre does not carry out any 'invasive' surgical or medical techniques such as blood tests etc requiring medical waste facilities. The Centre assesses people's functional ability through consultation, discussion and simple physical tests (e.g. reflex) and only generates standard office rubbish so does not require a dedicated clinical waste facility."

On the 14 October 2009, under FOI, I requested a copy of the Contract between the DWP and Atos. An edited copy arrived 10 November 2009.

The DWP and Atos conspire to keep the Contract secret to the detriment of patients such as myself.

The DWP did not publish the five categories of medical conditions and that in only one of the categories was a face to face assessment mandatory. See Annex B.

The then Secretary of State made proud boast of the numbers that had been denied benefits but was unable to state the medical conditions of those denied. More information has since been released which casts doubts on these claims.

(1) - Appendix 1 of Schedule 4 Section 4.12 Final Version - 15 March 2005

This lists cancer as a medical condition that must be referred to a Medical Advisor (GMC registered) for advice. The breach of contract has been confirmed by Atos doctor Dr Bruecker and by the "Atos" Independent Tier.

(2) - Medical Requirements Schedule 4 Section 4.1 Final Version - 15 March 2005

4.5.1.9 is legible, presented to the AUTHORITY in the English language and understandable to those without medical qualifications....

(3) - Medical Requirements Schedule 4 Section 4.1 Final Version - 15 March 2005

4.3 Serious Complaints

4.3.2 For the avoidance of doubt the main types of complaint that are included in this category shall include but will be not be limited to:

a) assault as a consequence of examination

(4) - Medical Requirements Schedule 4 Section 4.1 Final Version - 15 March 2005

4.3 Serious Complaints

4.3.2 For the avoidance of doubt the main types of complaint that are included in this category shall include but will be not be limited to:

b) injury as a consequence of examination

(5) - Common Business Requirements Schedule 4 Section 4.1 Part 1 Final Version - 15 March 2005

5.5 The CONTRACTOR shall ensure that any Claimant is not required to travel for more than ninety (90) minutes by public transport (single journey) for an examination, ...

(6) - Common Business Requirements Schedule 4 Section 4.1 Part 1 Final Version - 15 March 2005

5.7 The CONTRACTOR shall use reasonable endeavour to ensure that examinations commence within ten (10) minutes, of their scheduled time, when Claimants arrive in time for their appointment.

(7) - General requirement to act lawfully

The advice ESA 85 given by Atos to the DWP was a defamation in writing and as such constituted a libel. Atos fradulently claimed that the ESA 85 was a true and accurate reflection of the assessment. Atos fraudulently charged the DWP by claiming that the assessment was sound.

(8) - Common Business Requirements Schedule 4 Section 4.1 Part 1 Final Version - 15 March 2005

4.2.1 The CONTRACTOR shall acknowledge all complaints received directly from Claimants or their representatives within two (2) Working Days.

(9) - Common Business Requirements Schedule 4 Section 4.1 Part 1 Final Version - 15 March 2005

4.2.2 The CONTRACTOR shall provide a full response to each Claimant or their representative within the required turnaround times as set out in Schedule 5 of this Agreement. This schedule defines the time as twenty (20) working days.

(10) - Common Business Requirements Schedule 4 Section 4.1 Part 1 Final Version - 15 March 2005

3.2.2 The CONTRACTOR shall ensure enquiries are accepted in any reasonable format, (e.g. by telephone, in writing, by facimile or e-mail) ...

The DWP Commercial Management of Medical Services who have a duty to audit Atos stated in a letter to me:

"However, I can confirm that the Department has not exercised its contractual right to access for the purposes of auditing Atos Healthcare's compliance with its contractual obligations."

The Atos Independent Tier is not independent. Atos are reluctant to carry out this procedure and will place as many obstacles as possible to delay and deny that the Atos Independent Tier should take place. It it carried out in secrecy, its remit is closely scoped and a patient is not allowed to submit evidence. There are two parts of the report; medical and administration. Both are worthless. The Atos Independent Tier was not familiar with the Contract. The Atos Independent Tier confirmed that I, in breach of Contract, was scheduled to have been assessed by a nurse!

Atos covered up material facts. Atos delayed revealing who decided that a face to face was necessary.

The NAO has defined an Independent Tier procedure for the DWP. The DWP refuses to comply.

After two years and two months, 126 items of correspondence the DWP conceded. The Tribunal would have been the next step.

The NMC has stated that the assessment is outside their remit (rightly so as it is a "non medical" matter).

The NMC did investigate whether the Atos nurse, who decided that I required a face to face assessment, misrepresented herself as a doctor. The Contract between the DWP and Atos states that for cancer patients only a doctor can make the decision to require a face to face assessment (and only after contacting the patient's GP).

The finding of the NMC was that the nurse failed to read and as this was easily remedied no further action is required.

The Atos nurse is free to continue misrepresenting herself as a doctor for Atos with the ready excuse that she failed to read the particular ESA 50.

The GMC has stated that the assessment is outside their remit (rightly so as it is a "non medical" matter).

A. provide an adequate response to the complaints I have made about the service I have received from the DWP comprising the Executive, the JCP, the Commercial Management of Medical Services (DWP Commercial Directorate) and ATOS Origin IT Services Ltd (trading as ATOS Healthcare) since June 2009; and

B. provide correct information to the Secretary of State for Work and Pensions in falsely confirming that the ESA50 was correctly processed in deciding that a face to face assessment was necessary; the Nursing & Midwifery Council (NMC) can provide evidence regarding the veracity of the information provided to the Secretary of State, resulting in failure to take timely and appropriate action by the Secretary of State to my detriment; and

C. comply with the National Audit Office Independent Tier process and thus allow ATOS Healthcare to self regulate, in particular, ATOS decides what is and what is outside their remit, ATOS disallows evidence; and

D. comply with the Contract between the DWP and ATOS Origin IT Services Ltd (trading as ATOS Healthcare) and take action over breaches despite repeated and persistent requests; and

E. respond to the request I made for a copy of the medical report on which ATOS Healthcare changed its decision, made in May 2010, to place me in the the Employment and Support Allowance Support Group when previously, in August 2009, I was, in breach of the Contract, placed in the Employment and Support Allowance Work Related Activity Group; eventually after months of delay I received the medical report relating to the August 2009 decision, I have yet to receive the medical report supporting the May 2010 decision; and

F. remove the Nurse and Doctors involved from the DWP Chief Medical Officer's approved list; and

G. discontinue the use of the terms "customer" or "client", given that the use of these unjustifiable terms belittles my medical condition, insults my intelligence and ignores my inalienable rights under Commmon and Statute Law to be treated with dignity and respect, claimant as used by Parliament and in the Contract should be used; and

H. compensate me for the actual hurt and distress caused, the denial of payments and the excessive delays.

The DWP approach to producing statistics is partial, evasive and misleading. Polling companies such as IPSOS Mori are pleased to conform but they do qualify (in the small print) who are selected. Atos fails to say how their polling is carried out but always delivers over 90% claimant satisfaction or is that customer satisfaction or is that client satisfaction.

A short time after I was placed in the Support Group, I received a call from IPSOS Mori. The DWP gave out my TPS registered number without my approval. Clearly to the algorithm that selects who is to be surveyed, I must be "happy" as I was in the Support Group therefore I should have a more favourable impression. I asked for details about how the poll was conducted and copies of the questions. This was refused. Only telephone polling is undertaken. I said I would record the questions and my answers. This was not allowed. Clearly polling companies receive significant income from the DWP and Atos and would not wish for such a profitable income stream to end. Polling is not subject to independent audit even after a FOI request.

In producing statistics the numbers polled and failed to reply should be included. Sick people are unlikely to waste their strength is answering a long telephone poll. In the past I have developed customer survey systems and I know vast numbers of ways of delivering the figures that will be most favourably received. We may have moved on from mass phoning of call centre numbers by call centre staff to drive up the "customer satisfaction" level. Without independent audit statistics cannot be trusted.

Dame Carole Black in the 2011 Black-Frost Review of Sickness Absence explains in Clause 58:

"Each year, around 650,000 people make a claim to ESA supported by a medical certificate provided by a doctor. DWP data show that of the 840,000 claimants for ESA who undertook a WCA between October 2008 and November 2010, only around 320,000 (38 per cent) were found to have functional limitation(s) beyond the state threshold for the benefit."

In the small print at the bottom of the page:

"Excludes appeals, cases closed before an assessment was completed and assessments still in progress."

Notice the classic sleight of hand tricks of those who want to mislead by statistics. The first figure 650,000 is per year. The second figure 840,000 is per 2 years and 2 months; a strange time period indeed. The second figure is non sequitur to the first. If statistics are used there should always be an estimate of the accuracy and whether the figures are statistical relevant.

The ESA is supposed to be an annual procedure. I certainly have been requested to complete one at least once a year (see correspondence in Annex A below). This means over 2,000,000 assessments should be made each year and yet only 840,000 claimants undertook a WCA in a time period of 2 years and 2 months.

Dame Carole Black and the DWP know that WCA statistics are fiction (many experts have stated on the record WCA is not fit for purpose). Thus any conclusions based on WCA statistics are invalid.

The overall quality of a system is the quality of the worst component. If you pay peanuts you hire monkeys. The Atos assessment is the rotten core at the heart of the current welfare system. No viable system can be built on such foundations.

Hansard WCA Written Answers 20 December 2011.

Tom Greatrex: To ask the Secretary of State for Work and Pensions how many people have been found fit for work under the work capability assessment who had submitted an appeal against that decision and subsequently died prior to the appeal being heard. [87678]

Chris Grayling: The Department for Work and Pensions does not record the information requested. However, HM Courts and Tribunals Service (HMCTS) management information indicates that between October 2008 and October 2011, the most recent reported period, 31 appeals against decisions relating to work capability assessments have been withdrawn following the notification of death of the appellant. HMCTS cannot identify which of these appeals were against decisions where the appellant was assessed as fit for work.

Anecdotal evidence, cases published in news media, suggests that total deaths are far higher. I nearly died returning home after my assessment. It is believed that under the Coroners and Justice Act 2009 there is no requirement to record whether the deceased, under state retirement age, are in receipt of benefits or have been notified of reductions to their entitlement within a set period before the deceased's death.

Such records would provide useful evidence of the impact of the denial of benefits on the desperate.

Medical conditions are assessed using the discredited "non medical" model (UNUM) aka evidence based (excluding the patient's medical history - Dame Carole Black) aka bio-psycho-social-assessment (Lord Freud). This "non medical" model is as valid as using an "astrological" model or an "ecclesiastical" model or a "lottery" model to assess medical conditions. The DWP taints the great medical reputation of the UK by importing this pseudo-science hokum which many believe was designed by UNUM because UNUM's premium income was insufficient to meet projected outgoings. Naturally the medical regulatory bodies such as the GMC and NMC and the others distance themselves pleading these assessments are outside their remit because, quite rightly, they are based on a "non medical" model.

I wrote to the Vice-Chancellor, Cardiff University:

I am concerned that the academic credibility and reputation of Cardiff University is in danger of being undermined by being associated with the disability assessment work of Professor Mansel Aylward, Director of the Centre for Psychosocial and Disability Research (formerly the Unum Centre for Psychosocial and Disability Research).

Prof Aylward is widely credited, while Chief Medical Officer of the Department of Work and Pensions, of introducing and implementing the Unum approach to disability assessment. Unum, in their 6 May 2006 submission to Parliament, stated "we have a non-medical, enabling model of rehabilitation".

The evidence seems overwhelming that a "non-medical" model to address a medical condition is flawed. This approach has been followed in the US and the UK for over ten years. Unum (as UnumProvident) was fined millions in all US states for running "disability denial factories". In the UK, the vast number of cases appealed and conceded by the DWP before tribunal and the vast number of cases lost by the DWP at tribunal, is strong evidence that a "non-medical" approach, in practice without access to a patient's medical history, is seriously flawed.

The Vice-Chancellor, Cardiff University defended academic freedom.

Derby University have agreed to accredit Atos Healthcare's training in 'disability assessment' meaning that it could be used as part of a qualification towards a degree award.

Paul Wilkinson, Head of Corporate Sales for University of Derby Corporate, has said: "Accreditation of Atos Healthcare's Disability Analysis Training is an important development as it demonstrates that the course is meeting the higher education quality standards set by a UK university. We are delighted to be working with Atos Healthcare to support their delivery of training and wish the nurses every success on the training programme."

NIDMAR stands for the National Institute of Disability Management and Research. The NIDMAR education program consists of 24 modules covering the key skills and competencies essential for those working in the field of Disability Management and Return to Work Coordination. Modules focus on such topics as return to work plans, job analysis, workplace modifications, assessment, assistive devices, organisational skills, marketing, information technology, labour relations, rehabilitation, program development, and evaluation.

COHPA has been active politically to represent the interests of commercial OH providers to Dame Carol Black, Government and key bodies in the industry. "We have met with Dame Carol and Ministers from DWP /senior HSE (etc) to put our views across about the future of OH. We hold seats on Dame Carol's select committee for OH and the Council for Work and Health."

Atos is not subject to FOI requests.

Some of those denied benefits are forced to submit to training and work experience schemes. This are run by very profitable private companies and are not subject to FOI requests.

Professor Paul Gregg, Bristol University.

"If people are wrongly assessed as fit for work, the reform may end up costing the Government money, rather than saving it."

"It is not just about being harsh or tough on people."

"It is that too many people are likely to be put on JSA, which is not designed to help people with serious health problems, and not enough people are getting into the ESA zone where there is a specially designed programme for people with health problems."

"I was involved in the design of the help and support package available to ESA claimants to help facilitate a return to work. I was not involved in anyway with the WCA test, the pattern of face to face interviews etc that follow from this or the rate of benefits structure chosen."

"I believe that the WCA test is not working well and have said so publicly on many occasions."

The UK experience is that the "non medical" model has produced vast numbers of cases, such as mine, where the DWP concedes before referral to tribunal and vast numbers that are referred to tribunal which the DWP loses.

The US experience is that the "non medical" model produced vast numbers of cases in all the US states and which were overturned by class action. Unum was described as running disability denial factories. Unum was ordered to reassess and compensate.

Patients should be treated with compassion, dignity and respect.

All patients for all medical conditions should be allocated to the Support Group until such time as an assessment, compliant with the Contract between the DWP and Atos, has been completed. Completion is defined as when the patient has exhausted all remedies provided by Statute.

This would provide an incentive to the DWP and Atos to complete the process as swiftly as possible. The current incentive is not to pay and delay and defer.

Patients should never be referred to as "customers" or "clients". The Contract between the DWP and Atos does not allow the use of these terms but defines the term to be used as "claimant". "Claimant" has been used for many decades. The use of the unjustifiable terms "customer" or "client" belittles the patient's medical condition, insults the patient's intelligence and ignores the patients'rights under Commmon and Statute Law to be treated with dignity and respect.

In my case the DWP agreed to cease using the terms "customer" or "client" when they received a formal notice to cease and desist their harassment of me. Thereafter the DWP have used "claimant" in my case.

The word of a patient should be accepted without question if the patient has supplied medical evidence from the patient's GP and/or Consultants. The DWP can confirm independently with the patient's GP and/or Consultants.

The DWP website, the Atos website and all national and local government information website which refer to ESA and WCA should list the five categories of medical conditions (see Annex B) as listed in the Contract between the DWP and Atos.

In four out of the five categories of medical conditions (see Annex B), a patient should be required, at the least annually or as the patient's GP feels appropriate, to provide to the DWP confirmation of any changes to their medical condition and any changes to their GP and/or Consultants. The DWP can verify independently if they feel there is reason. Reasons can include gathering information for statistical audit.

All the medical conditions listed in the medical category (see Annex B) that cancer has been placed should be treated the same as cancer. To do otherwise would be discriminatory, may be in breach of the Equality Act and may contravene the European Convention on Human Rights.

The DWP should assess using actuarial considerations the effect on life expectancy of the patient's medical conditions. If this is less than the length of time for the patient to achieve the state retirement age then the patient should be placed in the ESA Support Group without further need for assessment.

This approach would provide the Government with a financial incentive to provide funds for research to increase life expectancy for those patients, such as myself, with an actuarial short life expectancy.

The decision on whether a face to face assessment should be made only by those with qualifications as listed in the Contract between the DWP and Atos. Atos should be fined heavily for non compliance with increasing fines for further non compliance.

The assessment should be made only by those with qualifications listed in the Contract between the DWP and Atos. Atos should be fined heavily for non compliance with increasing fines for further non compliance.

The DWP decision maker should confirm to the patient which of the five medical categories (see Annex B), as listed in the Contract between the DWP and Atos, Atos have placed the patient.

The DWP decision maker should confirm, if the patient has been placed in the three medical categories (see Annex B) which do not require a face to face assessment, that a face to face assessment has not occurred. If a breach of Contract face to face assessment has occured the patient should receive compensation and Atos should be fined heavily for non compliance with increasing fines for further non compliance.

The DWP should not issue a new ESA 50 form until twelve months have elapsed since the processing of the previous form, including appeals, has concluded.

The Appeals Tribunals should be able to refer an individual case to a higher court where precedents can be set. It is foolish to handle thousands of similar appeals on a case by case basis. This benefits no one.

The DWP should not indemnify Atos from actions by patients. If I sued Atos for assault and defamation by libel, it would be the DWP who would be liable for the actions of their contractor Atos.

The term DWP Decision Maker is adversarial in tone. It implies that there is a decision that may be in doubt. The tiny figure for fraud, outweighed by DWP administration errors and the significant under payment of benefits suggests that the tone is prejorative. A DWP case worker is a more appropriate and neutral term.

Those who manage and oversee the work of the DWP should use my case and see if the waste of resources and the "pass the document" processes are necessary.

The DWP should be renamed the Department for Welfare and Pensions. The new department's action should be governed by consolidated bills i.e. a new Welfare Act and a new Pensions Act. These should learn from the failings of the implementation of previous Acts.

The DWP should assign a single case worker for each patient or employment seeker. This one point of contact should be the patient or employment seeker's advocate. This case worker should be the mentor of the individual. The case worker should ensure the individual should receive all benefits that the individual is entitled to at national and at local level. The case worker should protect the individual from the rapacious predation and incompetence of companies such as Atos.

The record of Atos is poor by any standards.

In March 2008, Atos Healthcare employed 347.8 full time equivalent Healthcare Professionals undertaking medical assessments. In 31 August 2011 Atos Healthcare has 847.24 (full time equivalent) Healthcare Professionals undertaking medical assessments. It seems reasonable to me, given the numbers involved and the time allowed for each assessment, that it is likely that the Atos medical reports, which are generated by the Atos software, do not and cannot reflect the assessment.

Twenty minutes (the number of assessments divided by full time equivalent) is just sufficient time to walk slowly to the office, exchange greetings, enter patient details and a few notes before the set time is over. Does any intelligent person really give credence to a twenty six (26) page medical report (ESA 85) produced in such a manner?

I expect that every report produced by the same HCP is a variant of one created to find most individual patient work capable. As the DWP states in writing "we choose not to audit Atos". The DWP relies on the Atos Independent Tier, run by Atos for Atos, to audit Atos. This is inherently unjust and runs counter to legal processes. As the CQC, GMC and the NMC state this is outside our remit.

My case shows the assessment is a farce and a fraud.

My assessment took one hundred and ten minutes. It was the end of the day. I nearly blacked out a few times. I was at times in pain. The Atos doctor pushed me out as it was coming up to 18:00. I was found work capable.

As an example from my 26 page ESA 85 medical report, clause 1 Medical Conditions, Other Conditions Reported, Client states no other problems. Would I have forgotten to mention epilepsy, seizures, focal fits, migraines, blacking out (nearly happened several times in the assessment) and periods of extreme pain? Epilepsy is stated later in the report! The DWP does not audit.

In my case, over two years, there have been over twenty DWP and Atos individuals involved. My correspondence has been published on my web site. I ask the world to see if my experience suggests; the first action is to deny, the second action is to mislead, the third action is to correct and apologise, the fourth action is to defer, the fifth action is to refuse compensation ... and so it goes on ...and so it goes on ... and so it goes on ...

The 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). It is reported that in four out of every ten cases the Atos decision was overturned. This suggests in 2011, 150,000 people declared fit to work by Atos had that decision overturned by Tribunal. My case did not go to Tribunal. A conservative figure is that the DWP concedes two more cases for every one that goes to Tribunal. Atos crows in its annual report it makes the highest margin from the DWP in Europe.

The DWP and Atos are a mutual appreciation society. Atos wines and dines (COHPA - photos available) the DWP. The DWP awards (June 2010) customer delivery supplier of the year in the DWP Supplier Excellence Awards.

Now that Darra Singh, he of the evasive letter, is no longer CEO of the DWP, the Secretary of State should ask the Police to investigate the extent of maladministration and systemic fraud. I have published all my evidence. Large numbers are willing to do likewise. Previously I have asked for the Ministry of Justice to investigate. This has been refused. Why?

The Ministry of Justice should ask the Police to investigate the relationship between the DWP and Atos.

Atos should not be awarded any future Government contracts until a Police investigation has completed.

The following correspondence, 126 items listed, is with the DWP and Atos. There were additional items not listed. Documents appear without cover letters. The ESA 85 report just appeared. A copy of the ESA 50 report just appeared.

2009       

  1 12 May Letter From Atos Healthcare, Request for ESA50 ESA Questionnaire to be completed. 
  2 10 Jun Letter From Atos Healthcare, Request again for ESA50 ESA Questionnaire. 
  3 18 Jun Letter From Atos Healthcare, Request to telephone Atos. 
  4 24 Jun Letter From Atos Healthcare, Appointment for medical assessment. 
  5 28 Jun Letter To Atos Healthcare, Before the medical examination. 
  6  3 Jul Letter From Atos Healthcare, Appointment for medical assessment. 
  7 10 Jul Letter From the DWP, Asking for a medical certificate from my GP. 
  8 29 Jul Letter To Atos Healthcare, Complaint after the medical examination. 
  9 29 Jul Letter From the DWP, ESA payment approved, benefit of £89.90 per week. 
 10  8 Aug Letter From Atos Healthcare, Work Focused Health Related Assessment. 
 11 11 Aug Letter To the DWP, After assigned to Work Related Activity Group. 
 12 11 Aug Email  To Atos Healthcare, Complaint failed to acknowledge. 
 13 12 Aug Email  From Atos Healthcare, Acknowledge receipt. 
 14 12 Aug Email  To Atos Healthcare, Request for the Independent Tier. 
 15 13 Aug Email  From Atos Healthcare, Refrain from sending emails. 
 16 13 Aug Letter From Atos Healthcare, Apologies and meaningless promises. 
 17 14 Aug Letter From the DWP, Wrong date wrong fact. 
 18 15 Aug Letter To the DWP, Repeat request for copy of medical report. 
 19 16 Aug Letter From Atos Healthcare, New Highgate appointment. 
 20 18 Aug Email  To Atos Healthcare, Request to cancel appointment. 
 21 18 Aug Email  From Atos Healthcare, Refusal to cancel appointment. 
 22 18 Aug Email  To Atos Healthcare, Indignation at refusal to cancel appointment. 
 23 20 Aug Letter From Atos Origin, Travel expenses cheque. 
 24 22 Sep Letter From Atos Healthcare, Rambling apologies and more errors. 
 25 24 Sep Letter To Atos Healthcare, Complain over new appointment. 
 26 28 Sep Letter To Atos Healthcare, Repeat complaints request for Independent Tier. 
 27  2 Oct Letter From JobCentrePlus, Pathways to Work appointment. 
 28  5 Oct Letter To JobCentrePlus, Request to cancel Pathways to Work appointment. 
 29  6 Oct Email  To Atos Healthcare, Request for progress report. 
 30  6 Oct Letter From Atos Healthcare, Acknowledge request. 
 31  7 Oct Letter From Atos Healthcare, New issues more delays. 
 32  8 Oct Letter To Atos Healthcare, Request to hear within 20 days. 
 33 12 Oct Letter From JobCentrePlus, Pathways to Work threat bullying. 
 34 13 Oct Letter From Atos Healthcare, Confirm FOI request forwarded. 
 35 14 Oct Phone  From JobCentrePlus, Apologies...of course did not have to attend. 
 36 14 Oct Letter To JobCentrePlus, Confirm JCP had made mistake. 
 37 11 Nov Letter From Atos Healthcare, More delays. Can't find ESA50. 
 38 18 Nov Letter To Atos Healthcare, Request for names and the Independent Tier. 
 39 25 Nov Letter From the DWP, Opinion Poll request to take part. 
 40 25 Nov Letter To the DWP, Opinion Poll response agree on terms. 
 41 26 Nov Letter From Atos Healthcare, More delays. Independent Tier refused. 
 42 26 Nov Letter From the DWP, A new FOI request. Why?!? 
 43 28 Nov Letter To the DWP, Clarify FOI request. 

2010
       
 44  8 Jan Letter From Atos Healthcare, Offer of £100 consolatory payment. 
 45 11 Jan Letter To Atos Healthcare, Independent Tier request. 
 46 14 Jan Letter From the DWP, FOI response. 
 47 19 Jan Letter From Atos Healthcare, Independent Tier referral (at long last). 
 48 20 Jan Letter To Atos Healthcare, Independent Tier referral response. 
 49 21 Jan Letter To the DWP, FOI response and request for full information. 
 50 23 Jan Letter From Atos Healthcare, Independent Tier does not accept evidence. 
 51 24 Jan Email  To Atos Healthcare, Independent Tier should use NAO procedure. 
 52 24 Jan Email  From Atos Healthcare, Atos Healthcare email system broken. 
 53 25 Jan Email  From Atos Healthcare, Atos Healthcare will comply with DWP procedure. 
 54 27 Jan Email  From Atos Healthcare, Does Atos try "spoof job" entrapment? 
 55 28 Jan Letter From Atos Healthcare, ESA50 form must be completed again, why? 
 56 31 Jan Email  To Atos Healthcare, Request copy of original ESA50 form. 
 57  1 Feb Email  To Atos Healthcare, Requesting serious complaint action. 
 58  5 Feb Phone  To DWP BDC, The DWP BDC is not aware of serious complaint. 
 59  5 Feb Email  To Atos Healthcare, Brian Pepper, Atos Healthcare tardiness. 
 60  9 Feb Letter From the DWP, Changes in benefits to £91.40 per week. 
 61 15 Feb Letter From Atos Healthcare, "Atos" Independent Tier investigations. 
 62 22 Feb Letter To Atos Healthcare, Independent Tier convened on unsound legal basis. 
 63 22 Feb Letter To Atos Healthcare, Complaint over new ESA50 request. 
 64 22 Feb Letter To the DWP, Unsound medical advice and request for action. 
 65 28 Feb Letter From Atos Healthcare, Threat to ESA50 form or lose benefits 
 66  3 Mar Letter From Atos Healthcare, Atos believes Independent Tier legal 
 67  4 Mar Email  To Atos Healthcare, Response and Atos breach the Contract again 
 68 11 Mar Letter From Atos Healthcare, Forgets that ESA85 was unsound 
 69 19 Mar Letter From the DWP, Provides ESA50 copy and request for new ESA50 
 70 22 Mar Letter To the DWP, Short shrift for new ESA50 request 
 71 24 Mar Email  To Atos Healthcare, Another complaint 
 72 24 Mar Email  From Atos Healthcare, Acknowledgement received within 20 minutes! 
 73 25 Mar Letter From Atos Healthcare, Ignores substantive points again! 
 74 26 Mar Email  To Atos Healthcare, Further complaint 
 75  7 Apr Letter From the DWP, FOI Response to 21 Jan 2010 correspondence. 
 76 12 Apr Letter From the DWP, DWP does not have jurisdiction over Atos. 
 77 21 Apr Letter From the DWP, FOI Additional to 7 Apr letter and copy of 7 Apr 
 78 28 Apr Letter From the DWP, Data Protection They retain no information. 
 79 29 Apr Email  To Atos Healthcare Asking for progress and where is the £100. 
 80  6 May Email  From Atos Healthcare, Confirm will pay initial £100. 
 81  8 May Letter From the DWP, Placing me in the ESA Support Group 
 82 11 May Letter To the DWP, Requesting copy of medical advice and money owed. 
 83 25 May Letter From Atos, Healthcare Letter and cheque of initial £100. 
 84 26 May Letter From the DWP, Responding to DWP Legal Group 10 Mar 2010 letter. 
 85 27 May Letter To the DWP, Requesting all matters be addressed. 
 86  1 Jun Letter From the BA DSS, Certificate of Pay and Taxable Benefit etc. 
 87 24 Jun Letter From the DWP, FOI Response 
 88 24 Jun Letter From the DWP, FOI Response ... more 
 89 29 Jul Letter From the DWP Chief Executive, Response following Independent Case Examiner 
 90 29 Jul IB59   From the DWP Chief Executive, Outstanding request (not written in English) 
 91  4 Aug Email  To the DWP Chief Executive, Response to his letter. 
 92  6 Aug Letter From the DWP Jobcentre Plus, Special payment of £75. 
 93 21 Aug Letter From the DWP, Remittance Advice of £75. 
 94 27 Aug Letter From the DWP, Acknowledge 4 Aug letter. 
 95  1 Sep Letter From the DWP FOI, GMC reference and HCP definition. 
 96  3 Sep Letter From the DWP CMMS, Claimant and customer. 
 97  6 Sep Letter From the DWP, Review all in order 
 98  7 Sep Email  To the DWP, FOI Response to 1 Sep letter. 
 99  9 Sep Letter From the DWP CMMS, Addressing the 14 points. 
100 13 Sep Letter From the DWP CMMS, Addressing the 7 Sep FOI email. 
101 13 Sep Letter From MP, Initial response from DWP CMMS. 
102 29 Sep Letter To DWP BDC, Response to 6 Sep letter. 
103  1 Nov Letter To DWP BDC, Informing hospital admission. 
104  3 Nov Letter From DWP BDC, Apologising for delay. 

2011       

105  8 Jan Letter From DWP BDC,  Refusing to address any issue raised. 
106  1 Feb Email  To DWP,   Requesting Darra Singh CEO DWP to review. 
107  1 Feb Email  From DWP, Acknowledge receipt. 
108  8 Feb Letter From DWP, Changes in benefits to £99.85 per week. 
109 21 Feb Letter From DWP, Evasive answers from Matthew Nicholas, Director. 
110 15 Mar Email  To DWP,   Response to Evasive Answers. 
111 18 Apr Letter From DWP, Apology for delay claims replied to all issues. 
112 23 Apr Letter From BA DSS,  Certificate of Pay and Taxable Benefit etc. 
113 27 May Email  To DWP,   Request Atos to cease and desist harassment. 
114 25 Jul Letter From DWP, Response to email. 
115 31 Jul Email  To DWP,   Thanks for finally agreeing to comply with Contract. 
116 12 Aug Letter From DWP, Agreeing to use "claimant", Atos falsehoods, compensation. 
117 24 Aug Email  To DWP,   Responding to their letter. 
118 26 Aug Letter From DWP, Change in allowance £10 Christmas Bonus. 
119  9 Sep Letter From DWP, Apology for misleading information regarding Atos. 
120 21 Sep Email  To DWP,   Accept apology. Repeat request to remove approval. 
121 11 Oct Email  To DWP,   Company Pension details. 
122 14 Oct Letter From DWP, ESA Change in rates £99.85 + £10.00 (Christmas). 
123 17 Oct Letter From DWP, Company pension calculation. 
124 17 Oct Letter From DWP, ESA change in rates £0.00 (company pension) + £10.00 (Christmas). 
125 29 Dec Email  To DWP,   DWP failed to pay £10.00 (Christmas). 

2012
       
126  3 Jan Letter From DWP, DWP computer system fault so Christmas £10.00 not paid. 

The following correspondence is with the Secretary of State, my MP, senior DWP employees (Executive, Legal, CMMS, FOI), the ICO and the ICE.

Secretary of State
   9 Oct 2009 Letter To,  Requesting assistance.
 
Minister for Disabled People
  28 Oct 2009 Letter From, Outlines principles. 
  11 Nov 2009 Letter To,   Lists particular concerns. 
   6 Jan 2010 Letter From, Apologies for delay. 
  27 Jan 2010 Letter From, Hope matter resolved and copy of Atos reply.

MP
  24 Aug 2010 Letter To,   Requesting assistance. 
  26 Aug 2010 Letter From, To Secretary of State for Work and Pensions. 
  26 Aug 2010 Letter From, To Chief Executive JobCentre Plus. 
  26 Aug 2010 Letter From, To Secretary of State for Justice undue influence. 
   1 Nov 2010 Letter From, Minister response, no action to be taken. 
     Feb 2011 Email  To,   DWP Secretary of State Work Programme. 
  14 Mar 2011 Letter From, DWP Secretary of State Work Programme.
 
Prof. Harrington WCA Review
  19 Jul 2011 Email  To,   Evidence submitted for consideration. 

Work and Pensions Committee
   7 Nov 2011 Email  To,   Suggestions as to who can replace Atos. 
  11 Nov 2011 Email  From, Comments noted.
 
DWP The Legal Group
   7 Dec 2009 Letter To,   Misrepresentation of term customer. 

DWP FOI 1209-2565 (Who agreed to replace claimant with customer or client) 
   9 Feb 2010 Letter From, Freedom of Information (FOI) - no information held. 
  10 Mar 2010 Letter To,   Request for review and action. 
  11 Mar 2010 Letter To,   Misrepresentation of term customer after FOI. 
  29 Apr 2010 Email  To,   Asking for Progress. 
  30 Apr 2010 Email  From, Confirmation of being progressed. 
  15 Jun 2010 Email  To,   Asking for Progress. 

  12 Aug 2011 15:41 Email To, FOI asking for the DWP approved list of HCPs. 
  11 Oct 2011 16:54 Email To, FOI asking for a response to 12 Aug request. 
  19 Oct 2011 15:40 Email To, Request to the Information Commissioner's Office to review. 

DWP FOI 2336-2367 (request full list of DWP approved HCPs)
  27 Oct 2011 Letter From DWP, FOI responds presumably after ICO intervention. 
  14 Nov 2011 Email  From ICO, Confirming they informally reminded the DWP. 
  16 Nov 2011 Email  To DWP,   FOI request internal review to 27 Oct response. 
  25 Nov 2011 Letter From DWP, CMMS acknowledgement ICO related. 
  28 Nov 2011 Letter From DWP, CMMS written to ICO. 

DWP FOI 2551-3451 (request copies of annual reviews, customer surveys, IPR)
   7 Nov 2011 Email  To DWP,   FOI request annual reviews, customer surveys and software. 
   5 Dec 2011 Letter From DWP, FOI asking to clarify 7 Nov request. 
   7 Dec 2011 Email  To DWP,   FOI provided clarification. 
  12 Dec 2011 Letter From DWP, FOI response. 

DWP FOI 2557-3356
  13 Dec 2011 Letter From DWP, FOI response. 
DWP FOI 2581-IR 278
  14 Dec 2011 Letter From DWP, FOI internal review refuses to provide HCP list. 

Independent Case Examiner
   5 Jul 2010 On line form To,   Complaining about the DWP. 
   9 Jul 2010 Letter From,       No action as final response has not been given by DWP. 
   6 Aug 2010 10:20  Email From, Requesting if action is now required. 
   6 Aug 2010 17:45  Email To,   Requesting postpone action for now (too ill). 

   3 Aug 2011 10:37  Email To,   Requesting to progress my case. 
   4 Aug 2011 Letter From, Confirm progressing my case. 
  11 Aug 2011 Letter From, Jobcentre Plus complaints procedure not yet exhausted. 
  16 Aug 2011 Email  To,   Asking clarification. 
  17 Aug 2011 Email  From, Confirmed allocated to Initial Action Team. 
  22 Sep 2011 Phone  From, Requested to discuss case. 
  29 Sep 2011 Letter From, Clarification of complaint elements. 
   2 Oct 2011 Email  To,   Provide clarification. 
  12 Oct 2011 Letter From, Clarification regarding the points raised. 
  13 Oct 2011 Email  To,   Accept clarification and ICE precedents. 
  20 Oct 2011 Letter From, Clarification agreed awaiting assignment to case worker. 
  25 Jan 2012 Letter From, Case notes have been received from DWP. 

1. Unsuitable for calling to a Medical Examination Centre.

Age >75 years

Age <12 years

Both Blind and Deaf, Registered Blind (needs to be seen in own environment), Cases accepted under the Special Rules defining Terminal illness, Alzheimers, Amputation of both legs, Asperger's, Autistic Spectrum Disorder / Autism, Cerebral Palsy, Dementia, Hemiplegia, Huntingdon's Chorea, Korsakoffs Psychosis, Macmillan Nurse attending, Motor Neurone Disease, On oxygen, Paraplegia, Quadraplegia, Renal Dialysis, Severe Mental Impairment, Severe Learning Difficulty, Spastic Diplegia, Tetraplegia, Total Parenteral Nutrition, Unstable Angina, Wernicke's Encephalopathy

2. Reference to Medical Advisor required for advice.

AIDS, Astrocytoma, Bone Marrow Transplant, Brittle Bone Disease, Cancer, Cystic Fibrosis, Dermatomyositis, Glioma, Guillane-Barre Syndrome, Hodgkin's Lymphoma, Leukaemia, Liver Failure, Mental Retardation, Mental Subnormality, Multiple Sclerosis, Muscular Dystrophy, Non Hodgkin's Lmphoma, On Morphine / MST, Osteogenesis Imperfecta, Parkinson's Disease, Poliomyelitis, Polymyasitis, Registered partially sighted, Respiratory Failure, Rheumatoid Arthritis, Schizoaffective Disorder, Schizophrenia, SLE, Spinal Injury, Systemic Lupus Erythematosis, Scleroderma, 5evere Depression, Thallassaemia

3. Tentatively invite to Medical Examination Centre.

Agoraphobia (offer taxi), Anorexia Nervosa, Ataxia, Bipalar Affective Disorder / Bipolar Disease Manic Depression, Burns, Cardiomyopathy, Cerebrovascular Accident / CVA, Cerebrovascular Disease, CFS, Chronic Fatigue Syndrome, Crohn's Disease, Diabetic Neuropathy, Eating Disorder, Fibromyalgia, Haemopphilia, Heart Transplant, Hemiparesis, Learning Difficulties, Leg Ulcers, Myalgic Encephalomyelitis / ME, Obsessive Compulsive Disorder, Peripheral Neuropathy, Phobic Anxiety, Sickle Cell Anaemia, Social Phobia, Spina Bifida, Stroke, Subarachnoid Haemorrage / SAH, Ulcerative Colitis, Varicose Ulcers

4. Invite to Medical Examination Centre.

Alcohol Dependence, Anaemia, Angina, Ankylosing Spondylitis, Anxiety, Arrythmia, Asthma, Atrial Fibrillation, Back Pain, Bronchiectasis, Bulimia Nervosa, Cardiac Arrythmia, Cervical Spondylosis, Chronic Bronchitis, Chronic Obstructive Airways Disease, Chronic Obstructive Pulmonary Disease, COPD, Coronary Artery Disease, Coronary Heart Disease, Depression, Dermatitis, Diabetes, Diverticular Disease, Diverticulitis, Dizziness, Down's Syndrome, Drug Dependence, Eczema, Endometriosis, Epilepsy, Hearing Impairment, Hernia, HIV, Hypertension, Hyperthyroidism, Hypathyroidism, Hysterectomy, Incontinence, Ischaemic Heart Disease, Irritable Bowel Syndrome / IBS, Joint Pain, Kyphosis, Kyphoscoliosis, Labyrinthitis, Liver Transplant, Lumbar Spondylosis, Meniere's Disease, Migraine, Myasthenia Gravis, Neck Pain, Osteoarthritis, Osteoporosis, Overactive Thyroid, Panic Attacks, Pelvic Inflammatory Disease, Peripheral Vascular Disease, Personality Disorder, Prolapsed Intervertebral Disc, Psoriasis, "Registered Alcoholic", Renal Transplant, Rheumatic Heart Disease, Scoliosis, Slipped Disc, Underactive Thyroid, Valvular Heart Disease, Varicose Veins, Visual Impairment

5. Any other Diagnosis.

Not listed above should be referred to a Medical Adviser for advice

In July 2008, the American Association for Justice (www.justice.org) published a document "The Ten Worst Insurance Companies In America: How They Raise Premiums, Deny Claims, and Refuse Insurance to Those Who Need It Most". Allstate was the worst and Unum was the second worst.

McKinsey and Company are important Government and DWP advisors. McKinsey and Company represent the interests of major corporate clients. McKinsey and Company are so important that they usually meet Ministers and Chief Executives.

In January 2012, the Cabinet Office announced the appointment of Tim Kelsey as the new executive director for transparency and open data within the Efficiency and Reform Group (ERG) with immediate effect. For the previous six months Kelsey has been leading on transparency in the ERG on secondment from consultancy firm McKinsey & Co.

In November 2010, McKinsey and Company provided hospitality in the form of a dinner for Terry Moran, DWP Chief Executive, Pension, Disability and Carers Service (to 30 November) Director General, Universal Credit (from 1 December).

In May 2009, McKinsey and Company were appointed as a supplier to the DWP Cipher Consultancy Services Framework. The Cipher agreement will cost the DWP £500 million and will last four years.

National Audit Office include a summary of a McKinsey Quarterly article, "Five ways CFOs can make cost cuts stick, May 2010" in the NAO document "Reducing Costs in the DWP" published 23 June 2011 (www.official-documents.gov.uk/document/hc1012/hc10/1089/1089.pdf).

Consider the second (ii) point, if the McKinsey & Co. recommendation to Allstate are followed by the DWP (in line with the NAO recommendation):

Consider the third (iii) point, focus on units that can best afford to cut:

Consider the fourth (iv) point, change the strategy: