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This website provides information on how Atos runs its business, extracts from the Contract between the DWP and Atos including the MEDICAL CONDITIONS that mean a face to face medical assessment is not always necessary, ASSESSMENTS AND POINTS, the breaches of Contract that occurred in my case, my unsound medical report and the correspondence showing how difficult it is to obtain justice or advice.
The Government is inviting the public to submit petitions. Search epetitions.direct.gov.uk for "DWP" or "Atos" or "disabled" to list relevant petitions including Stop and review the cuts to benefits and services which are falling disproportionately on disabled people, their carers and families (http://epetitions.direct.gov.uk/petitions/20968).
Other ongoing petitions are Petition against constant vilification of sick and disabled claimants and Petition to "Sack Atos Immediately" .
The DWP occasionally consults the public http://www.dwp.gov.uk/consultations/.
Summary is my opinion on how poorly Atos Origin have implemented the Contract between the DWP and Atos Origin which has hurt so many dying, sick, the disabled and their carers. The wasteful bureaucracy and gross inefficiency is staggering and just adds greater and greater profits to Atos Origin. ESA Regulations contains details published by Parliament including the list of people from Atos and Unum who drafted the rules and regulations. Parliament contains information from and links to Hansard. DWP High Earners provides information on the salaries of the DWP high earners. Professor Paul Gregg, Bristol University contains information on one of the "architects" of ESA though he claims to have been involved in training and support modules.
To understand the Welfare Reform Act you need to go through in detail cases like mine that show how poorly it has been implemented. Parliament could amend further the Welfare Reform Act so that fewer house bound patients are left without the means to support themselves. All I ask is for the DWP to enforce the Contract between the DWP and Atos Origin and obtain refunds from Atos Origin where it is proved, as in my case, that Atos is in breach of the Contract. This will do much to protect patients and claimants.
I can't believe it is Government policy to deny house bound ill people the means to live. Should a Government just concentrate on reducing the budget without wanting to be concerned about the consequences?
It is the duty of a civilised society to look after those who need help most. I hope the Government starts showing compassion, gets involved in understanding the details and puts first the protection of those most in need.
This page highlights some of the current parliamentary material available on sickness, disability and carers' benefits. This includes select committee reports, briefing papers on current legislation and other subjects produced by the parliamentary research services, and the latest Early Day Motions put down by MPs http://www.parliament.uk/topics/Sickness-disability-and-carers-benefits.htm.
This July 2008 paper http://www.opsi.gov.uk/si/si2008/em/uksiem_20080794_en.pdf set out the regulations. This paper projects the annual net benefit will be £215m (by year10) and the total benefit £1.1bn (10years).
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
...
7.15 In devising the new Work Capability Assessment which will be integral
to the ESA regime, two technical working groups, consisting of medical
and other relevant experts, were set up to consider how the current
Incapacity Benefit 'Personal Capability Assessment' could be improved
and updated. One of these groups focused specifically on mental health
and learning disabilities and the other on physical functions. As well
as the technical working groups, consultation groups, consisting of
organisations representing the main user groups were set up.
The Department continues to involve these organisations in other
aspects of the work related to the capability assessments.
...
SAVINGS
Fewer people being paid benefit
...
Technical and Consultative Working Groups involved in the creation
of the Work Capability Assessment.
Mental Health Technical Working Group
Professor Geoff Shepherd, Director of Service Improvement,
Cambridgeshire and Peterborough Mental Health Trust
Dr Jed Boardman, Royal College of Psychiatrists and Sainsbury Centre for Mental Health
Dr Bob Grove, Department of Health and Sainsbury Centre for Mental Health
Miles Rinaldi, Head of Delivery, National Institute for Mental Health in England
Dr Paul Litchfield, Faculty of Occupational Medicine
Sue Godby, College of Occupational Therapists and Unum Provident
Dr Angela Graham, Atos Origin
Physical Function Technical Working Group
Anne Johnson, Occupational Therapist, Royal National Hospital for
Rheumatological Diseases
Dr David Henderson Slater, Consultant in Neurological Disability/Rehabilitation
Medicine, Oxford Centre for Enablement
Anne Spaight, Physiotherapist, and Chair of the Disability Living Allowance Advisory Board
Dr Peter Dewis, Disability Analyst and Customer Care Director, Unum Provident
Dr Angela Graham, Atos Origin Medical Services
Dr Andy Tyerman, Consultant Clinical Neuropsychologist, Vale of Aylesbury NHS Primary Care Trust
Brigid Campbell, Social Security Advisory Committee
Andy Barrick, Royal National Institute for the Blind
Christine Jess, Disability Employment Advisory Council
Mental Health Consultative Group
MIND Disability Rights Commission
MENCAP Rethink
Turning Point Judy Scott Consultancy
SANE RADAR
DEAC TUC
The National Autistic Society Salford Council Welfare Rights Services
Overarching Consultative Group
Leonard Cheshire Disability Alliance
Rethink DEAC
RNIB SENSE
RNID Arthritis Care
Macmillan Cancer Support SCOPE
MENCAP MIND
SSAC Citizen's Advice
TUC Disability Rights Commission
Child Poverty Action Group [from August 2006]
Notice that individuals from the discredited Unum company were involved. Back in 2002, a class action lawsuit charged UnumProvident (now First Unum or Unum) with operating "disability denial factories". The company also faced thousands of lawsuits filed by individuals who were denied disability claims.
These are pertinent extracts from Parliament written answers, debates reported by Hansard and from the Work and Pensions Committee minutes, oral and written evidence.
Tom Greatrex: To ask the Secretary of State for Work and Pensions what assessment he has made of the decision by the General Medical Council (GMC) of 4 October 2010 that an Atos Healthcare professional carrying out an assessment of a claimants suitability for disability living allowance is not subject to paragraph 2(a) of the good medical practice guidance; and what discussions he has had with the GMC on this issue. [87534]
Chris Grayling: The Department has not made any assessment of the decision, nor have there been any discussions with the GMC on this issue.
Tom Greatrex: To ask the Secretary of State for Work and Pensions what auditing process is undertaken by his Department in relation to the number of successful appeals by those found fit for work by Atos Healthcare and his Department's decision-makers following a work capability assessment. [87677]
Chris Grayling: All allowed appeals are referred back to DWP decision makers so that any learning points can be identified. Local arrangements are in place to cascade relevant information as appropriate. DWP is also working with HMCTS to identify any trends in decisions which it could usefully address.
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.
Teresa Pearce: To ask the Secretary of State for Work and Pensions what follow-up procedures are in place to determine the reason for a claimant's failure to attend a work capability assessment. [87689]
Chris Grayling: When a claimant fails to attend a work capability assessment Medical Services will write to the claimant asking why they have not attended. The letter asks the claimant to reply to the Benefit Centre dealing with their claim within seven days.
At the same time, Medical Services separately notifies the Benefit Centre that the claimant has failed to attend.
Where the claimant is considered vulnerable because of their particular health condition a decision maker will attempt to make contact by telephone.
If we are unable to contact a vulnerable person, the Department will attempt to visit the claimant to establish their reason for not attending.
Tom Greatrex: To ask the Secretary of State for Work and Pensions whether Atos Healthcare undertakes any assessment of the outcome of appeals on Work Capability Assessment. [87532]
Chris Grayling: Atos Healthcare assess feedback from the Appeals Tribunal Service, where its medical assessment is identified as substandard. The Appeals Tribunal Service handle appeals of the Department of Work and Pension's decision about a claimant's entitlement to a benefit following a Work Capability Assessment.
Q52 Chair: Because obviously the crucial thing is the gateway to get on to ESA, which is the Work Capability Assessment. We have had lots of complaints about Atos Healthcare and how they carry out their assessments. Is Atos going to carry on? Is the contract a long one? Are you in negotiation with them to look again? Lots of complaints about the rigidity of the medical assessment and how it doesn't take into account things like fluctuating conditions, mental health and all of that.
Mr Duncan Smith: I agree. We've already made changes, as you know. We have an external independent review and I can give you the names of the people that are on the scrutiny group, and the Permanent Secretary may want to say a little more about this: Paul Farmer, Chief Executive, Mind; Professor David Haslam, National Clinical Adviser, Care Quality Commission; Dr Olivia Carlton, Head of Occupational Health, Transport for London; and Neil Lennox, Head of Health, Safety and Fire at Sainsbury's. They will be acting as a scrutiny group to Professor Malcolm Harrington, Professor Emeritus at the University of Birmingham, and he will lead the independent review. So they will act as a scrutiny group to him.
They've already recommended some changes that are quite important and we've implemented some of these and plan to do that. First of all, to ensure that individuals awaiting chemotherapy are treated in the same way as those already receiving it, and you'll know that we announced that we'd make that change; expand the support group to cover more people with communication problems and severe disabilities due to mental health conditions; take account of someone's adaptation to a condition of disability and simplify the language of the descriptors. Most of all, basically, try and make the system more responsive to the fact that some people will come in front of the assessors and be different a day later, and to understand more what's in their medical records. I think that's reflected in this but that's the nature of it.
Do you want to add anything to that or have I missed anything?
Sir Leigh Lewis: No, not at all. The only thing perhaps I'd add is that we do, as we do with all of our providers, maintain a very, very active dialogue with Atos Healthcare. We take up individual cases where we have any reason, ourselves, to believe that there's something, prima facie, odd about the decision. One issue that I'm sure every Member of Parliament will know from their own postbag is that, in a sense, we perhaps need to do more to explain to people that the nature of the assessment is not whether Mr or Mrs or Ms Smith has this condition. It is whether that condition prevents them from undertaking some or any work.
So some of the cases that cross my desk - as I'm sure they'll cross the desks of Members - are where, in a sense, there are two different issues. The individual is saying, "But I have this condition; here's the evidence from my doctor, my GP, my consultant", et cetera. But the capability assessment, of course, is not disputing that the individual has that condition. It's trying to assess, with that, what is that individual's capability for work.
Q54 Chair: Just very quickly before we leave this, is the Atos contract up for renewal any time soon?
Sir Leigh Lewis: I haven't got that date in my head. So let us write to you.
Mr Duncan Smith: It will be up for renewal but I can't give you the date.
Sir Leigh Lewis: I don't think it's immediately up for renewal, but let us write to you.[2]
2. See Letter to the Chair from the Secretary of State, 28 September 2010, Ev 23. Back
Letter to the Chair from the Secretary of State, 28 September 2010
ATOS HEALTHCARE CONTRACT RENEWAL
During the Select Committee's evidence session on 15 September, I promised to write concerning the renewal of the Atos Healthcare contract.
The original Medical Services Agreement was awarded in 1998 by the then Department of Social Security to Sema Group (which subsequently changed its name to Schlumberger Sema and latterly to Atos Healthcare). At that time the services delivered were to the Department for Social Security but following machinery of Government changes in 2001, the administration of some of the benefits covered by that contract migrated to other Government Departments, for example War Pension transferred to an Agency of the Ministry of Defence and Statutory Sick pay to Her Majesty's Revenue and Customs. The Department for Work and Pensions (previously the Department for Social Security), remained responsible for the management of the overall Agreement.
The Medical Services Agreement between Atos Healthcare and the Department for Work and Pensions was awarded on 15 March 2005 by the Secretary of State for Work and Pensions following a competitive tender. The Agreement commenced on 1 September 2005 for a term of seven years with options to extend for consecutive terms of three and then two years. Such extensions were conditional on the evidence that they brought clear benefits to the Department outweighing competition. There is also provision to allow for up to twelve months extension if required, for example during a competition of the services.
The Department for Work and Pensions may exercise a break option at any time, giving ATOS healthcare twelve months written notice. In addition the Agreement may be terminated early if Atos Healthcare is in default of its obligations under the Agreement.
The scope of the Medical Services Agreement is to provide medical advice to, the Department for Work and Pensions; Her Majesty's Revenue and Customs, Service Personnel and Veterans Agency and Tribunals Service, to support decisions in relation to a number of benefits and pensions. These include but are not limited to:
Incapacity benefits.
Employment and Support Allowance.
Industrial Injuries Disablement Benefits.
Disability Living Allowance.
Attendance Allowance.
Statutory Sick Pay/Statutory Maternity Pay.
Child Trust Fund.
War Pension.
Vaccine Damage Payment Scheme.
Financial Assistance Scheme.
Compensation Recovery Scheme.
Appeals Tribunal Service.
The Agreement was amended in 2008 to incorporate Employment and Support Allowance. The Department has negotiated the terms of an extension to the contract to 2017 in order to allow for the completion of Incapacity Benefit to Employment Support Allowance migration. The extension will be subject to Atos Healthcare delivering substantial savings against the current estimated cost of 100 million per annum. I am still considering the merits of whether to extend the contract with Atos Healthcare. A final decision will be taken in the Autumn.
John Woodcock: To ask the Secretary of State for Work and Pensions what contracts his Department has signed with Atos to carry out the retesting and transition of incapacity benefit claimants to employment and support allowance; what the monetary value of each contract is; and what changes have been made to such arrangements since the present administration took office. [15746]
Chris Grayling: I have given approval for the retesting and transition of incapacity benefit claimants to employment and support allowance to be added to the existing medical services contract with Atos Healthcare up to 31 August 2012 at a cost of £59 million. There have been no changes made to such arrangements since the present administration took office.
Dr Whiteford: To ask the Secretary of State for Work and Pensions how many people will undergo the incapacity benefit migration process at Aberdeen during the incapacity benefit reassessment trial; and of these how many receive (a) short-term (lower) rate, (b) short-term (higher) rate and (c) long-term rate. [13496]
Chris Grayling: 850 people currently claiming incapacity benefits in Aberdeen and the surrounding areas whose cases are dealt with by Aberdeen Benefit Delivery Centre will be reassessed under the incapacity benefit reassessment trial. These 850 people will be selected from all incapacity benefits customers whose cases are dealt with by Aberdeen Benefit Delivery Centre.
We are unable to say what rate of incapacity benefit these customers receive as we have not yet selected the customers to be reassessed under the Aberdeen reassessment trial.
Customers will be selected for the trial if they are due to have a personal capability assessment as a part of their ongoing incapacity benefits claim. Some customers, such as those reaching state pension age before March 2014, will be excluded from the reassessment; others may move off incapacity benefits before the reassessment trial begins in October.
Dr Whiteford: To ask the Secretary of State for Work and Pensions what the estimated average time will be to process incapacity benefit reassessments being trialled at Aberdeen; and what the average processing time was in Aberdeen in the latest period for which figures are available. [13497]
Chris Grayling: After an initial award of ESA has been made, the customer is sent an ESA50 medical questionnaire, which they have 28 days to complete. The customer is then invited to a work capability assessment at a medical examination centre. This takes place within the first 13 weeks of the claim. After the customer has attended the work capability assessment, a Jobcentre Plus decision maker decides whether they are fit for work and therefore not entitled to ESA, entitled to the work related activity component of ESA, or entitled to the support component of ESA. From the date the ESA50 is issued to the final decision being made takes on average 42 days.
The target time for reassessment of incapacity benefits customers during the Aberdeen reassessment trial is 42 days. This period runs from the date the ESA50 is issued to the customer to date of the decision to find the customer fit for work, entitled to the work related activity component, or entitled to the support component.
Before the ESA50 is issued, the customer will be telephoned by a member of staff from Jobcentre Plus to give information and advice about the reassessment process. This contact is not included in the target of 42 days for the reassessment process.
Dr Whiteford: To ask the Secretary of State for Work and Pensions whether all incapacity benefit claimants will be asked to undergo a medical examination as part of the reassessment programme being trialled in Aberdeen. [13498]
Chris Grayling: Beginning with the trial in the Aberdeen and Burnley areas, customers who currently receive incapacity benefits will be reassessed to determine entitlement to employment and support allowance (ESA).
Those customers who are the most severely disabled or who are terminally ill will automatically be considered to have limited capability for work. Conditions which mean a customer will be automatically considered to have limited capability for work include:
terminal illness with a reasonable expectation of death within six months;
receiving or recovering from certain forms of chemotherapy;
pregnancy, where there is risk of harm to mother or child.
These customers will not need to attend a work capability assessment to determine their entitlement.
For customers who do not fulfil these conditions, entitlement to ESA is determined by a work capability assessment. Customers will be sent a medical questionnaire, the ESA50, by Atos Healthcare (our health services contractor) to complete and return. The contents of the ESA50 and any other evidence will be used to decide if the customer needs to attend a work capability assessment. If they need to attend an assessment, Atos Healthcare will call them to arrange an appointment. The work capability assessment is the main assessment for employment and support allowance. The assessment will concentrate on what people can do, rather than only focussing on what they can't.
Dr Whiteford: To ask the Secretary of State for Work and Pensions how many incapacity benefit claimants were unable to undergo medical examinations in the Aberdeen trial area because they were unfit to travel. [13499]
Chris Grayling: Neither the Department nor its supplier, Atos Healthcare, collate information on the number of customers called to assessment that are unfit to travel.
However, for the period June 2010 to August 2010, one incapacity benefit customer, who would normally have been examined at Aberdeen Medical Examination Centre, was assessed by home visit. A home visit can be arranged by Atos Healthcare when a customer has difficulty travelling to the examination centre, e.g. due to the availability of public transport or fitness to travel.
Mr Laurence Robertson: To ask the Secretary of State for Work and Pensions what recent discussions he has had with those responsible for making medical assessments of eligibility for employment and support allowance for people with (a) Asperger's syndrome and (b) other parts of the autism spectrum on their training in making such assessments; what medical experience such assessors are required to have; and if he will make a statement. [14585]
Chris Grayling: Officials have discussed the training of healthcare professionals in relation to Autistic Spectrum Disorders with Atos Healthcare to ensure that they are able to conduct assessments for employment and support allowance to the required standards.
All Atos healthcare professionals conducting Employment and Support Allowance assessments receive training regarding Autistic Spectrum Disorders. The training is tailored to individual need but includes provision of information about Autistic Spectrum Disorders contained in evidence-based protocols for mental health conditions, a face to face "learning set" on Asperger's syndrome, a distance learning module on Asperger's syndrome and a DVD on autism.
Healthcare professionals are required to have a minimum of three years post-registration experience and this should include broad based medical practice in roles that have clear relevance to a career in disability assessment medicine. In individual cases, solely at the discretion of the DWP Chief Medical Adviser, the requirement that a healthcare professional must have a minimum of three years post-registration experience may be waived.
Dr Whiteford: To ask the Secretary of State for Work and Pensions what the value is of his Department's contract with Atos Healthcare; and when the contract will next be reviewed. [12280]
Maria Miller: The Department for Work and Pensions re-awarded Atos Origin IT Services Ltd., trading as Atos Healthcare, a new contract to perform medical services on behalf of the Department from 1 September 2005. The total cost of these services amounts to approximately £100 million per annum. This figure not only covers the total number of examinations undertaken across all benefits, but also costs relating to written and verbal medical advice, fixed overheads, administrative costs, investment in new technology and other service improvements. The contract covered a seven year period with an option to extend for a further five years and is therefore currently under review.
Dr Whiteford: To ask the Secretary of State for Work and Pensions whether (a) any disciplinary action has been pursued and (b) any complaints have been received and investigated by his Department in respect of Atos Healthcare in the last two years. [12281]
Chris Grayling: Following completion of investigations, if appropriate, a range of actions can be taken including remedial action which may involve re-training or removal from the list of approved health care professionals and employment terminated. Depending upon the findings of the investigation the General Medical Council may also be informed. A statistical breakdown is not available.
The Department as a whole does not keep statistics on the number of complaints made about Atos Healthcare, however Atos Healthcare themselves have received 7,476 complaints over the last two years. For the last quarter ending May 2010 the total complaints, which includes complaints relating to accommodation, staff and operational processes, compared to the number of medical assessments completed was 0.57%.
Dr Whiteford: To ask the Secretary of State for Work and Pensions what information his Department holds on any bonuses or incentives paid by Atos Healthcare to staff undertaking incapacity benefit and employment and support allowance medical assessments. [12282]
Chris Grayling: The role of the health care professional is to provide an independent, impartial assessment of the effects of a customer's illness or disability on their everyday lives. Neither Atos Healthcare nor their health care professionals receive any kind of bonuses or financial incentive in relation to the outcome of benefit claims.
Dr Whiteford: To ask the Secretary of State for Work and Pensions whether his Department plans to review the terms of the Medical Services Contract with Atos Healthcare in relation to the trial of reassessments for incapacity benefit and employment and support allowance medical entitlements. [12283]
Chris Grayling: The Department is currently negotiating the terms of the services to reassess incapacity benefit recipients.
Rachel Reeves: To ask the Secretary of State for Work and Pensions when he expects to (a) commence and (b) complete the reassessment of those in receipt of incapacity benefit; and what recent changes to this timetable there have been. [1907]
Chris Grayling: The process of moving incapacity benefit recipients onto a more active benefit regime and giving them the support they need is a serious priority.
We will be doing everything to complete this process as quickly as possible, while ensuring the most vulnerable are supported appropriately.
We will be testing and learning from a small scale trial, which will run from October 2010. Full migration will begin in early 2011. We expect it to be completed over three years. There have been no recent changes to this timetable.
Mr Bain: To ask the Secretary of State for Work and Pensions what the timetable is for the Government's planned re-assessment of all current claimants of incapacity benefit for their readiness to work; and whether any targets have been set for the number of people to be removed from incapacity benefit through this re-assessment. [2162]
Chris Grayling: We will be testing and learning from a small scale trial which will run from October 2010. Full migration will not begin until April 2011. We expect it to be completed in 2014.
All claimants will be removed from incapacity benefits. No targets have been set regarding which benefit claimants will be placed. They will be moved onto either Employment and Support Allowance or other benefits appropriate to their circumstances.
It is worrying that the recommendations of the Parliamentary Inquiry Spring 2010, that the finding by CAB Scotland that the ESA is "Unfit for purpose" and the views of Mt Danny Alexander MP, now Minister appear to be ignored.
This is the Government that enacted the Welfare Reform Act.
These are pertinent extracts from Parliament written answers and debates reported by Hansard.
Jenny Willott: To ask the Secretary of State for Work and Pensions what the highest and lowest salaries were paid to (a) doctors and (b) nurses on (i) part-time and (ii) full-time contracts by Atos Healthcare for the purpose of undertaking incapacity benefit and/or employment and support allowance assessments under her Department's contract with Atos Origin in each of the past five years; and if she will make a statement. [324313]
Jonathan Shaw: The DWP do not hold any information regarding the amounts paid to Atos Healthcare staff.
The setting of salaries is a matter between the provider and their employees.
Jenny Willott: To ask the Secretary of State for Work and Pensions what the average number of days worked by (a) doctors and (b) nurses employed on part-time contracts by Atos Healthcare for the purpose of undertaking incapacity benefit and/or employment and support allowance assessments was under her Department's contract with Atos Origin in each of the last five years; and if she will make a statement. [324314]
Jonathan Shaw: The information requested is not collated centrally and could be provided only at disproportionate cost.
Jenny Willott: To ask the Secretary of State for Work and Pensions what the average salary paid to (a) full-time and (b) part-time contracted (i) doctors and (ii) nurses by Atos Healthcare for the purpose of undertaking incapacity benefit and/or employment and support allowance assessments was under her Department's contract with Atos Origin in each of the last five years; and if she will make a statement. [324315]
Jonathan Shaw: The DWP do not hold any information regarding the amounts paid to Atos Healthcare staff.
The setting of salaries is a matter between the provider and their employees.
Jenny Willott: To ask the Secretary of State for Work and Pensions how many (a) doctors and (b) nurses were employed (i) part-time and (ii) full-time by Atos Healthcare for the purpose of undertaking incapacity benefit and/or employment and support allowance assessments under her Department's contract with Atos Origin in each of the last five years; and if she will make a statement. [324316]
Jonathan Shaw: The information is as follows:
(a) (i) The number of contracted (sessional) part-time doctors employed by Atos Healthcare is as follows:
End February 2010-644
End February 2009-758
End February 2008-880
End February 2007-978
Please note that not all contracted doctors will undertake ESA/IB assessments-however at February 2010 there were 539 who were.
(a) (ii) The number of doctors who are full-time medical advisers (FTMA's) employed by Atos Healthcare for the completion of ESA/IB medical assessments expressed as full-time equivalents.
End February 2010-242
End February 2009-239
End February 2008-243
End February 2007-240
Full-time equivalents are those doctors who work directly for Atos Healthcare but may have different working patterns.
(b) (i) There are no nurses employed by Atos Healthcare as contracted (sessional) nurses.
(b) (ii) The number of nurses employed by Atos Healthcare for the completion of ESA/IB medical assessments expressed as full-time equivalents.
End February 2010-265
End February 2009-181
End February 2008-104
End February 2007-41
I may be misreading the Contract but it seems that the information that could not be provided only at disproportionate cost is a part of the management reports that must be provided as a contractual obligation as part of the Contract. The Contract specifies this information should be provided in electronic form which usually means it can be provided at minimal cost.
Annette Brooke (Mid-Dorset and North Poole) (LD): ...
The Dorset ME support group says that in its experience, the high number of people with CFS/ME being found fit for work under the employment and support allowance regulations leads to a high number of appeals, presumably at considerable cost to the taxpayer. It states:
"Within the Dorset ME Support Group, all our ESA Appeals so far have been successful suggesting that the assessment system is not fit for purpose where people with ME is concerned. Disability Analysts are trained to look at the disability and not the nature of the condition... Joined up government seems to be lacking."
Mr. Hancock: To ask the Secretary of State for Work and Pensions how many benefit claimants have been assessed by Atos Healthcare (a) since the start of their contract and (b) in the last 12 months. [311194]
Jonathan Shaw: The Department cannot state the number of individual claimants that have been assessed by Atos Healthcare since the start of their contract as data are not kept at that level.
The total number of completed medical reports carried out by Atos Healthcare in the period requested is as follows:
1 January to 31 December 2009 - 1,003,189
Notes: (Source: Atos Healthcare.)
1. The data refer to all services including but not limited to ESA, War Pensions, IIDB.
2. Figures provided relate to both exam and paper scrutiny.
3. Figures include multiple referrals for individuals e.g. re-referrals.
Mr. Oaten: To ask the Secretary of State for Work and Pensions with reference to the answer of 10 November 2009, Official Report, column 300W, on Jobcentre Plus: training, what qualifications and experience Atos Healthcare professionals are required to have before making medical assessments on individuals' fitness for work. [303658]
Jonathan Shaw: The approved health care professionals' (HCPs) role is to carry out an assessment of the functional effects of the customer's disabling condition, and to utilise the information gathered to provide the decision maker with an impartial and independent assessment.
Atos doctors must be fully registered with the General Medical Council without current or previous restrictions, conditions or warnings and hold a licence to practice from the date the GMC issues licences. In addition they must have at least three years post full registration (GMC or EEA-European Economic Area equivalent) experience as a minimum. Alternatively for non EU graduates three years post full registration experience in the doctors native country is required. In individual cases, solely at the discretion of the CMA, the requirements that no conditions or warnings be attached to registration and that the doctor must have a minimum of three years post registration experience, may be waived.
Atos nurses must be fully registered (level 1) Registered General Nurses without current or previous restrictions or cautions with the Nursing and Midwifery Council. In addition they must have at least three years post full registration experience. In individual cases, solely at the discretion of the CMA, the requirements that no cautions be attached to registration and that the nurse must have a minimum of three years post registration experience, may be waived.
Atos Healthcare HCPs are specifically trained to provide decision making authorities with independent, accurate and authoritative advice and reports on the effects of disability.
Initial Training-varies in detail according to which benefit is involved. However all such training follows a similar basic pattern, as follows:
Theoretical Training-Theoretical training commences with a trainer-led theory-based course usually delivered to a group of trainees in a classroom setting. Trainees who are new to the work of Atos Healthcare will receive instruction in such areas as disability analysis, customers rights, equal opportunities and professional standards. Detailed technical information relevant to the benefit concerned is provided. All Atos health care trainers have undergone specific training to prepare them for the role, including practical sessions to enhance their understanding of how adults learn.
Practical Training-Practical Training is the work undertaken by the new recruits that is produced in a controlled environment. For examination centre based assessments the trainee is supervised and appraised by an experienced medical adviser as they complete their introductory cases. In the domiciliary visit based benefits the initial cases are monitored immediately on return to allow feedback to be given without delay.
Demonstration of understanding assessed by multiple choice examination-for incapacity benefit, employment and support allowance and disability living allowance the trainee is required to attain a pass mark in a multiple choice questionnaire before they are allowed to proceed to the practical training. The questionnaire includes questions on the whole range of topics covered in the training course.
Demonstration of understanding by audit-In all benefits the initial cases produced by the trainee are target monitored by an experienced medical adviser and the training cannot be considered as complete until the HCP has demonstrated that their work is acceptable. Whenever any problems are identified appropriate feedback is provided. Further cases are monitored until the work is shown to be satisfactory. If the situation is not rectified the HCP may be required to repeat the entire training process. Continued lack of progress will result in the HCP being offered no further training and no further work.
Approval-All HCPs must be approved by the chief medical adviser to the DWP and separate approval is required for each benefit area in which the HCP is involved. Approval is dependent on successful completion of all stages of their training process and ongoing demonstration that the work being carried out meets a satisfactory standard.
Written Guidelines-As part of the trainees training and ongoing support, HCPs are issued with guidelines pertaining to the benefit involved. These guidance notes provide specific technical advice about the benefit concerned, outline best practise and contain general advice about disability analysis and service to the people with disabilities.
The assessment carried out is different to the more usual type of medical examination in which the HCPs aim is to make a diagnosis and decide on appropriate treatment. A GP or specialist is not usually trained in disability assessment medicine and therefore will often not have specific experience in assessing the disabling effects of medical conditions and the way in which a customer's illness or disability affects them in carrying out of a range of everyday work-related activities. As well as this difference in emphasis within the assessment process, the HCP will, when giving an opinion, be aware of the law relating to benefit entitlement. A specialist on the other hand is less likely to be familiar with the law.
In order to provide independent, accurate and authoritative advice and reports it is not necessary for HCPs to hold specialist registration with the General Medical Council. The DWP chief medical adviser approves HCPs to carry out assessments. Approval is dependent on strict recruitment criteria, completion of a course of training in disability assessment medicine approved by the CMA and evidence of satisfactory performance.
Minimum experience criteria for recruitment are laid down both employed and contracted HCPs.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I beg to move,
That this House recognises the vital support that attendance allowance and disability living allowance provide for people with disabilities; notes that these benefits are intended to meet the additional costs of living with an impairment or long-term health condition; further notes with concern that approximately 2.87 million people in the UK who receive disability living allowance or attendance allowance are not eligible for social care services; acknowledges that some 20,000 individuals have petitioned the Prime Minister and many more have petitioned individual hon. and right hon. Members to ensure that these benefits are secured; welcomes the Government's announcement that disability living allowance for people under 65 years will not be scrapped; and urges the Government to ensure that attendance allowance and disability living allowance for people aged 65 years and over are secured and not abolished as part of any future reform of the social care system.
Labour, led by Andy Burnham, defeated this Conservative and Liberal Democrat attempt to prevent these allowances be scrapped. The list of Labour MPs who voted against can be found here. http://www.publications.parliament.uk/pa/cm200910/cmhansrd/cm091208/debtext/91208-0013.htm
Mr. Jenkin: To ask the Secretary of State for Work and Pensions whether decisions relating to individuals' requirements for a second medical assessment for employment support allowance may be made by persons other than Ministers; and if she will make a statement. [298088]
Jonathan Shaw: Customers dissatisfied with a medical examination undertaken by the DWP medical services provider, Atos Healthcare, are advised to contact the Atos Healthcare national customer relations team with their concerns. All complaints of dissatisfaction with a medial examination received by Atos Healthcare are investigated and complaints which relate to the medical examination are scrutinised by an experienced senior disability analyst doctor to ensure that the medical report is reasonable and justifiable. Where a medical report is found to be deficient, the national customer relations team at Atos Healthcare will advise the DWP decision maker of the deficiencies. It is the DWP who are responsible for requesting Atos Healthcare to undertake a secondary medical examination if they feel it is necessary.
Mr. Harper: To ask the Secretary of State for Work and Pensions how many and what proportion of claimants of employment and support allowance had completed their work capability assessment within (a) one and four weeks, (b) five and eight weeks and (c) nine and 13 weeks of the start of their claim on the latest date for which figures are available; what the average waiting time has been for a work capability assessment for claimants of employment and support allowance to be concluded; and what the average time taken between the undertaking of a work capability assessment and a decision maker's decision was. [295517]
Jonathan Shaw [holding answer 26 October 2009]: The latest reliable cohort of ESA claims were for claims starting in April 2009. We use this cohort to estimate Atos advice timings of the assessment process:
There were 100 (1 per cent.) completed within four weeks.
An additional 2,100 (8 per cent.) were completed between five and eight weeks.
An additional 9,700 (37 per cent.) were completed between nine and 13 weeks.
Customers are able to backdate claims to before they first contact Jobcentre Plus and backdating was on average two weeks for incapacity benefit and it is expected that this will be the same for ESA. Therefore, the figures above show the technical time between when the claim was made and the completed Work Capability Assessment but the true time that Jobcentre Plus and Atos have to work cases may be shorter.
A more accurate reflection of the amount of cases that pass through the process within 13 weeks would be determined by taking into account factors, such as, the time taken to return paperwork, whether their condition can be assessed on paper based evidence alone, whether further medical evidence is required or requested and whether a customer actually attends their initial appointment or it has to be re-scheduled. This information is not currently available but we will continue to undertake analysis of performance as the ESA regime beds in.
We do not hold information centrally on the time taken from Atos providing medical advice to the JCP decision maker's final decision.
Figures are rounded to the nearest 100 and percentages are rounded to the nearest whole number.
Notes:
Data are based on time from claim start to completion of advice provided by Atos Healthcare. ESA claimants can backdate their claim before the time they first contact Jobcentre Plus to make a claim. Timings will therefore include any backdating of claims. For IB claims the average length of time claims were backdated was around two weeks and we expect the length to be similar for ESA claims. We do not hold information centrally on the time taken from Atos advice to the JCP decision maker's final decision.
WCA assessments take a number of weeks to complete and will assess a broad range of people whose assessments will take longer or shorter to complete depending on the details of their claim, such as: time taken to return paperwork, whether their condition can be assessed on paper based evidence alone, whether additional evidence is required and whether a claimant attends their initial appointment or it has to be re-scheduled. This inevitably means there are a number of claims in any cohort which are still outstanding many weeks after the start of the claim. The response takes a pragmatic approach by using the latest cohort we can reliably use that we do not expect includes a large number of un-cleared cases (by comparison with earlier cohorts which are more fully cleared), i.e. ESA claims which began in April 2009. Theses timings may change slightly if we reassess them at a later date as more assessments are completed.
Mrs. May: To ask the Secretary of State for Work and Pensions
(1) when she plans to introduce (a) a skills screen for employment and support allowance claimants after the start of a claim and (b) a mandatory skills health check at a later point in their claim when appropriate; [298777]
(2) when she plans to introduce pilots for mandatory skills health checks for long-term jobseeker's allowance claimants; [298783]
(3) when she plans to introduce a skills screen for all new jobseeker's allowance claimants; [298784]
(4) how many and what proportion of new lone parent income support claimants have attended a full skills health check; [298788]
(4) how many and what proportion of new lone parent income support claimants have received a skills screen as part of their work focused interview. [298790]
Jim Knight: Skills screening has already been introduced for all new jobseeker's allowance claimants. In the 12 Jobcentre Plus districts involved in trialling integrated employment and skills services, JSA claimants who have not attended a skills health check on a voluntary basis by week 26 of their claim are mandated to do so.
Lone parent customers are not encompassed by IES trials activity and therefore do not receive skills screening or a referral to skills health checks. Although lone parent income support claimants may attend a skills health check on a voluntary basis, no data is currently collected.
No decisions have as yet been made about the introduction of skills screening and health checks for customer groups other than JSA claimants. This will be considered as part of planning for the national implementation of an integrated employment and skills service for JSA customers in 2010-11.
Jenny Willott: To ask the Secretary of State for Work and Pensions what estimate she has made of the average (a) cost of carrying out and (b) time taken to carry out a work capability assessment for the Employment Support Allowance; and if she will make a statement. [294032]
Jonathan Shaw: It is not possible to supply the cost of medical examinations. This is because if the information was disclosed it would prejudice the commercial interests of the Department for Work and Pensions (DWP) and/or Atos Healthcare IT Services Ltd., the Medical Services contractor. This falls under the exemption in section 43 of the Freedom of Information Act.
The time taken to carry out a work capability assessment (WCA) for employment support allowance varies dependant on the customer's medical condition. This is because the examining health care professional's (HCPs) aim is to obtain the necessary information that is required by the Decision Maker, whose task it is to make the decision on benefit entitlement. The examination will therefore take as long as necessary to obtain sufficient information for the purpose of determining entitlement to benefit.
Mrs. Moon: To ask the Secretary of State for Work and Pensions pursuant to the answer of 22 June 2009, Official Report, column 684W, on social security benefits: medical examinations, how many of the health care professionals against whom complaints were made under the heading claimants experiences were the subject of more than one complaint and how many health care professionals have been (a) disciplined and (b) dismissed. [283836]
Jim Knight: Further to the answer of 22 June 2009, there were 15 health care professionals against whom complaints were made under the heading claimants experiences were the subject of more than one complaint.
20 July 2009 : Column 839W
The number of health care professionals that have been (a) disciplined is nil and (b) dismissed is nil.
Mr. Harper: To ask the Secretary of State for Work and Pensions what estimate her Department has made of the average cost of re-assessment of an existing incapacity benefit claimant as part of the programme to migrate the current incapacity benefit population onto the employment and support allowance by 2013; and how much her Department plans to spend on assessing the existing incapacity benefit population in (a) 2009-10, (b) 2010-11, (c) 2011-12 and (d) 2012-13. [288519]
Jonathan Shaw: The average cost of a medical assessment for an incapacity benefits claimant is commercially sensitive and can not be provided.
Planned expenditure on medical assessments for existing incapacity benefits customers is detailed in the following table.
2009 - 2010 £20 million
2010 - 2011 £45 million
2011 - 2012 £35 million
2012 - 2013 £35 million
Notes:
Figures include the planned expenditure on reassessing incapacity benefits claimants under the Personal Capability Assessment and the additional funding to reassess incapacity benefits customers under the Work Capability Assessment.
Figures are rounded to the nearest £5 million.
Tom Brake: To ask the Secretary of State for Work and Pensions what mechanisms her Department has in place to monitor the accuracy and quality of work carried out for her Department by medical assessors. [284573]
Jonathan Shaw: The contract between DWP and Atos Healthcare contains a number of quality targets to measure the performance of health care professionals (HCPs) which are monitored on a monthly basis. Quality and accuracy is regularly monitored through a variety of other methods including monthly management information, customer satisfaction surveys and feedback from complaints. The work of all HCPs is subjected to quality audit which is conducted by experienced medical auditors within Atos Healthcare. The quality of Atos Healthcare's audit is validated by senior medical auditors from Atos Healthcare and doctors working for the Chief Medical Adviser to the DWP.
Tom Brake: To ask the Secretary of State for Work and Pensions what minimum qualifications are required of medical assessors working for her Department. [284574]
Jonathan Shaw: The contract between DWP and Atos Healthcare specifies minimum recruitment standards that all approved health care professionals (HCPs) must be fully registered with the General Medical Council or Nursing and Midwifery Council without restrictions or conditions and complete a course of training in disability assessment medicine approved by the DWP Chief Medical Adviser (CMA). In addition they must have a minimum of three years post registration experience. In individual cases, solely at the discretion of the CMA, the requirement that no conditions be attached to registration and the requirement that health care professionals have a minimum of three years post registration experience may be waived. In addition all HCPs must be approved by the CMA to the DWP.
The term health care professionals (HCP) covers both registered doctors and registered nurses who conduct medical assessments on behalf of the DWP
Tom Brake: To ask the Secretary of State for Work and Pensions what the cost was of medical assessments carried out by Atos Health on behalf of her Department from 1 March 2008 to 28 February 2009. [284572]
Jonathan Shaw: The Department for Work and Pensions re-awarded Atos Origin IT Services Ltd., trading as Atos Healthcare, a new contract to perform medical services on behalf of the Department from 1 September 2005.
The total cost of these services from 1 March 2008 to February 2009 was £80,589,204. This figure not only covers the total number of examinations undertaken across all benefits, but also costs relating to written and verbal medical advice, fixed overheads, administrative costs, investment in new technology and other service improvements.
The individual cost of medical assessments carried out by Atos Healthcare is commercially sensitive information. To disclose this information would prejudice the interest of Atos Healthcare and the Department's future dealings with Atos Healthcare or other service providers.
Martin Horwood: To ask the Secretary of State for Work and Pensions what special training is received by doctors contracted by his Department to carry out personal capability assessments in severe and enduring mental health problems. [160762]
Mrs. McGuire: The doctors who are contracted by Atos Healthcare to carry out personal capability assessments on behalf of this Department receive comprehensive benefit-specific training across the full range of conditions and disabilities, including mental health conditions, before they can carry out medical examinations, assessments or give advice regarding benefit claims.
The training enables them to carry out personal capability assessments whatever the customer's condition or disability, as it concentrates on gathering and evaluating information and using it to determine and explain the functional effects of a person's condition so that a decision maker can use that information to decide entitlement to benefit. Doctors are only approved to carry out this work once they have demonstrated full competence, and the quality of their work will continue to be monitored to maintain high standards. Specific training modules are delivered that cover mental health problems and doctors are provided with evidence-based medicine guidance modules in specific mental health conditions and on learning disabilities.
Martin Horwood: To ask the Secretary of State for Work and Pensions how many personal capability assessments were carried out by Atos Healthcare for his Department in the last year for which figures are available; and how many of these were reviewing (a) mental health, (b) physical health and (c) both mental and physical health. [160763]
Mrs. McGuire: In the 12 months to September 2007, Atos Healthcare undertook 528,380 personal capability assessments. Information about the number of assessments that were reviewing mental or physical health is not available as it is not possible to break the figure down by incapacity.
The Department for Work and Pensions publishes press releases and those published by the previous Government.
The purpose of the Independent Case Examiner is to act as an independent referee for people who feel that the following Government Agencies or Businesses have not treated them fairly or have not dealt with complaints in a satisfactory manner. http://www.ind-case-exam.org.uk/
The Institute for Employment Studies (IES) aim to improve employment policy in the UK and internationally by carrying out authoritative research of practical relevance to policy makers and those responsible for implementing policy programmes and initiatives. http://www.employment-studies.co.uk/main/index.php
In June 2010, the new Government published all salaries of individuals working in the public sector that were greater than that of the Prime Minister.
These were published by the Cabinet Office (http://www.cabinetoffice.gov.uk/).
| Sir Leigh Lewis | Permanent Secretary | Permanent Secretary | £195,000 - £199,999 |
| Hunada Nouss | Finance Director | General Director General | £165,000 - £169,999 |
| Joe Harley | IT Director General & Chief Information Officer | Director General | £245,000 - £249,999 |
| Chris Last | HR Director General | Director General | £180,000 - £184,999 |
| Mel Groves | Project Director, Welfare & Wellbeing (Left 30 April 2010) | Director General | £175,000 - £179,999 |
| Stephen Holt | Director of Change Management | Director | £160,000 - £164,999 |
| Bill Gunnyeon | Director of Health Work and Wellbeing, Chief Medical Adviser and Chief Scientist | Director | £155,000 - £159,999 |
Professor Paul Gregg, of Bristol University (http://www.bristol.ac.uk/economics/staff/gregg.html) designed the ESA back-to-work programmes.
One of the architects of a new benefit system for disabled people has urged the Government to delay rolling it out after evidence that medical tests are wrongly finding thousands of people fit for work....
"...we are hearing a lot of anecdotal evidence and factual evidence in terms of what is happening to claimants of the new benefit to say that we have got a serious problem here and we need to rectify it before it starts being applied to the large stock."
Prof Gregg warned that 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," said Prof Gregg. "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 were there is a specially designed programme for people with health problems."
http://www.google.com/hostednews/ukpress/article/ALeqM5iVSvlBmu9ve03DBOwYy_cziUWvOw
I emailed Professor Gregg on 21 June 2010.
I believe you were involved in the detailed planning as to how Employment Support Allowance should be implemented.
I have a primary brain tumour. I have provided written evidence to the Parliamentary Inquiry. I have published in detail my experience see http://www.whywaitforever.com/dwpatos.html.
I would welcome your comments. In particular can you explain why the DWP appears to be reticent to enforce the clauses in the contract. I have published parts of the contract obtained under the Freedom of Information Act. Was it your intention to hide from the patient the medical conditions which meant a face to face assessment was not necessary? Was it your intention to hide from the patient the medical conditions which meant the GP or consultant of the patient needed to be contacted?
As the ESA50 includes the medical conditions and the ESA85 has the name of the medical assessor, do you think an audit should be carried out by the NAO to see how many face to face assessments were in breach of contract and how many assessments were unsound? Will you consider adding your name to http://www.gopetition.com/petitions/sack-atos-healthcare.html?
What are you going to do to improve matters?
I look forward to hearing from you.
Professor Gregg emailed me back within a short period of time.
Your information about my involvement in the design of ESA is inaccurate. 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.
Best wishes