The flaws in the Employment and Support Allowance (ESA) system are so grave that the appointment of a new contractor to carry out the Work Capability Assessment (WCA) will not solve the problems, MPs have said.
The Work and Pensions Committee’s critical report calls for the Government to undertake a fundamental redesign of the ESA end-to-end process to ensure that the main purpose of the benefit – helping claimants with health conditions and disabilities to move into employment where possible – is achieved. This should happen before 2018, it added.
In the meantime, the Committee recommends a number of changes which the Department for Work and Pensions (DWP) should make now, to help ensure that claimants receive an improved service, and that the outcomes for claimants are more appropriate.
Dame Anne Begg MP, committee chair, said: “Many people going through the ESA claims process are unhappy with the way they are treated and the decisions which are made about their fitness for work. The current provider of the WCA, Atos, has become a lightning rod for all the negativity around the ESA process and DWP and Atos have recently agreed to terminate the contract early.
“But it is DWP that makes the decision about a claimant’s eligibility for ESA – the face-to-face assessment is only one part of the process. Just putting a new private provider in place will not address the problems with ESA and the WCA on its own.
“We are therefore calling for a number of changes which can be made to improve ESA in the short-term, while also recommending a longer-term, fundamental redesign of the whole process.
“We hope that the new Minister for Disabled People [Mark Harper]… will respond positively to our constructive recommendations for improving the ESA process.”
Change needed now
Changes recommended by the committee include ensuring the ESA process properly identifies claimants’ health barriers to employment and the particular support they need, so that the conditionality that they are subject to and the employment support they receive can be tailored more closely to their circumstances.
In addition, the descriptors used in the WCA process should also be reviewed as part of the redesign, as concerns about their effectiveness, and the way they are applied, remain, despite the recent review commissioned by DWP.
Another recommended change is that DWP proactively seeks ‘supporting evidence’ on the impact of a claimant’s condition or disability on their functional capacity, rather than leaving this primarily to claimants, who often have to pay for it. The report says the DWP should seek this evidence from the most appropriate professionals, including social workers and occupational therapists, rather than relying so heavily on GPs.
Begg admitted that resigning ESA cannot happen “overnight” but said that the system needs to be improved now “because it is clearly causing claimants considerable distress and anxiety.”
She cited the re-letting of the contract to undertake the WCA as an opportunity to address some of the problems. For instance, the new contract should set out robust and clear service standards on the quality and timeliness of assessments and the reports produced by the contractor, and for the way claimants are dealt with.
“DWP has acknowledged that this will cost more money, but this is justified if the service provided by the new contractor is better,” Begg said. “To ensure this is the case, DWP needs to rigorously monitor the service standards to ensure they are being met and to take immediate action, including imposing penalties, if they are not. This has not always happened with the Atos contract.
“The changes we recommend include ensuring that, where possible, paper-based assessments are used to place people in the Support Group, rather than requiring them to go through a WCA, where their health condition or disability clearly has a severe impact on their capability to work. Unnecessary and too frequent reassessments should also be avoided.
“DWP should also improve the way it communicates with claimants – at the moment, the letters that are sent to claimants are too technical and complex. They need to be in plain English and avoid using jargon. The terms “limited capability for work” and “limited capability for work-related activity”, which are currently used to categorise claimants, are too confusing and DWP needs to find more meaningful alternatives.”
Tom Pollard, policy and campaigns manager at mental health charity Mind, welcomed the report. “Nearly half of people who are currently receiving ESA do so because of a mental health problem and we agree with the recommendation that the Work Capability Assessment needs to be urgently reformed in order to assess people fairly and accurately. The current assessment fails to take full account of the impact having a fluctuating condition such as a mental health problem can have on someone’s ability to work.
“The assessment process is just one small part of an entire system which is failing to provide people with the support they need. The vast majority of people with mental health problems want to work, but they need tailored, personalised support to overcome the barriers they face - from their confidence and skills through to employers’ attitudes and the support available in the workplace. Many people are being forced to undertake activities in order to receive ESA, but rather than helping people back to work, this often creates immense anxiety and can damage their health, pushing them further from work.”