10 August 2006
In a newsletter for tribunal members, Nick Warren, Regional Chairman of the North West Region of the Appeals Service, slammed the incapacity medical reports produced by Atos Origin Medical Services computers. In an embarrassing rebuff to the DWP and their multinational partners, the qualified solicitor branded the reports 'questionable', 'incomplete', 'curious' and containing 'absurdity'. He also revealed that credible claimants rarely have difficulty in beating the medical evidence at incapacity tribunals and raised questions about the training of Medical Services doctors.
The criticisms are contained in an article on evaluating evidence and writing statements in Judicial Information Bulletin Issue 20, dated March 2005. The Bulletin is circulated to all panel members who sit on appeal tribunals. A copy of the Bulletin, none of which are made available to the public, has been seen by Benefits and Work.
In his article, Nick Warren explains that tribunals are now starting to see the computerised medical reports and goes on to say that "they seem to make it more difficult to entirely adopt the reasoning of the PCA medical examiner." Which seems to be a polite way of saying that it's difficult to trust the reports.
One of Mr Warren's objections is that "The certificate at the end states not that the scoring is in accordance with the doctor's expert medical opinion, but that it is in accordance with guidance from DWP." In other words, the doctor may be putting DWP rules before their own medical expertise.
Mr Warren goes on to question how much attention Medical Services doctors pay to their own reports, pointing out that "Curious judgments appear in the text, for example that a person who due to mental illness never leaves the house alone has a life only "mildly" affected by it. The impression is that doctors do not read their reports as a whole before pressing the button."
He also questions what appear to be legal judgements made by the computer software: "Some reports include a standard phrase to the effect that an appellant's physical limitations may appear greater because of interaction with depression but this is to be accounted for in the mental health descriptors, not in the physical descriptors: a questionable proposition".
Finally, the Regional Chair points out that in computerised medical reports "Too often the history is incomplete or contains absurdity."
Claimants beat the evidence
It's hardly surprising then, that Mr Warren is of the opinion that claimants are in with a very good chance of winning incapacity appeals. He tells his readers that "A credible appellant who does not exaggerate rarely has difficulty in beating the medical evidence." This should be encouraging news for any claimant or representative.
Mr Warren clearly has little time either for the claim, often made by the DWP and parroted by some tribunal chairs, that Medical Services doctors are 'objective, disinterested, specially trained experts.' He points out that Social Security Commissioners want to be sure that tribunals have looked at the evidence properly rather that taking the easy route of 'slavish adherence' to pat phrases. He explains that:
"I am never quite sure what "objective" means in this context. I am also sceptical of the reference to "training" when the tribunal has no knowledge of the training except that it is supplied exclusively by the Secretary of State, one of the parties to the proceedings."
The revelation that one of the seven Regional Chairmen of the Appeals Service, who sit directly below President Judge Michael Harris in the judicial hierarchy, has such a low opinion of PCA medical reports will be deeply embarrassing both for the DWP and for Atos Origin Medical Services. That he felt confident enough to voice his opinions in a newsletter read by every member of every appeal panel in the UK suggests that it is a widely accepted and uncontroversial view.
Benefits and Work's only regret is that we weren't aware of Mr Warren's views before Atos Origin were awarded the Medical Services contract for the second time in 1995. However, we are now applying for a copy of the newsletter under the Freedom of Information Act and we will do our best to remind MPs of these views before the next contract is awarded.