12 April 2007
The identities of the people involved in making it much harder for claimants with mental health conditions to be found incapable of work are being kept secret by the DWP, leading to fears of strong private sector influence in the process.
Employees of both Unum Provident and Atos Origin are involved in the 'transformation' of the Personal Capability Assessment. Welfare rights experts condemned the new test as 'unworkable' and warned that it would harm vulnerable claimants' mental health.
In February of this year Benefits and Work revealed that just four months after details of a new 'transformed' test of incapacity for work were published, the mental health test had been revised again to make it a great deal more difficult to pass. The number of activities had been cut from 15 to just 10 and many descriptors had been rewritten to drastically reduce the possibility of claimants scoring points. (See: Clampdown on future mental health claimants 12.02.07)
Benefits and Work has now obtained a copy of minutes of a meeting of the PCA Mental Health Working Party held on 30 November 2006 at which it was decided to make the mental health test much harder to pass. However, the DWP have removed the names of the participants other than those of Moira Henderson and Richard Birkin, both senior DWP officials.
At the meeting it was explained that Moira Henderson and two unnamed people spent the day of 30th October 2006 looking at medical reports produced using the proposed new personal capability assessment. 105 cases were submitted for assessment, but the team had only time to evaluate just over half of them. Astonishingly, this was considered sufficient research to recommend huge changes to the test at a subsequent meeting on 30 November.
Two unnamed representatives of the PCA physical technical working group were at the meeting on 30 November along with members of the mental health group. The meeting had been called by Moira Henderson to discuss the mental health descriptors because 'it was anticipated that there could be major amendments whereas there was [sic] only minor amendments to the Physical descriptors'. The decision not to make major changes to the new physical health test was almost certainly based on the fact that considerably fewer of the evaluated claimants passed this test, whereas more claimants with mental health conditions were found incapable of work under the new test compared to the current one.
Some present at the November meeting appeared to consider that the new mental health test was an improvement whilst others considered that some cases 'had enormous scores which significantly showed overlap' and that 'Panic attacks was not a function impairment and he did not agree that it should be included'.
The minutes then show that 'It was agreed to delete the descriptors Ability to communicate appropriately with other people, Emotional resilience, Maintaining appearance and hygiene and Panic attacks and incorporate some of them in other descriptors.' A decision on whether 'frequency' should be defined in terms of daily, weekly or monthly could not be reached and this was passed on to the DWP's lawyers to consider.
The combination of changes made by the working group and by lawyers mean that the latest version of the mental health test will be very much harder to pass.
'The whole essence of the test has changed,' said Judy Stenger, mental health welfare rights adviser and author of the 'Big Book of Benefits and Mental Health'
'More than once a week is translated as most of the time, a specified place has become a place which is familiar, support has become the physical presence of another person and the ability to get to an appointment has been dropped altogether.
'In fact there have been 70-odd changes made by DWP legal experts across the descriptors, all of which seem to make it harder for claimants to secure sickness status because of their mental health.
'Vulnerable claimants who would have been deemed unfit for work in the eyes of experts will now find themselves forced to negotiate the considerable challenges of survival as Jobseekers. And it won't just hurt people's pockets, it will also harm their mental health.'
Alan Markey, Chair of the National Association of Welfare Rights Workers also condemned the changes:
'The new test is unworkable. It's difficult enough for experienced advisers to make sense of some the descriptors as defined by the Regulations. Take for example "Is unaware of impact of own behaviour to the extent that: has difficulty relating to others even for brief periods, such as a few hours, or causes distress to others on a daily basis or misinterprets verbal or non-verbal communication to the extent of causing significant distress to himself on a daily basis". What hope do claimants have?'
Conflict of interest
Benefits and Work has challenged the refusal of the DWP to identify those responsible for the sweeping changes made to the test. Unum Provident are a health insurance company who may benefit financially if fewer people are found incapable of work. Atos Origin Medical Services administer the test on behalf of the DWP and may benefit if the mental health test has fewer activities and is thus quicker and cheaper to administer. Employees of both companies are on the groups making changes to the personal capability assessment. We believe that claimants have a right to know what part, if any, was played by these individuals in changes to the mental health test and what steps were taken to ensure that no conflict of interests arose.