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13 January 2011

Three leading charities have submitted proposals for changing the mental health test for employment and support allowance (ESA).  However, the proposals run the risk of making things worse for claimants and, at the same time, the charities may have already fatally undermined any influence they once had.

Mind, Mencap and the National Autistic Society (NAS) were asked  by Professor Harrington, who carried out the recent review of the work capability assessment, to come up with ideas for improving the mental health test for ESA.

The charities have now submitted a 34 page document to Harrington which will be scrutinised and then passed on to ministers.

The charities have not suggested any radical reform of the test. 

Instead they have argued for keeping the current activities broadly as they are, but switching to a very much more complex scoring system. 

Under the current system there are ten mental health activities with 51 descriptors for which points can be scored.

Under the proposed changes the combination of possible scoring descriptors would rise almost fivefold to 225.

This complexity is achieved by having three sets of scores for most activities and then multiplying them together to come up with a final score for that activity.  For example:

1) Learning Tasks:

a) Has difficulty learning tasks that are:
simple (3)
moderately complex (2)
complex (1)

b) To the extent that learning such a task is:
impossible (3)
very difficult (2)
difficult (1)

c) After learning the task, they would be able to repeat it no more than
a day later (3)
a week later (2)
a month later (1)

Descriptor scoring:
If axbxc is less than 4 = 0 points
If axbxc is between 4 and 8 = 6 points
If axbxc is between 9 and 12 = 9 points
If axbxc is more than 12 = 15 points

Such a complex scoring system, adapted from an Australian model, would lead to extremely complicated claim forms – if they were to truly reflect the scoring system.  Appeals would also be likely to be much more arduous with so many more variables potentially open to dispute.  And, with the proposed cuts to legal aid, claimants would struggle to find advisors who had a clear understanding of the scoring system.

Potentially, the proposed scoring system is much more flexible and could lead to better outcomes for claimants.  But as the three agencies admit themselves in their report, the DWP could adopt their system but simply raise the minimum number of points needed, leaving claimants no better off.  Indeed, such a flexible and complex scoring system would allow the DWP to continually tinker with and fine tune the points needed for an award, in order to get precisely the number of failed ESA claims that suited their budget at any given time.

Rather than accepting that it is reasonable to use computer guided assessments and a points system, this was an opportunity for these agencies to ask for a radical overhaul of the entire work capability assessment.  This might have included insisting that compulsory activities and benefits sanctions have no place in a system intended to help and support people with mental health conditions and learning difficulties into work.

In theory, the voluntary sector are not without bargaining power at the moment: the Coalition is desperate for charities to be heavily involved as subcontractors in the Work Programme to be introduced later this year in order to give it legitimacy.

If the chief executives of all the major charities had refused to be involved in the Work Programme without a radical overhaul of the WCA that would have exerted considerable pressure on the government.  This would not have been unreasonable, given that, in their report, the three charities say plainly of the current work capability assessment that:

It is mechanistic, impersonal and inflexible.
Applicants are being pre-judged based on factors like appearance and
attendance rather than simply on the basis of the assessment.
A huge number of applicants with substantial difficulties are scoring zero
points on the assessment.
Too many applicants who should be in the Work-Related Activity or
Support groups are being declared ‘Fit for Work’.

Even if the proposed changes are introduced, it will be long after the summer when the Work Programme begins.  Yet two of the three charities, Mind and Mencap, are part of the Disability Works UK consortium bidding to be subcontractors from the outset of the Work programme.

It is clear then, that the government has not got a great deal to fear in terms of opposition from agencies that are willing to take part in a system that imposes  compulsory activities and benefits sanctions on their own wrongly assessed members.

Still, it was probably never on the cards that a large number of chief executives would revolt.  Not when you consider that the head of the Association of Chief Executives of Voluntary Organisations is Stephen Bubb, fancy tie connoisseur and passionate supporter of the voluntary sector winning as many government contracts as possible.

Or, rather, that should be Sir Stephen Bubb, as he was the very proud recipient of a knighthood for services to the voluntary sector in the Coalition’s first New Year’s honours list.

Arise Sir Stephen, defender of the poor, sick and disabled.

Read about Sir Stephen’s Duchamp tie and about his fun meeting at the reform club and about his knighthood.

Download the proposed amendments to the WCA.

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