Thursday, 10 January 2013

Unethical work capability assessment is not fit for purpose


“Do you have pets at home?” The client answered in the affirmative, so the records show that the client, “Feeds and cares for dog without difficulty”. The truth was their pets were cared for by their children.

This is from an account given by the Citizens Advice Bureaux (CAB) in their evidence to the third year review of the Work Capability Assessments. It is one of many statements from their clients experiences of WCA.  In yet another case it was reported a  "client sought advice as the HCP recorded no abnormality and no problem with hands, despite the client having visibly swollen and deformed hands, with a consultant rheumatologist report confirming this."

Anecdotal, yes. But anecdotal evidence can be powerful when the sum total creates a coherent and meaningful testament; when each voice like a thread weaves a tapestry that is compelling and authentic. When there are common features to each narrative. "They did not listen." "They moved on to the next question when I tried to explain." For how else can such evidence be? These are real lives, real people with real stories to tell. Each witness contributes their story of a system that isn't working; a system that is cruel, impersonal and ineffective. And it is cruel and ineffective precisely because it does not listen to their stories.

The CAB evidence should be heeded. Many of the clients they advise have their WCA decision reversed on appeal. It is usually reversed in the light of facts, knowledge and understanding that is not considered in the assessment. The experience of how their clients have been treated in the process is second to none. Their conclusion about the system is damning.


"Citizens Advice retains concerns about the descriptors that are used for assessment purposes. Evidence received from clients suggests that the descriptors that are currently used are not the best markers of a clients disability, or a fair assessment of what they could reasonably be considered ‘fit enough’ to do in a work-environment."

WCA is not fit for purpose. It is based on no reasonable evidence that it works, and meanwhile it does harm.  The Work and Pensions Secretary, Mr Duncan-Smith says it will do good because it will help people back into work to lead productive lives; it will, he says, "make them better people". A utilitarian ethical consideration should consider the ratio of benefit to harm. The harm  cannot simply be ignored because politicians believe in the greater good. Driving people off benefits regardless of the consequences is at best reckless; but when that harm is already clear, it is immoral. And the harm to patients with mental health problems is already compelling.

In a survey of GPs commissioned last year by Rethink Mental Illness and carried out by ICM, 84% of GPs said they had patients who presented with mental health problems such as stress, anxiety or depression as a result of undergoing, or fear of undergoing, the Work Capability Assessment; 21% said they had patients with suicidal thoughts; 14% had patients who had self harmed; 6% had patients who had attempted or had committed suicide. They also thought that the system failed to consider their knowledge and understanding of the patient's history and condition.

How many tears must be shed before their stories are read? We cannot help people 'back to work'  simply by driving them off benefits regardless of their circumstances and regardless of the way their disability affects them in their daily lives.   A process that takes no account of this is a system that is not fit for purpose. It is a heartless and cruel system. In a civilised society we can do better.


If you are concerned about the WCA and how it is affecting people's lives there are two petitions you might consider signing:









2 comments:

  1. Enough said. I thought I was unshockable - I'm not

    ReplyDelete
  2. I thought I was unshockable. I'm not

    ReplyDelete