Watchdog finds 'weaknesses' in sickness benefit system

Women holds temples The assessments determine whether people qualify for benefits through sickness or are fit to work

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Auditors have found "weaknesses" in the contract between the government and Atos, the private firm paid to carry out fit-to-work medical assessments.

The contract underpins the Department for Work and Pensions's efforts to move people from sick benefits into work.

The National Audit Office said the DWP had failed to penalise Atos for "underperformance", and had not set "sufficiently challenging" targets.

Ministers said the terms of the contract were under "constant review".

French firm Atos was paid more than £112m in the last financial year to carry out about 738,000 face-to-face medical tests on benefit claimants.

Wrong decisions

The DWP used the test results, known as work capability assessments, to decide whether people were fit to work or eligible for Employment and Support Allowance (ESA).

The assessments were first introduced on a pilot basis by Labour in 2008 and rolled out across the country by the coalition government.

Officials at the DWP have got many decisions wrong, with nearly four out of 10 appeals upheld at tribunals. The NAO said it was unclear whether the quality of the tests was to blame for the number of wrong decisions.

Start Quote

This is a contract that really needs a lot more scrutiny to understand how effective it has been”

End Quote Tom Greatrex Labour MP

In a letter to Tom Greatrex, MP for Rutherglen and Hamilton West, the NAO's Comptroller, Amyas Morse, said it was hard to know whether changes to the tests were needed.

"It is difficult to assess, as the department does not routinely request feedback on the rationale for tribunal decisions," he said.

"Without such data it is not clear whether any changes in the medical process are needed."

The DWP had previously admitted that Atos had not carried out some fitness testing within the agreed time limits, and performance had been "below the standard" since mid-2011.

The NAO criticised the DWP for not seeking "financial redress" for these delays, saying just 10% of the penalties triggered by poor performance had been applied.

The spending watchdog added that the DWP's negotiating position has been undermined by "inaccurate forecasting" of the number of people likely to need a medical test.

'Paying twice'

Mr Greatrex said he had asked the NAO to review the contract after being told by ministers that the details, including information about financial penalties, were "commercially confidential".

"My underlying concern was the fact that the contract is worth £112m a year to Atos," he told Radio 4's Today programme.

"At the same time, through the Tribunals Service, the appeals are costing about £60m a year so effectively we are paying twice to try to correct the mistakes in the initial assessments or the process that leads to the assessments and decisions.

"That isn't good value for money and this is a contract that really needs a lot more scrutiny to understand how effective it has been."

Start Quote

It is a complicated area but we are committed to making it a success to ensure it is both fair and accurate for the user and value for money for the taxpayer”

End Quote Iain Duncan Smith Work and Pensions Secretary

Mr Greatrex urged ministers to reflect on the report and consider reforming the system.

Major changes to the tests were recommended in 2010 by independent adviser Professor Malcolm Harrington. Last month he told the BBC the system had improved but was still "patchy".

The DWP said the contract had "changed considerably" since it was signed by the Labour government in 2008 and ministers had twice - in 2009 and 2012 - demanded improvements.

Feedback from tribunals was now fully evaluated, it added, and in many cases new information was presented at appeal which was not available when the assessment was conducted.

"In 2010, the Work Capability Assessment was not working properly and since then we've substantially improved it," said Work and Pensions Secretary Iain Duncan Smith.

"It is a complicated area but we are committed to making it a success to ensure it is both fair and accurate for the user and value for money for the taxpayer."

'Challenging contract'

A spokesperson for Atos said it had worked very closely with the DWP on a "complex and challenging contract" to "fulfil all our contractual obligations".

"We have also been flexible within the contract, for example implementing changes and recommendations from the Harrington report.

"Where changes to the contract have resulted in slower processing times we have worked alongside the department to address this."

Regular complaints have been made about the medical tests since they were first introduced.

In May 2011, six charities - including the MS Society and Parkinson's UK - urged the government to make the tests fairer for patients whose symptoms varied in severity over time.

A month later, campaigners claimed in a letter to the Guardian newspaper that assessments were causing "huge" distress and had even resulted in suicides.


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  • rate this

    Comment number 115.

    In reality, it is little different from the previous system, just that it’s failings are publicised.

    Years ago, & 4 days after a specialist (x-rays, tests etc) said I needed further operations, one of the govt. quacks said nothing was wrong…
    ending in a complaint to the BMA about the fraudulent quack.

    It took a few years to improve to a level where work was possible again .

  • rate this

    Comment number 114.

    Government and Whitehall have shown repeatedly their inablility to compile contracts fit for use, that cover failures of provision or that include any clawback – Bank bailouts, Shipbuilding, transport and utilities have all shown considerable use of trust and Gentlemans Agreement. All of this costs the taxpayer, none of it can be reclaimed from Whitehall.
    What a cushy job. We could all do it.

  • rate this

    Comment number 113.

    hello this is of course not at all surprising, I have won my case at two tribunals and now I wait for a third. Once I one the first DWP really wanted me hence my third tribunal. Each tribunal takes approx 14months to happen. Life is very difficult during the wait costing me dearly healthwise. had no income since april 30th this year. Atos always give me 0 points the judge has always given me max

  • rate this

    Comment number 112.

    @102 Graham
    Appeal your decision. The Atos "medical professionals" are not even doctors in the vast majority of cases. They are jumped up nurses who take a course over a few weeks. They decide your case along with a computer. At appeal you can take all your evidence. 90% of cases are won at appeal if you take a specialist advisor to your appeal. 40% are won if you go alone. Don't give up.

  • rate this

    Comment number 111.

    If we need to save money, let's start with cutting all funding for corporate welfare scroungers such as ATOS.

    Back in the day when NHS GPs mostly decided fitness for work, 15+ years ago, the welfare bill was far less burdensome.

    (Of course, the main increase in welfare spending has been due to privatised social housing - i.e. welfare for private landlords and banks in mortgage interest.)

  • rate this

    Comment number 110.

    No one believes that people who cheat the system should get away with it, the problem is that this accounts for a minority of those claiming incapacity. It's akin to using a sledgehammer to perform a cornea transplant. And, sorry to say, a private firm working on contract to reduce numbers and being paid accordingly based on removal of people from this will make the wrong decisions, as shown here!

  • rate this

    Comment number 109.

    I don't think it's even a British company. More taxpayer money going overseas . . . . . . . . I thought Skoda police cars and Nissan council vans were bad enough!

  • rate this

    Comment number 108.

    @64 xyriach
    My point is that he can still operate a computer, he can still communicate, he can still contribute. Technology in this area is advancing...
    Not all disabled people are rocket scientists & businesses won't invest in technology just to allow the disabled to do things the abled bodied can do anyway, so in reality it is just condemning them to a lifetime of misery & unemployment.

  • rate this

    Comment number 107.

    My Mother had a quadruple heart bypass. 2 months later she was declared 'fit to work' because she could lift a kettle at home. What if she was brick layer?

  • rate this

    Comment number 106.

    this fitness for work test is not targeted at those claiming DLA - that is a NEW test that Atos has just won the rights to administer at another cost of millions of pounds in their pocket. And for your information northeastcorner at the moment, you are allowed to work and claim DLA that was one of the reasons it existed

  • rate this

    Comment number 105.

    I'm recovering from surgery and off work at the moment, at 41 I have worked all my life. I will be returning to work, but more surgery will be needed in the future and before I reach retirement age I will not be able to work. I am, frankly, terrified of the world I might live in by then and cannot help feeling that the hope of some is that we die before we reach the wrong side of the balance sheet

  • rate this

    Comment number 104.

    Step 1. The taxpayer pays for a GP. The GP diagnoses that his patient is unfit for work.
    Step 2. The taxpayer pays a private company to assess if that individual is fit to work. The company assesses that he is.
    Step 3. The taxpayer pays for a tribunal to assess the individual. The tribunal agrees with the GP.
    Conclusion. Taxpayer money wasted. Incompetent private company wins the euromillions draw

  • rate this

    Comment number 103.

    As with G4S, incompetent contracting negotiations and oversight.

    If Atos do not correctly assess resulting in £60 million that amount should be deducted from their fee - what's difficult about that ?

    If private sector is used for these jobs the contract / incentives have to be correctly formed otherwise the taxpayer will be ripped off every time.

  • rate this

    Comment number 102.

    When I was 56 I volunteered to have a special medical assessment it was designed to get the over 50's back to work. I was then contacted and told I was unemployable due to my Osteo-arthritis. I have just had an ATOS medical age 63 and told I now only score 6 points out of 15 so I don't qualify. The statements of facts from the examiner had been very carefully trimmed. Why a French company?

  • rate this

    Comment number 101.

    This must be the first ever HYS where almost every comment is positively rated! That says all you need to know about private companies and government contracts.

  • rate this

    Comment number 100.

    All very well trying to get people who can work into work, trouble is the work isn;t there. Part time cleaning jobs are not going to meet the exorbitant cost of living in this country. Employers demand experience but there are no opportunities to gain experience, only rich people these days can go to university and graduates now expected to do internments (work for no money) total explotation.

  • rate this

    Comment number 99.

    ATOS is working the way the government wants it to. How, I have had my biggest relapse of a long-term condition in 20 years and have been off sick 5 months. I have not gone on to benefits yet for fear of being penalised as have read the horror stories on many health related 'blogs'.

    The system is ill conceived and everyone is being told they are fit to work. Tell me who will employ me - no one

  • rate this

    Comment number 98.

    Dear BBC, I have one hell of a story for you if you want it, I also have PROOF of Atos liars, some on secretly recorded video & even a written admission of lying on my Atos 'medical report' sent to the GMC from one of the Atos 'doctors' that I have encountered!..Get in touch & I'll happily tell you all about it if you want me to....

  • rate this

    Comment number 97.

    Shock horror - news that using ATOS for DWP assessments is flawed and is costing the government money - or should I say costing US TAXPAYERS money. Why, when this type of thing comes to light, does no-one get sacked. In any other job if you make poor decisions over & over again (as working with ATOS has proved) that cost ££Millions you would be sacked as you are obviously incompetent. Not here

  • rate this

    Comment number 96.

    Governments require the skills of civil servants to procure services for all aspects of delivering goverment business.

    Procurement and project management, once contracts are in place, has been poor for decades.

    They're incapabable of writing a project specifications or setting measurable targets and then do little to ensure delivery. Why not they don't get fired for getting it wrong.


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