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 315.

    Fit for work is fairly vague description. Many people may not be fit to be a bricklayer, but could easily do an office job. A lot of IT jobs could be done from home, sat on a sofa if you can use a keyboard.

    This would be far better off saying you are fit for jobs similar to x, y, z. now here is some suitable training so that you could get one.

  • rate this

    Comment number 314.

    290. panda many disabilities and illnesses are invisible. If all you get is winter fuel allowance then go to the CAB and see if you're eligible for other benefits, you are, after all, entitled to them. Also, on some disability benefits, you're allowed to earn £20 a week or work 16 hours. So that 'cash in hand' may actually be people who are able to work. DLA, for example, is an in-work benefit.

  • rate this

    Comment number 313.

    @304.fraz3375: Oddly racist. "I'd rather employ Polish people," implies you'd presume not to employ Polish otherwise.

    You may have difficulty understanding the welfare system. A "Polish person" can't just come to England and collect sickness benefits, so a greater proportion of Polish immigrants in England are healthy, thus in work. Sick/disabled Polish are back in Poland, also having a bad time.

  • rate this

    Comment number 312.

    294 INQUA
    yes that is what i am saying even experts can be and are fooled those that want to do so will fool them

  • rate this

    Comment number 311.

    I am so lucky I do not need to claim, (I might be entitled I don't know if it's means tested or not). I wouldn't be able to stand the stress of it all. Some days I am OK for most of the day, most days not. I am writing this creased up in pain though if I were well enough to get to an interview on a good day I would fail. I wouldn't employ me, why should any employer be expected to?

  • rate this

    Comment number 310.

    I read some posts on here and have to wonder why the poster even visits their GPs, they obviously do not trust them do diagnose anything. I bet if you had a diagnosis of cancer you would listen to your doctors advice, but if a disabled person gets a diagnosis their doctors or liberal do gooders !
    This stupidity is behond me !

  • rate this

    Comment number 309.

    Why is anyone surprised?

  • rate this

    Comment number 308.

    Don' t forget that Atos are not the ones making the decisions, it is the DWP. Also that Atos carry out the examinations as prescribed and agreed with the DWP.. It is a case of don't shoot the messenger. These contracts are complicated and both sides need to work together to make them work. Confrontation rarely soles these issuses.

  • rate this

    Comment number 307.

    Talking of benefit cheats, I've just done the math. £112,000,000 for just over 7000,000 interviews is £151 for about 20 minutes face to face, that's £453 an hour. I'll bet my pension that my GP doesn't get that much.

  • Comment number 306.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 305.

    A relation of mine (worked all her adult life) had a brain haemorrhage two years ago, spent months in hospital and therapy unit. She cannot walk, but manages a few yards with a zimmer, can't converse properly, needs husbands help to go to toilet, doesn't really know what day it is. BUT, atos have passed her fit to work!

  • Comment number 304.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 303.


    If you suspected the diagnosis to be false then as a "manager" surely you should have questioned it further?

  • rate this

    Comment number 302.

    For genuine claimants who are wrongly assessed by the DWP and therefore not entitled to ESA, cannot legally claim Job Seekers Allowance because if they are unfit for work due to the severity of their health problems/disability, they cannot declare themselves available for work. If they did so, they would be fraudulently claiming! WIN WIN for the government not claiming! not classed as unemployed!

  • rate this

    Comment number 301.

    #144 Reading your list of people to attack - you seem to have a problem with people who are all obeying the law. So your proposition is attack law abiding people instead of people who are breaking the law!

    Tax avoiders are obeying the law, if govt drafts a stupid law that allows tax avoiders to legally reduce their tax bill blame the govt and get the law changed

  • rate this

    Comment number 300.

    A close friend with degenerative spinal condition, having undergone significant, recent spinal surgery was assessed fit for work.The French doctor spoke little or no English. No proper analysis was performed. The notes were not read or not understood. My wheelchair bound friend continues to undergo extensive treatment and chronic pain relief. So much for the sham of fairness.

  • rate this

    Comment number 299.

    The DWP is saying that GP's cannot be trusted to diagnose their patients. It says GP's are either incompetent, easily duped, or conspiring with their patients to defraud the taxpayer.

    The Health Department is saying that GP's know what is best for patients, and can run the NHS efficiently for the taxpayer. GP's will decide how to spend £90 billion of taxpayers money.

    They cannot both be right.

  • rate this

    Comment number 298.

    As a manager I'm used to dealing with all sorts of GP sick notes but even I was flumoxed by one diagnosis. A quick look on Wkikipedia showed that this illness had ceased to be recognised in Europe and North America some thirty years ago but was acknowledged in Asia. I'll let you guess the nationality of the GP concerned but obviously I couldn't question the validity of the diagnosis.....

  • rate this

    Comment number 297.

    A relative of mine had an ATOS medical. He has a foot brace on one leg, a full cast and brace on the other and visits the hospital continually due to his illness. He was told that because he could get from one chair to another he was fit for work. His benefits were withdrawn and ended up at a food bank to support him. "Is there anyone out there who would like to employ him" I don't think so!

  • rate this

    Comment number 296.

    Firm I used to work for lost a contract, and the network side went to Atos. When they started migrating sites to their network, parts of the system stopped working at those sites. Atos refused to believe it was caused by their network, until we spent weeks compiling performance statistics that tracked every instance to the day a site was migrated to the Atos Network.


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