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 395.

    Try this one for size.
    I am full time employed but on Incapacity Insurance and signed unfit to work by an Atos Doctor, I have to claim ESA as part of the policy (even though I still pay full tax & NI).
    I have O/A and other problems and am on massive doses of opiates. DWP medical has me fit for work (again an Atos Doctor), I won my appeal last time and 12 months later the process starts again.

  • rate this

    Comment number 394.

    So over 60% of appeals are dismissed at tribunal, suggesting that savings in the long term, rightly or wrongly, will be made by this process. More funding could then be offered to those who really do deserve our support.

    The Paralympics will remind us that many of the disabled are remarkable people doing remarkable things.

  • rate this

    Comment number 393.


    After I have finished on here I am going sign on, look for non existant jobs "transcribing" as you so eloquantly put it, then im going to my local supermarket to buy 8 litres of cheap strong cider. Ill then go and drink them in the local park and chase small furry animals when im drunk.

    Fancy a cold one?

  • rate this

    Comment number 392.

    The levels to which the left will stoop know no bounds. The Tax payers demand that checks should be made to weed out the malingers & crooks thieving the benefits that rightly belong to the disabled
    And the screech Hitler and Extermination. It a disgrace. Get on board protect the disabled from these crooks demand that the resources go where they should root out thieves & their supporters !!

  • rate this

    Comment number 391.

    Those who really can't work should be helped. But those capable of working must be coerced into doing so by the benefits system. The message has to be clear, to steer us away from the corrosive 'entitlement' culture that would make the original champions of the welfare state turn in their graves. To pretend otherwise is to devalue these people's potential - and condemn the country to stagnation.

  • rate this

    Comment number 390.

    Claimants don't produce 'new evidence' at a tribunal, they produce 'evidence' to prove their case as described on the ESA50, a form receive by ATOS prior to a medical. The DWP & ATOS do not contact a claimants GP or Hospital, the claimant is relied up on to obtain such evidence themselves by paying privately, which is usually en-route to an appeal. My opinion; DWP & ATOS are at fault.

  • rate this

    Comment number 389.

    Why is it so difficult to get this right? There are many people who genuinely need these benefits and so should get them. There are a few (still a minority) who play the system. I do not understand why it is so difficult to identify these people and why it costs so much money with private assessors. We just need to have regular doctor refferrals every 6 months to sort the the truth from the myth.

  • Comment number 388.

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

  • Comment number 387.

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

  • rate this

    Comment number 386.

    Perhaps Theirry Breton (the CEO of ATOS) spends too much of his time running his other global monster (Carrefour) to be much bothered about this contract.

    Carrefour is after all the world's second largest retailer, and Europe's largest retailer.

  • rate this

    Comment number 385.

    1 Minute Ago

    If you want benefits surely you need to be assessed from time to time. Peoples conditions change.


    I recall a story where a woman applied for DLA 3 times and each time she was refused. The reason? Her amputated leg might grow back. It would be interesting to see that condition change.

  • rate this

    Comment number 384.

    347. sheila coleman - Many of called disabled claiming huge benefits - please cite source. Yes there are SOME but the vast majority are legitimate. True, stopping and reclaiming from cheats should be quicker but it is due to Gov rules, laws and incompetence that this does not happen. The fact is the Gov are paying vast amounts of money for a poor and inefficient service. Any sign of any savings?

  • rate this

    Comment number 383.

    If the Tories are in trouble so let’s attack, the defenceless and the poor. Keep the people fighting among themselves, Public vs Private Sector, employed vs unemployed, well vs sick? So long as you can keep the people focusing on relative small matters you can get away with reducing taxes for the rich, allowing non doms to come and go without paying taxes and trousering our pension money.

  • Comment number 382.

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

  • rate this

    Comment number 381.

    What's wrong with someone doing work that they are capable of doing?

    There's nothing wrong with someone who is not capable of work being assisted through the benefits sytem. But think of how many other genuinely need people could be assisted to a greater extent if the scroungers could be weeded out.

  • rate this

    Comment number 380.

    It is a shame that all those genuine claimants have to go through this process - but it is only there because of those who try to defraud the system.

  • rate this

    Comment number 379.

    @ 347, sheila, Really? may of our 3.5 million disabled are filmed doing sports.
    That is complete rubbish, wheres your proof?
    I asume you can post a link to back up your statement?
    Id like to see these disabled people who are doing sports and DIY and (heaven forbid) RUNNING! Most i know are just struggling to survive.

    Please keep your made up ignorant facts to yourself.

  • rate this

    Comment number 378.

    We all know that this scheme is a scam and that ATOS have 'targets' to meet. Yet another immoral brainchild of a government of duffers.

  • Comment number 377.

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

  • rate this

    Comment number 376.

    if you can sit at a PC and write a comment for the BBC website whilst creased up in pain, surely you could do the same for money and transcribe written notes into electronic form, or something similar? Why should I pay for you to be off work when you have demonstrated your ability to use a PC whist suffering?


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