How can we fairly assess people's capability for work?
On Tuesday I led a half-hour Westminster Hall debate on the Work Capability Assessment (WCA) – the test people have to undergo to get the new sickness benefit Employment and Support Allowance (ESA). I regularly hear stories about people being assessed as fit for work who then have this decision overturned on appeal (the most recent figures show one in three appeals are successful) – thus this issue has thus attracted lots of attention.
There was a long debate on this subject last month where a broad range of concerns were aired, so I decided to focus on one specific area – the descriptors for mental, intellectual and cognitive function that are used in the face to face assessment that most applicants undergo.
I emphasised the importance of getting these descriptors right, noting that 35% of people going through the assessment were recorded as having a mental or behavioural condition as their primary condition – the largest single group of ESA claimants.
Back in 2010 the government’s independent reviewer of the WCA, Professor Malcolm Harrrington, asked three charities – Mencap, Mind and the National Autistic Society – to provide recommendations on refining these descriptors. They produced a report in April 2011 and Professor Harrington endorsed this in November of the same year.
The charities argued that the current descriptors measure just one aspect of an applicant’s condition, or try to include more than one aspect on a single linear scale. For example the severity, frequency and fluctuations of a condition are often conflated into the one descriptor.
The charities proposed new dynamic descriptors that take separate account of different aspects of applicant’s conditions. However the government have rejected these recommendations, arguing there isn’t sufficient evidence the current descriptors aren’t working or that the proposed descriptors would work better. While they have proposed a ‘gold standard review’ to look into this, the charities involved expressed concern that this has yet to materialise. I expressed concern in the debate that the government might be using this as a cover to kick the issue into the long grass.
In responding the minister Chris Grayling said some things I welcome. He confirmed the whole ESA process has no financial targets – the words he used were ‘it’s about saving lives, not saving money’. He also said he had no problem with more people being put in the ESA support group (where recipients get more financial support) as opposed to the work-related activity group (where people are required to attend training and undertake voluntary work etc).
However the minister went on to argue that the charities hadn’t actually done what they were asked to do. He said they were asked to make recommendations to improve the descriptors, but instead they made proposals that he claimed would involve amending all the other descriptors (such as those for physical conditions), redoing the department’s computer systems, and retraining all their staff. Again he emphasised the lack of evidence to back up the charities’ proposals.
He indicated that a similar report on the descriptors had now been produced for fluctuating conditions more broadly, and that both these recommendations and those on mental health would be put through the gold standard process soon. When I pushed the minister on a timescale, he said it was his intention to complete this process in the next few months.
My reaction? Firstly I'd question the minister's suggestion that the new descriptors would require such a fundamental overhaul of the WCA process. Moreover, Chris Grayling’s suggestion that the charities overstepped the mark ignores the fact that they clearly think that the current system puts simplicity before getting the right result, and that tweaking the wording falls short of the more profound change necessary. He also dismissed the fact that the charities’ position was backed up by both an independent panel of experts – the scrutiny group – and Professor Harrington himself (to whom the minister normally pays the highest respect).
I’m glad I drew a commitment to get the gold standard process up and running quickly. If work needs to be done, it should be done sooner rather than later, as the longer we wait the more people are going to be wrongly assessed as fit for work.
On a related note the work and pensions select committee (of which I am a member) recently produced a report on the government’s new Personal Independence Payment – the replacement for Disability Living Allowance. We emphasised the importance of getting the assessment for this test right first time. My Westminster Hall debate has simply reinforced this message.
Sheila Gilmore is the Labour MP for Edinburgh East