The Middlesbrough Partnership Manager presented a report which identified emerging issues in connection with Work Capability Assessments, which people could undergo in seeking an Employment and Support Allowance.
As part of the background information it was confirmed that given the Government's significant reforms to the welfare benefits system and implications for Middlesbrough the Council together with its partners had been working together through a jointly agreed action plan and communications strategy to put in place a number of actions to help mitigate the impact of such changes.
The report submitted focussed on one element of the reforms relating to Employment and Support Allowance (ESA) which replaced Incapacity Benefit and Income Support and had a focus on helping people with an illness or disability to move into work.
Whilst the Department for Work and Pensions (DWP) was responsible for its delivery, Healthcare professionals employed by ATOS Healthcare provided medical services to the DWP. Their main role was to give medical advice to help decisions being made on entitlement to the benefit and therefore a key part of their involvement was in the assessment process as outlined in the report submitted.
Reference was made to two elements to ESA:
Contributory - awarded if enough national insurance contributions had been paid by the claimant.
Income-related- awarded if the claimant's income and savings were low enough and not provided if there were savings of more than £16,000.
The amount of ESA was provided on different factors as outlined and for both elements of ESA the claimant would usually have to undertake Work Capability Assessments (WCA), effectively medical tests in two parts to prove that they had limited capability for work.
The Board was advised of a number of concerns which had been expressed both locally and to some degree nationally in relation to the following aspects:-
(a) in making a claim, does the claimant have access to IT and the appropriate IT skills;
(b) the standard of advice being provided by the DWP to claimants;
(c) the new assessment criteria was stricter resulting in a greater number of claimants being turned down at the initial assessment stage;
(d) there was a higher level of appeals being lodged within a strict timetable which was also resulting in a high level of success;
(e) if people needed to appeal a decision the chances of success were greater if they were represented but there was limited capacity for agencies to provide representation;
(f) if a person was successful at appeal, they were then provided usually under short time scales with a new assessment which could lead to them being found fit for work;
(g) it would appear that some people with serious health conditions could be assessed as being fit for work;
(h) whether or not claimants with possible mental health conditions were being provided with the necessary support to help them through the assessment process;
(i) does the person undertaking the medical assessment always have the appropriate medical qualification/experience to allow accurate assessments to be made;
(j) were Government targets impacting on the decision making process and as such do the targets reflect what the actual level of eligibility to the Allowance might be;
(k) possibility of such issues being replicated when the Disability Living Allowance was replaced by Personal Independence Payments later this year.
Officers reported on specific cases which demonstrated the increasing difficulties for individuals and the impact on the Council in terms of incurred costs as a result of additional support required at home. Evidence had shown that people with serious illness had been found fit to work in accordance with the DWP criteria. There were incidences where claimants had been given zero points at an assessment despite having a serious disability preventing them from working.
Members sought clarification on the contractual arrangements by which ATOS Healthcare provided medical services to the DWP and were keen to seek assurances that the persons undertaking any medical assessment had the appropriate medical qualification and experience to cope with an increasing number of individuals with complex medical conditions.
The Board was provided with statistical information from the Citizens Advice Bureau which illustrated the increasing number of enquiries following the ESA reforms. In 2010/2011 there had been 1,100 enquiries, in 2011/2012, 2,200 and 2,800 enquiries so far in respect of 2012/2013. An indication was also given of an increasing number of people enquiring about Disability Living Allowance.
From evidence available there was a concern about the clarity of the DWP guidance and accuracy of the recording of basic fundamental information compiled on individuals.
In terms of the wider implications the Board agreed that the following were issues for further examination:-
(i) the impact on the claimant and given the possibility of it being a stressful process do they have the necessary access to support;
(ii) implications of the changes for Council services;
(iii) impacts on Council partners;
(iv) wider impact on local economy.
Other areas for possible examination included:-
(a) need to raise public awareness to the difficulties;
(b) appeals process and impact of current delays in terms of individuals and for the Council;
(c) circumstances around Work-Related Activity Group;
(d) time-limit of ESA to one year and affect on individuals should the claimant's partner be working resulting in the loss of benefit.
ORDERED as follows:-
1. That the Officers be thanked for the information provided which would be incorporated into the overall review.
2. That further information be provided at the meeting of the Board to be held on 2 April 2013 regarding possible terms of reference for the scrutiny investigation.
3. That a representative from the Department for Works and Pensions be invited to attend a future meeting.