The tragedy of Alice

How the Work Capability Assessment costs lives - its impact on people with mental health problems is more serious than Atos have acknowledged.

You probably won’t have heard much about the case of Alice (name changed). She’s a 33-year-old woman who lives in the West Country with her parents. She’s very poorly: she suffers from severe bipolar disorder, and has been sectioned on numerous occasions after harming herself.

In February last year, she received a letter from the outsourcing company Atos, which told her that she was about to lose her disability living allowance and would have to undergo an assessment before could receive employment support. Shortly after this, Alice was found by her mother in the bathroom. She'd slashed her throat in the bath. She was taken to hospital for treatment, and survived.

Alice’s community psychiatric nurse and a forensic psychologist contacted Atos, and told the company not to contact her directly again. The company agreed. The morning after she’d been released from hospital, she returned to find another letter concerning an appointment. She slashed her throat again, and was readmitted to hospital.

Alice’s mother got in touch with Bufferzone, a local benefit advice charity. They managed to restore her benefits without the need for further tribunals. But the last issue of Private Eye - thus far the only publication to have covered this story - carried a staggering update:

Last week, Atos wrote to Alice again. Fortunately the letter arrived while her condition was stable and she suffered no ill effects. Tony Lea of Bufferzone was again forced to take up her case. Atos told him the letter was computer-generated - and could not be stopped. Brilliant.

Perhaps, were it to concern another company, this ludicrous tale of cruel incompetence would be making more headlines. But the problem is, we’ve run out of ways of telling the story. Here’s a list of 30 similar tales where the outcome was worse: the victim died.

As John McDonnell MP has pointed out in Parliament:

The first [now second] example on the list was that of Paul Reekie. Some Members may have known Paul, an award-winning writer and poet in Leith, Scotland. He did not leave a suicide note, just two letters on the table beside him. One was about his loss of housing benefit and the other was about his loss of incapacity benefit.


Tony Lea, Alice’s advisor, has been working at the coal face for years. A garrulous, likeable man, (“Stop me if I’m going on: I’m just some bloke with a big mouth”) he set up Bufferzone six years ago, originally as an advocacy service for those suffering from mental illness. Its remit expanded - now he helps the homeless, alcoholics, those suffering from disability, victims of abuse, and other vulnerable. He’s got a whole load of stories, from meeting a mentally ill woman in the middle of a field at night with the police in tow because that was the only place she’d talk to him, to being attacked and having his car windscreen smashed. He’s seen it all: last year, on a budget of £16,000, which he secured from Lloyds TSB, the Co-Op, the Claire Milne Trust and Awards for All, he managed to support 187 people.

And one thing he’s sure of is that Alice’s case, though shocking, is hardly new. He wonders whether the rules should mean that a risk assessment has to be carried out before contact is made with people like her. “I was struck when I saw her in the ward,” he tells me. “I couldn’t believe how badly she’d damaged herself. But I’ve seen this sort of thing day in, day out. The simple fact is, the people behind the assessment don’t understand mental illness, nor do they understand invisible, fluctuating conditions like fibromyalgia or chronic fatigue syndrome. A question like “Can you switch off an alarm clock?” just doesn’t begin to cover these conditions or co-morbidity - the way that one affects the others. And they’re not just putting the lives of the mentally ill at risk - they’re putting the lives of the people with whom they could end up working at risk too.”

It’s not just the likes of Tony who have noticed this - or, here in more detail, charities like MIND. In January’s parliamentary debate, which I wrote about here, there was general condemnation of the Workplace Capability Assessment’s (WCA) performance when it comes to mental health. Michael Meacher said the “current criteria and descriptors do not sufficiently—or even at all—take into account fluctuating conditions, especially episodic mental health problems.” Pamela Nash described “Seeing people who have claimed employment and support allowance as a result of a physical disability or illness ending up with mental health problems owing to the stress of going through the system.”

Madeleine Moon described a female constituent, “Mrs E”, who had worked as an accounts officer, but suffered a vicious sexual assault which left her with post traumatic stress disorder. She went to an Atos assessment for Employment and Support Allowance, was found fit to work, and found herself in a similar situation to Alice, repeatedly having to attend appeal tribunals and having her payments stopped on several occasions due to “administrative errors,” the stress leading to a suicide attempt. She concluded: “This lady is being hounded by the state: there is no other way of describing it. There is no excuse for this behaviour. This is a company that is not playing fair by this country’s most vulnerable people.”

So what’s being done? The answer is detailed on Atos’s company blog: “We have put in place a network of Mental Function Champions to spread best practice across the business and offer advice and coaching to other professionals carrying out WCAs. We invited leading external experts in mental health to help us shape the role for the Mental Function Champions, and we now have 60 Champions.” As Heather Wheeler MP made clear, not only are these “champions” only giving guidance (they won’t be sitting in on interviews), but given the WCA’s lack of suitability to deal with the issue of mental health, it’s patently clear that 60 is not enough of them.

And more to the point, what do they really do? The journalist Kate Belgrave has been monitoring the development closely and has recently written this excellent blog post on the lies, prevarication and lack of transparency that has characterised the initiative (as she told me on the phone last night: “At one point, we started to wonder if these people even existed”). Since that blog was published Atos has told her group that a face-to-face meeting is possible, but it would have to be off the record. They are waiting to find out if they’ll be able to report on any discussion.

Flawed, secretive and cruel: it’s the very worst of the shadow state. Or, as John McDonnell MP put it:

The concern expressed by Members about an issue of public administration in all [these stories] is unprecedented in recent decades. There is example after example of human suffering on a scale unacceptable in a civilised society.



Protesters carry placards during a protest against Atos in London in August 2012. Photograph: Getty Images

Alan White's work has appeared in the Observer, Times, Private Eye, The National and the TLS. As John Heale, he is the author of One Blood: Inside Britain's Gang Culture.

Photo: Getty Images
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The Conservatives have failed on home ownership. Here's how Labour can do better

Far from helping first-time buyers, the government is robbing Peter to pay Paul

Making it easier for people to own their own first home is something to be celebrated. Most families would love to have the financial stability and permanency of home ownership. But the plans announced today to build 200,000 ‘starter homes’ are too little, too late.

The dire housing situation of our Greater London constituency of Mitcham & Morden is an indicator of the crisis across the country. In our area, house prices have increased by a staggering 42 per cent over the last three years alone, while the cost of private rent has increased by 22 per cent. Meanwhile, over 8200 residents are on the housing register, families on low incomes bidding for the small number of affordable housing in the area. In sum, these issues are making our area increasingly unaffordable for buyers, private renters and those in need of social and council housing.

But under these new plans, which sweep away planning rules that require property developers to build affordable homes for rent in order to increase the building homes for first-time buyers, a game of political smoke and mirrors is being conducted. Both renters and first-time buyers are desperately in need of government help, and a policy that pits the two against one another is robbing Peter to pay Paul. We need homes both to rent and to buy.

The fact is, removing the compulsion to provide properties for affordable rent will be disastrous for the many who cannot afford to buy. Presently, over half of the UK’s affordable homes are now built as part of private sector housing developments. Now this is going to be rolled back, and local government funds are increasingly being cut while housing associations are losing incentives to build, we have to ask ourselves, who will build the affordable properties we need to rent?

On top of this, these new houses are anything but ‘affordable’. The starter homes would be sold at a discount of 20 per cent, which is not insignificant. However, the policy is a non-starter for families on typical wages across most of the country, not just in London where the situation is even worse. Analysis by Shelter has demonstrated that families working for average local earnings will be priced out of these ‘affordable’ properties in 58 per cent of local authorities by 2020. On top of this, families earning George Osborne’s new ‘National Living Wage’ will still be priced out of 98 per cent of the country.

So who is this scheme for? Clearly not typical earners. A couple in London will need to earn £76,957 in London and £50,266 in the rest of the country to benefit from this new policy, indicating that ‘starter homes’ are for the benefit of wealthy, young professionals only.

Meanwhile, the home-owning prospects of working families on middle and low incomes will be squeezed further as the ‘Starter Homes’ discounts are funded by eliminating the affordable housing obligations of private property developers, who are presently generating homes for social housing tenants and shared ownership. These more affordable rental properties will now be replaced in essence with properties that most people will never be able to afford. It is great to help high earners own their own first homes, but it is not acceptable to do so at the expense of the prospects of middle and low earners.

We desperately want to see more first-time home owners, so that working people can work towards something solid and as financially stable as possible, rather than being at the mercy of private landlords.

But this policy should be a welcome addition to the existing range of affordable housing, rather than seeking to replace them.

As the New Statesman has already noted, the announcement is bad policy, but great politics for the Conservatives. Cameron sounds as if he is radically redressing housing crisis, while actually only really making the crisis better for high earners and large property developers who will ultimately be making a larger profit.

The Conservatives are also redefining what the priorities of “affordable housing” are, for obviously political reasons, as they are convinced that homeowners are more likely to vote for them - and that renters are not. In total, we believe this is indicative of crude political manoeuvring, meaning ordinary, working people lose out, again and again.

Labour needs to be careful in its criticism of the plans. We must absolutely fight the flawed logic of a policy that strengthens the situation of those lucky enough to already have the upper hand, at the literal expense of everyone else. But we need to do so while demonstrating that we understand and intrinsically share the universal aspiration of home security and permanency.

We need to fight for our own alternative that will broaden housing aspirations, rather than limit them, and demonstrate in Labour councils nationwide how we will fight for them. We can do this by fighting for shared ownership, ‘flexi-rent’ products, and rent-to-buy models that will make home ownership a reality for people on average incomes, alongside those earning most.

For instance, Merton council have worked in partnership with the Y:Cube development, which has just completed thirty-six factory-built, pre-fabricated, affordable apartments. The development was relatively low cost, constructed off-site, and the apartments are rented out at 65 per cent of the area’s market rent, while also being compact and energy efficient, with low maintenance costs for the tenant. Excellent developments like this also offer a real social investment for investors, while providing a solid return too: in short, profitability with a strong social conscience, fulfilling the housing needs of young renters.

First-time ownership is rapidly becoming a luxury that fewer and fewer of us will ever afford. But all hard-working people deserve a shot at it, something that the new Conservative government struggle to understand.