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.

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Nicola Sturgeon and the SNP’s echoes of New Labour

The fall of Blair should be a set text for anyone wishing to know what happens next to the SNP.

If there was one thing the SNP and New Labour had in common, it was the hope. Both offered themselves as a burning torch of optimism to publics that had become tired of the same old gang running things in the same old way. Both promised a fairer, more equal society and fearless embrace of the modern world with an appealing freshness and energy. The voters bought it: both won big, repeatedly.

The thing is, if you’re elected on a mandate to be different, you’d better be different. In many areas, for a long time, New Labour managed to be just that. The smiling PM with the huge majority pushed through bold policies, some of which even worked. Tony Blair’s strategy was so successful that the Conservatives and the Lib Dems reshaped themselves in his likeness.

But, as some say, it’s the hope that kills you. When the inevitable attritional realities of governing start to weigh; when you make, as you will, bad decisions; when the list of enemies grows long; when you’ve simply had your time; you’ll fall like all the rest. Only, when you’ve soared so close to the sun, you have that much further to plummet.

The fall of Blair should be a set text for anyone wishing to know what happens next to the SNP. The debate on 21 May between the Scottish party leaders was, I think, a foretaste of a sure outcome – a public that until recently was politically and emotionally invested in the Nats is growing restive. In time, this will turn to disenchantment, then anger, then revenge at the ballot box. That is the unbreakable cycle of democratic politics.

Some of us have warned since the start that the SNP had over-promised and could only under-deliver. Its raison d’être is independence; everything else is just another brick to build the path. And so its education reform cannot be either brave or unpopular, even if it needs to be so to work, because the SNP cannot afford to alienate teachers or the teaching unions, or parents.

The same goes for the NHS, and doctors and health unions and patients. All the separatists have done – all they could have done, given their nature – is deploy the rhetoric of the radical while body-swerving hard choices and conflict at any cost. And where they have found themselves taking flak, they’ve pointed south to Westminster: “It’s no’ our fault, it’s theirs.”

Yet the voters show signs of wearying. Middle Scotland is either ignored or maligned by the middle-class socialists who drive the nation’s political debate, but it is where elections are won. The SNP has secured the support of enough of these people to win every recent election in style, but somewhere along the way the party seems to have forgotten this was a mandate not for independence, but for good government. Ten years in to SNP rule, each new audit of public services seems to wail like a warning siren.

So, during the debate, it was Nicola Sturgeon, not the Conservative leader, Ruth Davidson, or Labour’s Kezia Dugdale, who found herself in the audience’s cross-hairs.

There were the teachers, who complained about the damp squib that is the Curriculum for Excellence, the SNP’s flagship education policy; who pointed out that a fifth of primary pupils are leaving without basic literacy and numeracy skills; and who warned that lowering the standard of exams in order to push up the pass rate was not a mark of success.

Then there was the nurse who said she had been forced to use food banks (the existence of which has been used repeatedly by the SNP as a stick with which to beat the Conservatives and Westminster). “I can’t manage on the salary I have [which is set by the Scottish government],” Claire Austin told the panel. “You have no idea how demoralising it is to work in the NHS.” She delivered the killer line of the evening: “Do you think your perceived obsession with independence might actually cost you . . . in this election?”

The list of reasonable criticisms of the SNP’s governance is growing. The ideological obsession with free university tuition for Scottish students is increasingly seen as a sop to the better-off. Sturgeon’s demand for a quick second independence referendum, when a worried Middle Scotland was focused on what Brexit might mean for its future, was tone deaf.

The SNP has another problem (one that New Labour, for all its flaws, didn’t face): its doctrine of infallibility. The Nationalists’ constitution explicitly prohibits SNP elected members from criticising the party, its policies or each other. Although total unity is useful when you’re on the climb, it starts to look bonkers when the cracks are showing.

The word “cult” has long dogged the SNP. The party has tried hard to normalise its electoral appeal while keeping the flame of independence burning, but this has been a difficult balancing act. The pro-independence mob is an ugly thing when unleashed (and it has suited the leadership to open the cage door at times). After the debate, Claire Austin found herself at its mercy as the Nats briefed – wrongly – that she was the wife of a Tory councillor. The SNP branch in Stirling said, Tebbitishly, that if she was having to use food banks, “Maybe she needs to tighten her belt a bit more?”

Joanna Cherry, a QC, MP and the SNP’s home affairs spokesperson, was forced to apologise for spreading “Twitter rumours” about Austin. The ravening horde has largely kept its head down since the 2014 independence referendum, but it hasn’t gone away – it is not enough for the SNP’s critics to be debated: they must be destroyed. This isn’t the behaviour of a normal political party.

I have a feeling that when the SNP does fall, it will fall quite quickly. Its belief in its infallibility, and its inability or unwillingness to do self-deprecation or apology, will increasingly exasperate voters. There is nothing to suggest the current public policy failings will be addressed, and many signs that things will get worse.

How then do you arrest your fall? The SNP offered hope and promised it was different, and the voters believed it. The sense of betrayal could make for a very hard landing indeed. 

Chris Deerin is the New Statesman's contributing editor (Scotland). 

This article first appeared in the 25 May 2017 issue of the New Statesman, Why Islamic State targets Britain

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