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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In defence of the metropolitan elite

Railing against low-paid academics will not solve Britain's inequality problem. 

It’s a measure of how topsy-turvy our political culture has become that Theresa May, a Conservative, Oxford-educated prime minister, can claim to be on the side of "ordinary working-class people" against a sneering "elite". But while Brexit has made this division central to our political culture, we’ve been heading in this direction for a while. 

Earlier this year, I was watching a heated exchange between centrist Labour MP Alan Johnson and Left Unity’s Simon Hardy on the Daily Politics show. At one point, Johnson bellowed across the table: "You’re a middle-class intellectual!" So this is now a stand-alone insult, I thought to myself, and took to Twitter to share my indignation. A friend immediately replied: "He means you." And she’s right. I am indeed a middle-class intellectual, a member of the metropolitan elite. Given the prevalence of post-Brexit elite-bashing, I’m loath to stick my head above the parapet. But as my liberal intellectual English lecturers used to say, these terms need unpacking. 

The right-wing anti-elitism that we are seeing all around us co-opts the left’s opposition to financial and corporate dominance and converts it into opposition to those who are educated. To listen to Tory speeches now it’s as if the top 1 per cent didn’t own half the world’s wealth, as if the sales of individual global corporations hadn’t overtaken many national economies, as if CEOs didn’t earn 300 times the salary of the average worker. No, it’s the liberal, metropolitan elite that’s the real menace – those mighty "experts" and "commentators". As Michael Gove, another Oxford-educated Tory, declared during the EU referendum: "People in this country have had enough of experts." 
Anti-elitism conflates political office and cultural and educational distinction on the one hand, with social privilege on the other. But there’s no intrinsic reason why there should be a homogenous "political class", or that those with expertise or artistic judgement should necessarily be rich. In 1979, 16 per cent of MPs had a background in manual work; in 2010 the proportion had dropped to 4 per cent. The history of the Worker’s Educational Association and the Open University reveals a lively tradition of working-class intellectualism. It’s true that, right now, political and cultural capital are appallingly centralised, and there is a revolving door between ministerial office and business. The range of people entering the arts and higher education has been narrowed by the removal of social security and block grants.

Today's anti-elitism, far from empowering the disenfranchised, covertly promotes neoliberal economics. High standards are equated with having the upper hand. Attacks on "cosmopolitan elites" - i.e. those who benefited from affordable education - entrench inequality, put the left on the back foot and protect the real elites – all this while producing a culture that’s bland, dumbed-down and apologetic.
This manoeuvre is everywhere. Brexit is a surreal pageant of inverted protest - May’s use of the royal prerogative supposedly represents the will of the people. The beneficiaries of the PM's grammar school "revolution", she claims, will be "the hidden disadvantaged children". Those who question the evidence base for this are simply metropolitan snobs. ‘This is post-referendum politics’, the BBC’s education editor reminded us tellingly on Today, ‘where the symbolic status of grammar schools as a chance to better yourself has trumped the expert consensus’.
The higher education bill currently going through Parliament brandishes the downtrodden student consumer as a stick with which to beat academics. According to the business-friendly University Alliance, academia’s reluctance to emphasise "employability" carries "more than a whiff of snobbery". Top-down curation is out; impact, feedback and engagement the new mantra. With their worth constantly weighed against the most pressing social priorities, cultural organisations no longer seem convinced by their own right to exist.
The "democratisation" of education, media and culture must be recognised for what it is -  a proxy for real democracy and any attempt to tackle social and economic inequality. Just as the redistributive work of politics is shunted onto embattled and underfunded sectors, the same anti-elitist pressure weakens politics itself. Democracy is thoroughly distorted by economic forces. But the solution is not, as right-wing populists do, to attack the system itself - it’s the only means we have of creating a fairer world. 
This anti-political sentiment is aimed disproportionately at the left, at do-gooding idealists and defenders of the "patronising" welfare state. Stricken with anxiety about being out of touch with its former heartlands, Labour is unable to strategise, put up a credible leader, or confidently articulate its principles. Unless it can tell a positive story about informed debate, political institutions and – yes – political authority, the left will remain vulnerable to whatever Ukip contorts into next.

It’s time to stand up proudly for good elitism – for professional judgement, cultural excellence and enlightenment values. Once, conservatives championed political authority and high art. But now that they’ve become scorched-earth modernisers, it’s time for progressives to carry the torch. Otherwise, disparities of wealth will become ever sharper, while the things that give our lives meaning dissolve into mediocrity.



Eliane Glaser is a senior lecturer at Bath Spa University and author of Get Real: How to See Through the Hype, Spin and Lies of Modern Life.