How do we make the fit-for-work tests fit for purpose?

Maximus has just taken over the running of the controversial Work Capability Assessment from Atos. What’s broken and how can they fix it?

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David waited nervously to see the physiotherapist who would judge whether his learning disability stops him from working, just as thousands like him do every month.

David already knows the answer – for him, it does. But he felt powerless.

Half a million other people are waiting for this assessment who, like David, want to live normal lives and just need a little help. Whether extra help to find a job, or support because they can’t work, the Work Capability Assessment (WCA) is the gatekeeper to a lifeline that millions of disabled people rely on. This lifeline, the out-of-work benefit Employment and Support Allowance (ESA), helps disabled people to live the kind of life that most people take for granted.

David lives independently with a carer - someone who helps him to shop, cook, manage his money and even get out of the house - things he struggles to do alone. They told the physio this, and more, in his scarcely 15-minute long assessment. Several months later, David got a letter telling him he’d been refused ESA and was ‘fit-for-work’.

His choice was to either go hungry or claim Jobseekeer’s Allowance (JSA). This would force him to spend 35 hours every week applying for jobs on a computer. He can’t use a computer or spend 35 hours per week looking for a job because of his learning disability. David would probably end up being sanctioned as a result and eventually go hungry anyway.

David and his carer couldn’t believe it, especially as the physio’s report didn’t reflect David’s needs at all. Like many people with a learning disability, David tends to agree with questions he doesn’t understand - something the assessor clearly wasn’t aware of. ‘Tick box’ is how many describe the assessments, designed by the Department for Work and Pensions (DWP) and carried out by a third party.

David couldn't see how badly the assessment had been, as he couldn’t read his own report; his carer had to. Bizarrely the DWP doesn’t provide alternative formats like ‘easy read’ for their disability benefit assessments.

When asked to reconsider their decision, the DWP maintained that David was fit-for-work and had to find a job. David now has to face a tribunal, represented by his 75-year-old dad, leaving him feeling even more powerless than when he walked into that assessment.

In 2012/13, £66m of taxpayers’ money was spent defending ESA tribunals like David’s, with just four in ten being upheld.

At the start of March, Maximus took over the running the WCA from Atos. Perhaps Maximus will improve the quality of assessments, the quality of training (which clearly isn’t adequate), and perhaps more people will get the right results.

Maximus could improve the assessment right now by matching claimants with more suitable assessors - ending the current lottery of whether you’ll get a doctor, nurse, physiotherapist or occupational therapist who may not understand your disability.

But Maximus can only change so much. It’s up to the DWP to fix the rest of the issues. Issues like the backlog of half a million people, the flawed ‘tick box’ interview, the refusal to provide information that disabled people can understand (here's an easy read sample – it’s not hard to make). Things like the rigid format of the assessments and the fact that people on ESA - no matter their condition - repeatedly undergo assessments, whether or not their condition has changed or even can.

We don’t know how Maximus will fare. We don’t know if the DWP will make those changes. We do know that changing the company conducting the assessment won’t fix a fundamentally flawed system.

We don't need a system that forces thousands of our society’s most vulnerable people, like David, to live in fear of the next letter dropping on their floor, the next ring of their phone, or the next knock on their door.

We need a fit-for-work test that is itself fit-for-purpose. 

James Bolton leads work on welfare and health policy at Mencap and is the co-chair of the Disability Benefits Consortium, a group of over 50 health and disability charities. James was an expert witness for the Public Accounts Committee’s investigation into Personal Independence Payments in 2014. He tweets at @JamesABolton.