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Changes to the 'fitness to work' test sneaking under the radar

Changes to the contentious test designed to judge whether seriously sick or disabled people in Britain are fit for employment are being proposed without debate, despite evidence to show they will have a "huge and damaging impact".

OurKingdom Ourkingdom
17 January 2013

In less than a fortnight, the UK government is due to make a set of changes to the Work Capability Assessment (WCA). The WCA is the ‘fitness to work’ test which assesses whether sick and disabled people can get Employment and Support Allowance (ESA): a benefit designed to help and support very unwell or profoundly disabled people into work.

Although these changes have been advertised as small ‘amendments’, a new briefing co-published by Ekklesia, the beliefs and values think-tank, and Sue Marsh, a disability campaigner and author of the blog Diary of a Benefits Scrounger, warns that the amendments will have a "huge and damaging" impact on the way people's illnesses are reviewed. 

Below, we publish a version of Sue Marsh's blog for Diary of a Benefits Scrounger, setting out the two main problems identified with the proposed legislation and their human cost. 

Problem One: False Assumptions

In the fitness to work test, your needs are assessed by a ‘healthcare professional’ employed by the French private company ATOS. This assessor doesn’t just need to look at your current difficulties. For example, they can also imagine how using an aid (e.g. a wheelchair) might improve your ability to work and make a judgement based on that –without even asking your opinion! However, if the proposed legislation is allowed to pass, this “imaginary test” will be able to be used for many more aids (including guide dogs and false limbs!). This means that soon thousands more people could be judged as fit to work, without being consulted, on the basis of an “imaginary” aid they don’t own or may not be able to use.

It gets worse. Even if returning to work may clearly put you at risk, these changes will mean you can still lose your disability benefit – as long as the assessor believes that trying a new therapy or treatment might reduce that risk. There’s no need for evidence that the treatment will help: you will lose support either way, making it much harder to manage if the treatment doesn’t work as hoped – let alone if it ends up making things worse.

Imagine Bert, who suffers from severe schizophrenia, but is found fit to work and made to take behavioural therapy in the hope of improving his condition. He will lose his disability benefit, without the assessor having to look at several vital questions: how hard it would be for Bert to contact a psychiatrist? How long would an NHS appointment take to organize? Are there private options in his area – and could he afford them if so? What if the therapy doesn’t work, or takes a long time to adjust to?

If the government’s rule changes go through, people like Bert who are desperate to work will find it nearly impossible to get an accurate assessment, affecting the quality of their support and actively preventing their efforts to get back into work.

Problem Two: Separating physical and mental health

The government is also trying to change the way people’s conditions are assessed by dividing health problems into two separate boxes: ‘physical’ and ‘mental’. When looking at what tasks people can do, only the ‘physical half’ of the test will apply to those with physical disabilities. The same goes for the effects of treatment: for e.g., if you’re takingmental health medication, only mental health side-effects will be looked at.

This completely fails to understand the way that many disabilities and illnesses can lead to both physical and mental effects. This is also the case for many common treatments: such as those for schizophrenia, Parkinson’s disease and multiple sclerosis.

Think of Emily, who suffers severe, chronic pain because of nerve damage to her leg. Emily is among the 49% of chronic pain sufferers who also suffer depression as a result of continuous pain. An assessor may see Emily as able to do some work as long as she takes strong painkillers for the rest of her life, meaning she could pass the ‘fitness’ test. Yet the painkillers may not deal with the depression caused by her condition. Painkillers have also often been shown to affect people’s wakefulness and decision-making. So taking the medication may affect Emily’s ability to do a job in a completely new way – yet because these new problems are cognitive, they would not need to be looked at by the assessor when making their decision. 

Pretending the effects of illnesses and disabilities can be separated in this way goes against all medical practice. Going even further, and using this method to ignore sick and disabled people’s needs, is at best hopeless policy, and at worst deliberate cruelty. 

To find out more about the proposed legislation, go to Diary of a Benefit Scrounger, or see the below:

* The Briefing on Employment and Support Allowance (Amendment) Regulations 2012 can be read and downloaded in full, and as an executive summary, here: http://www.ekklesia.co.uk/ESAbriefing

* Press Release: 'Latest Work Capability Assessment proposals will worsen plight of sick and disabled people' - http://www.ekklesia.co.uk/node/17811

* WOW (War on Welfare) petition site: http://wowpetition.com/ The Government Direct e-petition can be found here: http://epetitions.direct.gov.uk/petitions/43154

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