Yes, but which people?



The National Audit Office (NAO) scrutinises public spending for Parliament and is independent of government. An audit report earlier this month concluded that the Department for Work and Pension’s spending on contracts for disability benefit assessments is expected to double in 2016/17 compared with 2014/15. The government’s flagship welfare-cut scheme will be actually spending more money on the assessments themselves than it is saving in reductions to the benefits bill – as Frances Ryan pointed out in the Guardian, it’s the political equivalent of burning bundles of £50 notes.

The report also states that only half of all the doctors and nurses hired by Maximus – the US outsourcing company brought in by the Department for Work and Pensions to carry out the assessments – had even completed their training.



The NAO report summarises:

5.5

Million assessments completed in five years up to March 2015

65%

Estimated increase in cost per ESA assessment based on published information after transfer of the service in 2015 (from £115 to £190)



84%

Estimated increase in healthcare professionals across contracts from 2,200 in May 2015 to 4,050 November 2016

£1.6 billion

Estimated cost of contracted-out health and disability assessments over three years, 2015 to 2018

£0.4 billion

Latest expected reduction in annual disability benefit spending

13%

Proportion of ESA and PIP targets met for assessment report quality meeting contractual standard (September 2014 to August 2015).

This summary reflects staggering economic incompetence, a flagrant, politically motivated waste of tax payers money and even worse, the higher spending has not created a competent or ethical assessment framework, nor is it improving the lives of sick and disabled people. Some people are dying after being wrongly assessed as “fit for work” and having their lifeline benefits brutally withdrawn. Maximus is certainly not helping the government to serve even the most basic needs of sick and disabled people.

However, Maximus is serving the needs of a “small state” doctrinaire neoliberal government. The Conservatives are systematically dismantling the UK’s social security system, not because there is an empirically justifiable reason or economic need to do so, but because the government has purely ideological, anticollectivist prescriptions.

This is a government that claims social security is “unsustainable” and a “burden” on the public purse, yet has no problem with an



In April 2014, Atos was forced to abandon their contract with the government because of a growing public backlash, but not before they had profited from very large sums of public money. Meanwhile, sick and disabled people have had their support callously slashed to the bone, people have suffered and some have died as a consequence of that. Yet our welfare state is being used as a sporting arena for big business profit-making, eating up public funds that were supposed to help people who have encountered difficulties meeting their basic needs through disability, losing their job or becoming ill.

The selling of our public services and lucrative contracting out of state functions to private companies who exchange public money for a notoriously poor service is a prominent feature of Tory “small state” Britain.

The Department for Work and Pensions uses the controversial work capability assessments to decide if people are eligible for benefits or to force those on long-term sick leave back into work. The assessment is conducted using a computer software package called Logic Integrated Medical Assessment (LiMA) application.

The assessments are heavily weighted towards finding people capable for work, regardless of the medical evidence presented by claimant’s own doctors. Patients with severe brain damage, kidney failure, cancer, multiple sclerosis and Parkinson’s Disease, amongst many others with seriously incapacitating illnesses, have been found fit for work. On 24 April 2013, a woman who was a double heart and lung transplant patient died in hospital only days after she had been told that her Incapacity Benefit was being stopped and that she was fit for work. There are many other instances of grave errors in the decision-making of the Department for Work and Pensions which are based on the work capability assessment.



Between April 2015 and March 2018, the Department for Work and Pensions expects to carry out around 7 million assessments which it estimates will cost a total of £1.6 billion.

The National Audit Office report on contracted-out “health and disability assessments” states that the cost of providing assessments is rising and providers are still struggling to meet expected performance standards, and that providers continue to struggle with hiring and training staff.

From the NAO summary:

“The Department continues, however, to struggle with setting targets and requirements with clear evidence and failed to adequately test bidders’ assumptions, for example about staff training, during the contract tender process. It does not yet have a clear strategy for contracting-out assessments and risks damaging market interest through tight procurement timetables, inflexibility towards critical assumptions and lack of transparency. …For PIP, both providers have failed to meet targets for the quality of assessment reports since October 2013. The Department is paying more for assessments, caused in part by capacity shortages pushing up salaries.”

In the last month, recruitment website healthjobs.co.uk has added almost 100 job advertisements for “functional assessor” roles with Maximus, the US company contracted by the Department for Work and Pensions to conduct work capability assessments. Applicants are required to have two years post-qualification medical experience and are offered positions with whoppingly “incentivising” salaries that start at £72,000, with some roles attracting salaries of up to £98,000. The salary for a junior doctor working in the National Health Service (NHS) with two years of experience is approximately £30,000.

Junior doctors working within the NHS were forced to take industrial action recently – the first strike action for more than four decades – over the government’s proposed new junior doctor contracts, because of serious concerns about patient safety, the quality of doctor’s working lives and the lack of recognition regarding the strain of working long and unsocial hours.



The British Medical Association said:

“The biggest threat to patient care is the government’s insistence on removing safeguards which prevent junior doctors from being forced to work dangerously long hours without breaks, with patients facing the prospect of being treated by exhausted doctors. “The government is threatening to impose contracts in which junior doctors have no confidence and which represents the first step in a wholesale attack on all NHS staff at night and over weekends. We want a contract that is safe for patients, fair for juniors and good for the NHS.”

Maximus offer substantially better working conditions and pay for junior doctors, but compromising patient safety is an inevitable consequence of the company drive to provide “administrative solutions to improve the cost effectiveness … and efficiency of government-sponsored benefit programs.”

One NHS doctor, Karl Norrington, noted on Twitter that despite Maximus’s company motto: “Helping Government Serve the People” – in reality Maximus is: “paying drs to medically endorse a political agenda regardless of how it affects patients.”

Government entices #juniordoctors to leave NHS frontline offering them (a lot) more £’s to get people off benefits pic.twitter.com/8VoKxnvPCP — Karl Norrington (@karlnorrington) January 23, 2016

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Related

The disturbing truth about disability assessments

Why I blew the whistle on Atos fitness-for-work test

We can reduce the Welfare Budget by billions: simply get rid of Iain Duncan Smith