Monday 11th April, Channel 4, 8pm
The row over cuts to welfare benefits has rocked the Government to its core. Iain Duncan Smith resigned, attacking his own department's plans to cut disability benefits as balancing the books on the back of the poor and vulnerable.
Dispatches goes undercover in a 4 billion pound company who assess the disabled for benefits, and discovers unprofessional conduct from one of its assessors, including derogatory statements about claimants, “Disability known as being fat, she asks for help to wipe her arse because she’s too f**king fat to do it herself”
Over three million people currently claim disability benefits in the UK, which costs £14 billion. Iain Duncan Smith originally created Personal Independence Payment (PIP) as a new way to help disabled people with everyday needs. PIP is already harder to access than the old Disability Living Allowance – further cuts were a step too far. “As it came through in the budget, that is deeply unfair and was perceived to be unfair. And that unfairness is damaging to the government, it’s damaging to the party, and it’s actually damaging to the public.” Iain Duncan Smith
George Osborne has backed down; the cuts have now been put on ice. But the new benefit that prompted the row - Personal Independence Payment – is still a key part of the government’s reform of the benefits system.
Hundreds of thousands of disabled people now have to apply for this new benefit and many claim it is deeply unfair. Former Paralympian Ade Adepitan investigates and, using secretly recorded material, reveals some disturbing sides to the new benefit.
Until recently those with disabilities received the Disability Living Allowance (DLA), but in two years the system will be defunct and everyone will need to apply for PIP. The DLA system used assessments from patient’s doctors; the PIP system instead uses contracted companies to assess claimants, these companies report in to the Department of Work and Pensions (DWP) who decide on the claims.
- The DWP reject 52% of all new claims.
- In the first quarter of this year 57% of over 7000 appeals were won by the claimant
How the PIP assessment works:
Each claimant must fill out a 35 page questionnaire before they meet their assessor. The assessments are scored using a system of points, claimants receive points based on how well they can perform daily activities – such as making a meal, getting dressed or washing.
- 0 points – if you can perform a task well
- 8 points is the minimum required to receive benefit, £22 per week
- You can sometimes receive a maximum points if you can’t perform a task at all
- The maximum benefit is £140 per week.
Undercover at Capita:
A £140 million contract to carry out PIP assessments in Central England, Wales and Northern Ireland was won by the giant outsourcing company Capita. According to Capita’s website they are looking for: ‘health professionals who are able to undertake a disability assessment – people who actually have an empathy with disabled people, have an understanding and desire to seek to improve the lives of disabled people.’
Dispatches sent psychiatric nurse, Noel Finn, undercover as a trainee disability assessor to see how the PIP assessments are conducted. Noel has fifteen years’ experience, and undertakes Capita’s 20 day training programme in Birmingham. The training emphasises that his relationship with clients will be different to his days as a nurse.
During training Noel is told that one of his priorities is to get through his assessments quickly.
Capita’s Chief Medical Officer explains, otherwise the company loses money, “The issue we have is the amount, so we obviously need to get you to be doing as many assessments in a day as you can possibly manage, and we need the quality to be maintained as well. If we don’t do the correct number of assessments we will get penalised by DWP financially, if we don’t get a certain quality we get penalised.”
The DWP disagree. They say they don't pressurise contractors to speed up assessments.
Capita told us that at no point did their Chief Medical Officer suggest that assessments should be rushed compromising quality.
Mental State Examination:
A third of people applying for PIP have mental health issues, they are assessed using the Mental State Examination (MSE). The Capita trainer informed the reporter that the assessments are shallow :
Capita Trainer ‘This is a very, very shallow assessment, MSE… you’re there for 45 minutes, so the MSE is part of that whole assessment, but you’re not there just to do an MSE.’
Dispatches showed the footage and computer generated system to one of the experts who advised the DWP on how to assess the disabled. Consultant Psychiatrist Dr Jed Boardman from the Maudsley Hospital said, “Now the purpose, it struck me, of the assessment was to actually assess people’s functioning, but there seemed to be very little evidence they were being trained to assess like that. What they seemed to be trained to do was get through an examination very quickly and make their rating on the basis of a rather, well, superficial examination or interview with those claimants.”
In Birmingham, the company’s Chief Medical Officer tells Dispatches reporter Noel that :
“It’s not a mental state exam as we see it, it’s more of a mental… it’s like a mental health overview. So the difficulty is, obviously, it’s been branded as a mental state exam, and obviously you’re looking and saying ‘well hold on, there are certain bits that are missing… certain bits aren’t in there.’ Which, obviously, is very confusing”
Dispatches were also told that the MSE is carried out without the claimant’s knowledge.
Dr Jed Boardman, “The Chief Medical Officer’s statements about the mental state examination did surprise me… the training did not seem to be fit for purpose, that is to train people to do accurate and effective assessments.”
Case Study – James:
James is 26, a student at Cambridge, who suffers from depression, OCD and bulimia. James got DLA in 2013, using the money to pay for therapy and to live independently, in February last year he was told he had to apply for the new PIP. He was assessed by Capita.
James, “They were looking at tasks like eating and preparing food, just whether I could do it physically. Physically I can cook. So they assume that I have no problem with that. I’m articulate and I’ll explain ‘psychologically that’s really difficult for me. It’s distressing and I can’t feed myself in a safe way’.”
James was turned down for PIP, despite over a decade long history of mental illness. James appealed his assessment and 6 months later was given a hearing. They unanimously agreed with James and overturned the decision.
Case Study – Nikki:
Nikki is 28, she was already receiving PIP for physical disabilities when she had a fall and banged her head resulting in amnesia. Every time she wakes up she thinks its October 2014, the day of her accident. Nikki has now been unemployed for 14 months, after 12 years of working.
Nikki and her partner notified the DWP about their change in circumstance and were told she had to be reassessed. The PIP assessment retracted Nikki’s financial support, she is now appealing the decision.
Capita assessor failure to maintain professional standards:
After he completed his training our undercover reporter was sent to Northampton to learn the ropes from experienced employees.
Alan is a Disability Assessor; his job is to work out whether disabled people will qualify for PIP. Alan was deemed, by his manager, to be well trained and a good assessor to learn from. He’s keen to talk about the money he earned from Capita at the start of their contract in 2013.
Alan: The money? It was ridiculous. I was getting around 20 grand a month, most months.
They’d pay around £80 an assessment for the first 8 assessments, then they paid £160 an assessment for 8-14, then they paid £300 per assessment for 14-21.
Noel: So I imagine they’re all banging them out very quickly then?
Alan: Oh yeah, we was flying through them, because of that money. That’s 20 grand a month.
Alan tells Noel that sometimes he completes his assessments before even meeting the claimant:
Alan: So you’d think there’s something significant as a leg missing would be ‘oh my god there’s the money; but when it gets to the nuts and bolts of it he does everything really don’t he? I’d literally finished his assessment before I’d even walked through the door. I’d done it on Saturday. Cos the informal observations with only one leg…
Noel: Yeah, yeah
Alan: He’s not going to claim that and then turn up with two legs
Dr Jed Boardman, “he represents both a failure of his own professional standards, but also, a, sort of, problem in the system that is not somehow looking closely enough at the quality of that interview.
Alan talks to Noel about the use of informal observations, where the assessor watched the claimant but doesn’t tell them that the observations are part of the assessment:
Noel: Do you catch many out with the informal obs then?
Alan: Most of its informal obs you catch them out on
Noel: Do you don’t tell them you’re doing an informal obs then?
Alan: No, no. If you tell them you’re doing an informal observation they’ll watch what they’re doing.
Alan: They’re informal, that’s why you don’t have to say anything. They’ll tell you everything that they want to tell you, is wrong, you can completely dismiss it more often than not. You’ll get your whole assessment done with watching what they do.
The information held on Capita’s computers is confidential and very sensitive. On Noel’s second day he finds Alan photographing his computer screen.
Alan: Take pictures of your assessments as well
Noel: Take pictures of them, why?
Alan: Once they’ve attended, take a picture. Well, if you come to your payday and you haven’t got all your assessment reports, how can you prove you’ve done them?
Barrister Simon Butler comments, “it’s quite clear there has been a breach of the Data Protection Act, that there’s been a clear breach of the patient’s confidentiality because you’re not entitled to take photographs of the patient’s information and therefore as far as I’m concerned and from what I’ve seen that would be a serious breach of his professional standards”
Capita are clear that they want assessors who ‘have an empathy with disabled people’, Alan is clearly disrespectful about an overweight claimant:
Alan: Disability known as being fat
She asks for help to wipe her arse because she’s too f**king fat to do it herself
Alan shares his views with his manager Jessica
Alan: Now this woman’s so fat she can’t wipe her own arse
Jessica: Well we’ve all been there Alan
Alan: No we haven’t! How have you been there?
Jessica: I was just saying, you know, it could happen to anybody.
Alan: Yeah but I’ve got to give her an award for it
Jessica: Maybe if she did it, it would be like… exercise?
Noel then notices that the manager is removing a notice making claimants aware of their right to have the assessment recorded.
“The comments and actions of [this contractor] clearly fall short of what we expect and are totally unacceptable. We are obviously appalled by and sincerely apologise for this individual’s disrespectful comments and actions. [He] will no longer work for Capita.”
In response to our evidence, Capita said:
“It is the DWP, not Capita, who makes the decisions on whether to award a benefit or not. Capita focuses on delivering to the DWP’s requirements while equally importantly supporting and expecting all our assessors to treat every person sensitively and with respect. We will continue to review and refine the content and quality of our training and our work with disability organizations to ensure that we meet the needs of the DWP and treat people claiming this benefit appropriately.”
Department for Work and Pensions response:
“We strongly refute these claims. The assessment process of PIP has been extensively reviewed to ensure it is robust, the claims process is as straightforward as possible, and decisions are made based on the evidence.
Since April 2013, just 5% of decisions have gone to appeal and only 2% of all PIP decisions have been overturned. We expect the highest standards from the contractors who carry out PIP assessments and work closely with them to ensure PIP is working in the best way possible.”
THE GREAT BENEFITS ROW: CHANNEL 4 DISPATCHES Monday 11th April, Channel 4, 8pm
Reporter: Ade Adepitan
Exec Prod: David Henshaw
Prod/Dir: Richard Butchins
Prod Co: Hardcash Productions