Today I’ve written about the news that US firm Maximus are set to take over administering Work Capability Assessments for Progress. My article is available here but I’ve reproduced it in full below.
Today the government announced that American firm Maximus have been awarded the contract to carry out medical assessments to determine whether people who claim they are unable to work due to ill health or disability should be entitled to benefits.
When this work was first outsourced to the French firm Atos Healthcare in 1998, this decision seemed relatively uncontroversial. However, in 2008 Labour replaced the old incapacity benefit with employment and support allowance, and alongside this came a new test – the work capability assessment.
We did this with the right intentions. With the decline of heavy industry, the number of incapacity benefit claimants had more than doubled from 1.2 million in 1979 to 2.6 million in 1997. Although this figure then stabilised, Labour ministers realised that some of these people might be able to work and that this would benefit their health in the long term.
However, by the general election in May 2010, it was becoming clear that the WCA was getting too many decisions wrong. Unfortunately, the new Conservative-led government was so unmoved by these failings that Iain Duncan Smith ordered that the number of assessments be increased. So while assessments had previously been restricted to new applications for ESA, in November 2010 Atos started to put all 2.2 million existing incapacity benefit claimants through the WCA.
Unsurprisingly things did not improve – many people who were genuinely unable to work were still being declared as fit to do so, and there is now a backlog of more than 700,000 claimants awaiting an assessment. These delays not only cause financial hardship – they also often exacerbate people’s existing physical and mental health conditions.
Although they initially defended Atos, by summer 2013 ministers had decided to use the firm as a lightning rod for discontent. This led to Atos announcing that it would negotiate an early exit from its contract earlier this year, and as a consequence responsibility for WCAs will now pass to Maximus.
I am clear that Atos did not cover themselves in glory. Although many of their staff are decent, hardworking people, I regularly heard stories about others being unprofessional, insensitive and rude.
But critics should resist the temptation to channel all their anger towards Atos or Maximus – ultimately the WCA is government policy, and whichever contractor is in place, they will simply be doing ministers’ bidding.
A whole series of changes need to be made to the WCA. At a minimum:
- Assessor training needs to take account of fluctuating and progressive conditions
- Evidence from GPs and other experts needs to be given more weight
- Informal targets need to be lifted
- The frequency of reassessments needs to be reduced
The easiest (and cheapest) way to make these changes would be through a new contract but I fear that the government will have missed this opportunity in their deal with Maximus. In June the minister who was then responsible for this issue, Mike Penning, said ‘I just do not have time to negotiate a brand spanking new all-singing all-dancing contract.’
This highlights the flaws in outsourcing such a controversial and flawed process. If the government had been brave enough to take the process back in-house, even if just for a temporary period, it would be far easier to sort these problems out. Instead by simply changing the provider but not the test, thousands of sick and disabled people could be incorrectly assessed as fit for work for years to come.