13 March 2012
Held in the Television Interview Room, House of Lords
13th March 2012 at 2pm
Countess of Mar - Chairman
Katie James - AYME
Tristana Rodriguez - AfME
Dr Charles Shepherd - MEA
Christine Harrison - BRAME
Sir Peter Spencer - AfME
Sue Waddle - MERUK
Mary-Jane Willows - AYME
Janice Kent - ReMEmber
Bill Kent - ReMEmber
Tanya Harrison - BRAME
Countess of Mar - Chairman
Due to the unforeseen absence of a Chairman, the Group decided to proceed with an informal discussion.
1. Professor Malcolm Harrington: Independent Review of the Work Capability Assessment (WCA)
Professor Harrington opened the discussion with an overview of the work which had been done by the team for the Independent Review of the Work Capability Assessment. The review was now into its 3rd year, which would be the final year for Professor Harrington. Someone else would lead the review for its final 2 yrs.
Professor Harrington said that the Year 2 report built on Year 1 recommendations, exploring the issues which there had not been the opportunity to do in the limited time available in the first year. What was achieved was implementation of changes to the process recommended in Year 1. By the end of the 3rd year, Professor Harrington said that it would be known whether any improvement had been made. There should be evidence of a decrease in the number of people who did not attend the WCA or complete application. Decision makers would have to give information to explain what they had based their decision on.
Other ongoing pieces of work by the review team revolved around descriptors. The DWP were exploring ways to build the evidence base for changes to the descriptors through an Evidence Based Review. They would work with the charities and had asked Professor Harrington to do this.
Professor Harrington advised the Group not to view the review of the fluctuating conditions descriptors as the be all and end all, but that it could be a starting point. He said that, following the work of the fluctuating conditions group, he was also consulting with experts about the need for a separate descriptor considering pain and fatigue.
Dr Charles Shepherd commented that claimants experience difficulty in getting medical evidence. They may be discharged from specialist clinics and a number of GPs were refusing to provide medical reports. Other clinicians refused to do them on the grounds of a conflict of interest.
Professor Harrington said that the emphasis should be on an individual’s capability of work, not their clinical diagnosis. He made the point that there was no condition where diagnosis could result in an automatic qualification. But if that was the case claimants could not be ruled out on the grounds of an M.E. diagnosis either, but rather the functional loss. So the solution was left with good witness and history taking.
Christine Harrison asked whether there would be an independent review of the Personal Independence Payment (PIP). Professor Harrington said this had been raised in the House of Lords as an amendment and there would be two reviews in the first four years after implementation.
Professor Harrington advised the fluctuating conditions group to keep in touch with any progress that was made in the mental health descriptors because this would give an indication of how to go about driving the work on the fluctuating conditions descriptors forward. The ideal scenario would be to test the mental health and fluctuating conditions descriptors at the same time, and Professor Harrington would like to see this happen.
Dr Charles Shepherd said they might be able to take some people from Atos who succeeded under appeal and test them under the new and old methods to see how they get on. He said that the fluctuating conditions group produced ample anecdotal evidence that the descriptors are not working. There was no evidence base for the 1 yr limit on ESA, or 6 1/2 months to recover from chemotherapy.
Professor Harrington said that a concern which had been voiced by Atos was that some people at appeal were using the decision makers justification to ensure that they raised the bar at appeal. A further problem had been that Atos assessors were being asked to do too many assessments in a day. He also said that Atos has no competition in terms of providing national assessments in England, Ireland, Scotland & Wales
Christine Harrison mentioned that BRAME. had worked closely with Terry Moran when he was Director of DWP DCS and he had personally supported BRAME’s call for a joint working group of the main ME groups and their medical representatives to work with the DWP to revise the DWP Guidelines for ME/CFS. A Good consensus document was produced from this work but the DWP went back and, without further consultation, published a guideline that was little changed from that at the start of the process.
Professor Harrington said that it must be ensured that the information given to the decision makers was to be up-to-date. He suggested that Forward M.E. should put themselves forward to submit and review training documentation.
Christine Harrison made the point that assessors needed to know how to ask questions sensitively to get the true picture whilst preserving the dignity of the claimant. Professor Harrington said that he had told the DWP to consult with relevant charities with regards to their particular part of DWP guidance.
Professor Harrington told the Group that he had had his Year 3 plan approved by the scrutiny group.
Christine Harrison said that it was very concerning that DWP forums are being disbanded at the time when there is so much welfare reform. This has not been made formally public.
Dr Charles Shepherd asked whether there was any opportunity to make sure that DWP guidance was aligned with Atos. Professor Harrington said he gathered from Dr James Bolton that this was possible. Christine Harrison suggested asking the Chairman to write to Atos on behalf of the Group.
Christine Harrison asked whether the DWP had provided a response with regards to people who had asked to have audio recording at their Work Capability Assessments. Professor Harrington said that the evaluation report is not on the DWP internet site, and he would be asking the DWP what actions they proposed later in the year.