Wednesday, 24 July 2013

Even the DWP isn't happy with ATOS

Within 13 weeks of starting to receive Employment and Support Allowance (the main sickness benefit currently available) claimants are assessed by the DWP to decide whether they are sick or disabled enough to continue to receive the benefit. In the majority of cases this process includes attending a medical examination. These examinations are performed by a company called ATOS. 

To many claimants the name 'ATOS' signifies anxiety, powerlessness, and anger, because of the quality of the examinations and the way in which they are carried out. If you want confirmation of this, just find someone you know who is - or was - getting Employment and Support Allowance and ask them what the examination was like.

Or you could note the opinion of Dr Mark Porter, Chair of BMA, who wrote to the Mark Hoban, Minister for Employment, on 12th June this year (,  expressing concern 'that the current process is insufficiently rigorous and consistent, causing avoidable harm to some of the weakest and most vulnerable in society'.

Or you could consider the report of the Public Accounts Committee in Parliament of February this year ( ). The report criticised the DWP for failing to manage the contract ATOS properly, stating (Conclusions and Recommendations, paragraph 5) that 'the lack of challenging targets for medical quality allows the contractor to conduct thousands of poorly administered tests each year without sanction."

Well, now it seems that even the DWP itself thinks that ATOS isn't doing the job very well, according to a press release published on 22nd July ( ).

 The press release follows an audit of around 400 ATOS medical reports. Reports were graded A - C. 41% of the reports were given 'C' grade. The press release does not say what a C grade means (except to say that a C grade report does not mean that an assessment is wrong), but the Public Accounts Committee did, in its report above: it stated that 'a grading of 'C' is classified as "failing to meet professional standards"' (Contract Management, paragraph 13). In other words, about 2 in 5 ATOS medicals in the audit failed to meet professional standards.

What is the DWP planning to do about this? It says 'in light of the audit we required Atos to put in place a performance improvement plan and will be bringing in new providers to increase capacity'.

The second proposal is interesting - the minister appears to be saying that ATOS will be losing its monopoly. Although he hasn't mentioned this, the need to address the monopoly position of ATOS was a major concern to the Public Accounts Committee. It is worth quoting paragraph 4 of the committee's Conclusions and Recommendations in full:

'The Department has failed to develop a competitive market for medical services. The market for medical service providers is under-developed and Atos Healthcare is currently the sole supplier for all the Department's medical assessments. It has also been awarded two of the three current contracts for the Personal Independence Payment. The Department is too relaxed about the risk to value for money resulting from a dependence on a monopoly supplier, and on the limitations this has on the Department's capacity to remedy poor performance. The Department should assess the risks associated with the use of a monopoly supplier and actively pursue opportunities to develop a competitive market through the deployment of its framework contract.'

Do I think this is good news? Yes, I do: I think anything that calls ATOS to task and breaks its stranglehold over provision of medical services is a good thing.

However I'm not getting too excited. Ultimately, the performance of ATOS reflects a cultural mindset that starts at the top, with government. That mindset is one which believes that too many people are getting sickness and disability benefits. This is why the whole structure is at it is, from the regulations that define who isn't fit for work and who is, through the way the DWP puts those regulations into practice, to the behaviour of the contractor who provides the medical services.  

Without a change in ethos from the very top, therefore, although we may hope for improvements in claimants' experiences at medical examination, it is naive to expect much else to get better.

If you want more detailed information about Employment and Support Allowance, and challenging negative decisions about it, check out my website:

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