Ministers are planning a multi-billion pound overhaul of health assessments for people applying for disability benefits that have previously been fiercely criticised as “demeaning and degrading”.
The Department of Work and Pensions (DWP) has published a contract notice announcing its plans for a £3.1billion revamp of heath checks for Personal Independence Payments (PIP) and other benefits.
The changes will be made as it commissions a new seven-year contract to run the health and disability assessment service for people applying for benefits.
The assessments are used by DWP decision-makers to determine eligibility for a wide range of benefits and are currently carried out by private companies including Maximus, Atos and Capita, under contracts worth more than £1bn.
People with disabilities or health conditions currently have to undergo two separate checks – known as PIP assessments and Work Capability Assessments – but this will be integrated into one assessment under the new model.
While the DWP says the changes will improve the process for millions of claimants, charities have raised fears the new one-stop system will lead to more people missing out on benefits they are entitled to.
“This is a huge risk unless quality of the assessment is tackled,” Raji Hunjan, chief executive of anti-poverty charity Zacchaeus 2000 Trust (Z2K), told HuffPost UK.
“To have one assessment for two benefits essentially runs the risk that people could be denied both benefits at the same time and leave claimants with absolutely no income whatsoever, and completely reliant on food banks or whatever donations they can get access to.”
The new DWP contract tender invites private firms to bid to run health assessments for Personal Independence Payments (PIP), Employment Support Allowance (ESA), Universal Credit and other smaller benefits.
PIP and ESA are both benefits awarded to support people with disabilities and health conditions, while Universal Credit is the government’s landmark welfare reform that has replaced six other working-age benefits.
The size of the tender – the largest issued by the department since 2012 – suggests a complete overhaul of the system is envisaged, Gus Tugendhat, founder of contract data provider Tussell, told HuffPost UK.
“While health assessments are a necessary part of delivering our welfare system, the current arrangements have been mired in controversy,” said Tugendhat, whose firm provides analysis on UK government contracts.
“Let’s hope that it puts the conditions in place for DWP and its private sector partners in future to conduct these assessments in an efficient and compassionate manner.”
The contract details also reveal the new service will be delivered by a “DWP-owned single digital platform”, meaning applications will be moving online. It is not currently possible to apply for PIP digitally.
The DWP says this will enable greater sharing of information across different benefit applications and reduce the need for people to provide information on multiple occasions.
But the “digital-by-default” online-only model already rolled out for Universal Credit has proved controversial, with concerns it is excluding people from the welfare system, particularly vulnerable groups.
‘Demeaning and degrading’
The revelations about the revamp come after years of complaints about the system of health assessments.
People with disabilities have described the process as “demeaning and degrading” and charities say the high rate of successful appeals against PIP benefit refusals show the system is not working.
The latest figures, published in 2018, reveal DWP decisions not to award PIP payments were being overturned at 71% of appeal hearings.
“Our biggest concern is that there’s nothing here that says anything about quality and moving away from assessments being a tick-box exercise,” said Hunjan. “I cannot think of any campaigners that have suggested that one assessment for two benefits is the answer to the problems that we’ve seen.”
She criticised the outsourcing model as “fundamentally flawed”, saying private contractors are not the right organisations to be delivering health assessments.
“A key problem is that the assessment itself is not necessarily done by specialists of the [health] conditions that people might present with,” she added. “Also the claimants we’ve spoken to say assessors lack empathy and we’ve certainly witnessed this.
“It is intrinsically wrong, because you need the assessments to be done within a culture which is one of believing claimants and understanding that they are the experts in their own condition, and you’re more likely to get that in the health sector and the charity sector.”
DWP secretary Amber Rudd last week announced an end of repeat PIP benefits assessments for disabled pensioners, saying she wanted a more integrated system.
The DWP says the new multi-billion pound contract will result in a better service and save money for the taxpayer.
“As the secretary of state made clear last week, our priority is to significantly improve how we support disabled people,” said a department spokeswoman.
“Integrating the service that delivers PIP assessments and work capability assessments will improve the assessment process for millions of people claiming health-related benefits.
“Future contract costs will be subject to the public procurement rules to ensure quality and value for money.”
Data from Tussell shows health assessments represent one of the DWP’s biggest areas of spending with private companies.
Since 2012, the department has awarded a contract to consultancy group Maximus People Services worth £595m, two to IT services firm Atos worth a combined £391m, and two to Capita for £244m – all to provide health assessments.
‘I am begging you please help me’
HuffPost UK has previously reported on the death of Mark Barber, who took his life within days of learning his disability benefits would be cut by £20 a week.
The 49-year-old gardener, who suffered debilitating disabilities after surviving a horrific machete attack, was found dead in his housing association flat in West Sussex on July 26, 2017.
In the weeks before his death, Barber had been asked to complete a reassessment of his benefits by the Department for Work and Pensions.
He told his friend and neighbour Lorraine Barry he was hopeful of getting a bit more money following the reassessment, which at points made him so anxious he had to be persuaded to stay in the room.
But he later learned of the fateful decision to cut his benefits, despite his chronic health problems.
“I am officially begging you please help me!” Barber wrote on Post-It notes found in his flat following his death, setting out his anxieties over money.
Barry criticised the benefits reassessment process as fundamentally flawed and a “massive waste” of public money.
“I don’t think they work, not least because they put people through so much of a struggle,” she said. “I don’t understand why the DWP are not just speaking to healthcare professionals.”
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