The PIP assessment is rigged to fail - here's how you can challenge it

PPR calls for the scrapping of the current PIP assessment – here are the reasons why

“Sundays are the best days, when there is no post”

(Participant in PPR focus group, speaking about PIP process)

Please note: This article is drawn from PPR’s submission to the Independent Review of the PIP Assessment Process. To read the full submission click here.

People with physical and mental health conditions and disabilities have a human right to be provided with the assistance and support they need to participate equally in all aspects of society. This includes the right to financial support, which since June 2016 has taken the form of PIP.  But the reality is that people entitled to this support are being forced to participate in what is a deeply distressing, invasive and demeaning experience. It is also one in which the decision making process itself is fundamentally flawed, relying as it does on an assessment by a target and profit driven private company rather than the person’s own testimony and evidence from a person’s GP and other  relevant health professionals.

The roll-out of Personal Independence Payment (PIP) is causing huge anxiety, distress and profound harm to many sick and disabled people. The Department for Communities’ target is to carry out 125,000 assessments by December 2018 – as of July 2017 43,000 people had been forced through this assessment.

The human stories behind this are extremely upsetting to read and hear about, and unfortunately there are very many of them.  

The Right 2 Work group ( R2W) which is campaigning for human rights protections in the social security system, through the introduction of its human rights checklist, the People’s Proposal,  is currently gathering evidence from people with experience of the PIP assessment process. Descriptions of the process include words such as ‘unfair’ ‘punitive’ ‘distressing’ ‘demeaning’ ‘degrading’ and ‘invasive’.

 

One local person who has spoken publicly about his experience, Mr. Terence Charles, a Fermanagh man who has cerebral palsy,  said that he left the assessment feeling ‘stressed and  intimidated’. He said he was made to feel as if he as ‘trying to defraud the system for requesting this Personal Independence Payment’. He added that many of the questions he was asked were either ‘invasive or pointless’. Mr. Charles said that overall  ‘I found it degrarding and I felt like my personal space was invaded’.

The recent inquiry into PIP and ESA by the Westminster Work and Pensions Select Committee was deluged with evidence, from people with similarly horrendous experiences of the PIP assessment process.

The Department’s own figures give an indication just of the scale of the misery being caused.

Facts and Figures

Almost half of all claims ( new and DLA re-assesed) up to July 2017 were denied by the Department for Communities.  Only 18% of new claims and 23% of reassessed claims were successful at the Mandatory reconsideration, a new internal stage in the appeals process, which is essentially designed to choke off appeals. When people did manage to appeal, over a third were successful, with claimants likely to be twice as successful at appeal hearing if they had a representative with them ( the figure for England is 69%).

39% of PIP claimants have a mental health condition, yet the Department for Communities does not carry out any impact assessment before denying these people their right to financial support to enable them to participate equally in society.

The reports being compiled by the private companies paid by the Department to carry out assessments are appallingly bad much of the time. Up to 56% of all assessment reports compiled by Capita were rated as ‘unacceptable’ by the Department for Work and Pensions, whose target figure is 3%.

In January 2018 the Department for Communities commissioned a review of the PIP assessment process, as required by the welfare reform legislation introduced in 2015. This review is due to report in June 2018.

In its submission to this review PPR called for the scrapping of the current assessment process, and its replacement with a genuine, person centred, human rights compliant process, one which places evidence from the person themselves and those health professionals they are known to, at the centre of that process.

Implementation of the People’s Proposal, developed by the R2W group would ensure that the problems identified below, were addressed. This proposal commands widespread support, including from a majority of local councils, all political parties bar one, major trade unions and from within the community, voluntary and advice sectors.

Central to the failures of the current PIP assessment process are the following:

1.      The lack of any due process in the assessment process.

At present the process routinely excludes proper medical evidence and/or expert testimony, as well as personal testimony and an honest, accurate assessment of essential criteria.

The assessment process fails to give primacy to evidence from a claimant’s GP or other relevant health professional, a vital element of any meaningful consultation. Assessors may obtain, but are not obligated to do so, information on a claimant from that person’s GP. Instead, claimants are ‘invited’ to send further evidence as part of their claim     (note that the cost of obtaining their GP file, which can be up to £50, is borne by the claimant). The Royal College of GPs has criticised this approach on the basis that placing the onus on the claimant to gather medical evidence carries risk.

The ‘tick box’ nature of the assessment is the very antithesis of the ‘genuine consultation’ people are entitled to. Claimants report that they are forced to respond to a barrage of unseen, multiple choice questions, many of which are meaningless and irrelevant to their condition, as well as being invasive and deeply distressing.

The ‘reality gap’ between a person’s story and the assessors’ subsequent report has been well documented. According to the Westminster Work and Pensions Committee, the shockingly high level of inaccurate assessments, reported to equate to 56% of all Capita reports for DWP,  translates into ‘human costs to claimants and financial cost to the public purse’.

2.      Lack of impact assessment

International human rights law requires that nobody is deprived of the minimum essential level of benefits. Yet the Department for Communities is knowingly in breach of this by failing to conduct any impact assessment before making a decision to deny disabled people the additional financial support they require and are entitled to receive.

Disabled people experience additional costs in most areas of everyday life, ranging from £1,513 weekly for a person with high-medium mobility and person support needs to £448 for a person with intermittent or fluctuating needs. The provision of PIP was intended to help claimants with these additional costs arising from a person’s disability. Cutting this financial support can therefore have potentially devastating consequences for individuals affected.

This failure to conduct an impact assessment is in breach of obligations under a number of UN human rights treaties and is leaving people with disabilities at real risk of poverty and further marginalisation from society.

3.      PIP Assessments are driven by the profit motive

The delivery of public sector contracts by large, private outsourcing companies such as Capita, driven by the profit motive, are inherently associated with lower quality and higher cost. The Work and Pensions Committee inquiry concludedthe current contracts have not made the system fairer, have not made it more transparent and have not made it more efficient’.  The estimated value to Capita of the Department for Communities’ PIP contract to Capita is roughly £60million. The personal testimonies gathered by the R2W group speak very powerfully as to why profit should never be allowed to be a motive in what should be a highly skilful, sensitive and empathetic assessment of people’s needs for additional support. It is clear that the current decision making process, where Capita assessors act as ‘messenger’ between the claimant and the Department for Communities is fundamentally flawed and wide open for corruption.

4.      Lack of relevant training, qualifications and compliance by PIP assessors

Criticisms have repeatedly been made of the lack of relevant qualifications and expertise by health assessors required to properly assess the full range of complex, physical and mental health conditions claimants present with. PPR has cross referenced the professional standards which all health care professionals conducting PIP assessments, and who are registered with the two relevant bodies, the Nursing and Midwifery Council (NMC) and the Health Care Professions Council (HCPC) must abide by. It has concluded that it would be impossible for those professionals to adhere to their professional standards. The R2W group has raised this with both the NMC and the HCPC, as well as with the Professional Standards Authority ( PCA),  the oversight body for both NMC and the HCPC. The PCA has indicated that it is currently conducting an investigation into this matter.

Based on all of the evidence it is abundantly clear that the current PIP assessment process is fundamentally flawed and is causing huge harm and distress to people with disabilities and long term health conditions. PPR does not believe that it is capable of being reformed. We are calling for its scrapping and replacement with a genuine, person centred, human rights compliant process, one which places evidence from the person themselves and from relevant health professionals including their GP, at the centre of that process.

See PPR’s submission for the full list of recommendations.