'This brutal new system': a GP's take on Atos and work capability assessments'

I see work capability assessments damaging patients struggling with mental health issues and serious illness

I had not seen Eileen for some time, until a few months ago when I was asked to phone her. She sounded distressed, confused and frightened and did not understand what was happening to her. She has been a patient of mine for 10 years and over time, I've tried to help her cope with her mental illness. A few years ago her mental health had deteriorated so much that she needed to be in hospital.

All her benefits had been stopped, Eileen explained, and she was in arrears with her rent. She was assessed by Atos, a private company employed by the government to carry out what it calls the "work capability assessment" to decide whether people receiving incapacity benefits should be sent back to work. Eileen found the form she was asked to fill extremely long and bewildering. The assessment is a tick-box exercise, with points scored depending on the patient's replies. The assessors do not ask GPs like me to provide any medical information about patients to help them make their decisions, even though someone may have received incapacity benefits for many years.

Later, Eileen was sent a letter. She was fit for work, she was told, and so she would no longer be receiving benefits. Instead, she would need to go out seeking work. She had no money and soon fell behind with her rent and bills. She told me she didn't understand why all this was happening to her, but having no money, she decided to leave London to look for work elsewhere. But she had nowhere to stay, and ended up sleeping on the streets. Nor could she find work, despite the government's mandate that she do so. She eventually returned to London to seek help. She has no insight into her mental illness and doesn't believe she is unwell.

I have watched with mounting horror as my patient, an extremely vulnerable woman, has been put at risk of homelessness and deteriorating illness as a result of government policy. I am very aware of the importance of work, and as a GP will always encourage people to look for a suitable job if I think they can. But I also know my patients, and I am outraged that some are being put through the punishing stress this assessment causes. Many of my patients have gone through the Atos assessment to be told that they are fit for work with all their benefits stopped without notice. The financial impact is extreme. Several of my patients have shown worsening symptoms of depression, and some have become suicidal. Because we were so concerned about a patient's mental health – which worsened as a result of the stress caused by these assessments – we have had to involve a psychiatric crisis team.

The government will say that there is an appeal process built into the system for those who have been passed capable of work and disagree with the outcome. True, but it is very expensive. In my experience, patients whom I consider unable to work or even look for work usually win their appeal. In a recent appeal hearing, the tribunal judge read my medical report and concluded on the back of it that, contrary to the Atos assessment, my patient was indeed incapable of working.

I have witnessed a woman in her 20s who has a condition that means she is slowly dementing, and will eventually die at a young age. She is unable to walk, and now even unable to talk. She is looked after round the clock by her family. Her family has been forced to endure great stress from the work capability assessment. I believe that this could have been avoided had I been asked to provide a medical report explaining her disability, prior to the assessment process.

In another case, a man in his 40s had been homeless for many years. He has learning difficulties, alcohol problems and also has insulin-dependent diabetes. He is unable to read and write. A charity worked closely with him and managed to find accommodation and medical care for him, and they encouraged him to engage with the local drug services. In our GP clinic, we were working closely with him to help him to manage his diabetes better, in the hope of avoiding acute emergency admissions had his diabetes remained uncontrolled. Despite all this intensive help, Atos bulldozed their way in and found him capable of work. All his benefits were stopped immediately, and he is now in arrears. He has appealed and is waiting a tribunal hearing – a process that can take up to six months. Meanwhile, all that precious rehabilitation work we were offering him has also stopped as he has become so stressed, depressed and at times suicidal.

I am fearful that more of my patients will be put at risk of homelessness and suicide by this brutal new system. From my perspective, the most disadvantaged in our society are being punished. Work is good for all of us, if we are lucky enough to be in employment. But not all of us have the skills to work and some of us are so unwell or damaged by past experiences that they cannot do a job. We should accept that some people, for many different reasons, need supporting.

Instead of forcing vulnerable people onto the streets, why not concentrate on helping young people find worthwhile, fulfilling jobs? Leave patients like Eileen alone. She does not deserve the punishment that is currently being wrought upon her. For her safety and well-being, and for the sake of a humane society, I hope she wins her appeal.

• The name of the patient, and details of her case, have been changed to ensure confidentiality

6 Replies

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  • Hi ren robin

    I could not agree more, the mentally and physically ill are being targetted and being put under undue stress, which only serves to make their condition worse. If only more were being done to get young, fit and able people in work! Sigh.................

    Lyndy

  • Hi All

    Just my opinion but I really do think that the gov wants to get rid of the old and disabled so they can save on the expenditure they are creating. they are paying ATOS for taking people off the the sickness benefits and DLA etc (that is why their boss gets million pound bonus) this action is creating terrific stress in the old and disabled some of whom have even committed suicide.

    I have no idea what we can do to turn the tide on this and fear there will be more deaths to come because of these (if not criminally then morally wrong) policies.

    The next place that seems to be coming under the health cuts are the A & E departments, doctors are being encouraged to treat some seriously ill patients at home to save the cost of the beds at the hospital. What my concern is, what do politicians know about

    A - sick people and

    B - how to run a hospital.

    They have the costs made up by the bean counters (Accountants) and these can be read in any way that the politicians want so they can say "look at the figures" to justify their actions.

    I do believe those in charge are wanting to get rid of the non tax paying people be it old, sick or disabled they have to go. but what they have not taken into account is that

    A - They will one day become old (although I suppose being millionaire they will not count)

    B - They may become sick and/or disabled ( again the same, being millionaires they will not count)

    All I hope is for those to become like the rest of the us who rely on the pittance we are given by them and to feel like we do waiting in fear of losing our benefits and therefore our homes and everything.

    Wishing you all the best and kindest regards

    Terry

  • If you are worried about any of these issues there is a group on Facebook which you can join to try and add your voice and make a difference ... I am trying to think what it is called, ah yes one banner, if you feel this strongly about all the issues you have mentioned maybe joining that group as well as this site may be of help. I know the founder has health issues. I am not a member of this group myself but have heard of it and if you have political worries then maybe that would be a group you might like to join

    VG x

  • There are many out there that need to be told to get off their back sides and get back to work. My brothers tells of a man in his 40's who claims and get benefits including DLA and yet he is out digging the garden all summer. Work my brother says he would find hard. However the minute this man walks out the front door he walks with a stick as if he was a cripple. Unfortunately there are too many people out there getting benefit that do not need it and should be encouraged back to work. Like the woman in the newspaper that got seen on a fair ground ride after saying she couldn't work because she had a bad back.

    Two years ago i had a big job. I was a senior staff nurse on a busy cardiac unit and i loved it. I was looking forward to staying there until i retired. But my life crumbled to nothing, well not nothing but certainly not what i wanted it to be. Both my physical and mental health became critical but thankfully i had a great, fantastic GP who caught me has i fell and helped me to get the help i needed.

    This story made me cry because it feels as if it could have been me if things had been a little different and i hadn't had the support i needed when i needed it.

  • I'm getting very scared at the harsh way that vulnerable people are being treated and cannot believe some of the horror stories I come across.

    I was 60 years old last week and am unemployed after having being made redundant 4 years ago. I have only worked maybe 6 months since then. I have realised that all the jobs I apply for have conditions which meet the criteria for a younger generation and there's nothing I can do about that.

    My work is very specialised and I love doing what I'm good at doing, and although I suffer from fibromyalgia I would be able to carry on working in this field - if I could get a job that is....

    At my age I would love to start taking it easy, but I can't as I can't retire for another 3-4 years. Is this fair? I'm always under stress to make ends meet and have to attend back to work programs etc.

    How can the government expect those of us who don't have a job to carry on signing on for the next few years?

    I have so many complaints about how I am treated but it doesn't touch these poor vulnerable souls who even the doctors can't help. So sorry for my rant and send you all gentle hugsxxxx

  • crimes against our most vulnerable people, are being commited on a daily basis,the sick the poor, the disabled. thank God there are still people out there with a concience and the education to help stand up for these souls, no wonder so many are commiting suicide which i suspect is not being reported or recorded,help our people to rise up against this greedy bunch of parasites who steal of the pooor and give to the rich as well as helping themselves to taxpayers money without consience.

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