Thursday, 17 January 2013

Thousands of disabled and sick people will be hit by new ESA/WCA changes #esaSOS

On 28 January 2013 the UK government is due to make a set of changes to the Work Capability Assessment (WCA). The WCA is the flawed ‘fitness to work’ test which assesses whether sick and disabled people can get Employment and Support Allowance (ESA): a benefit designed to help and support very unwell or profoundly disabled people into work.  

Although these changes have been advertised as small ‘amendments’, they will in fact have a huge impact on the way people’s illnesses and disabilities are assessed. Many vulnerable people’s needs will suddenly be able to be overlooked or ignored, meaning they could end up losing the support they desperately need to manage their conditions.

Hundreds of thousands of sick and disabled people across Britain need your help to fight these changes!

In the fitness to work test, your needs are assessed by a ‘healthcare professional’ employed by the French private company ATOS. This assessor doesn’t just need to look at your current difficulties. For example, they can also imagine how using an aid (e.g. a wheelchair) might improve your ability to work and make a judgement based on that – without even asking your opinion!

However, soon this “imaginary test” will be able to be used for many more aids (including guide dogs and false limbs!). This means that soon thousands more people could be judged as fit to work, without being consulted, on the basis of an “imaginary” aid they don’t own or may not be able to use!

It gets worse. Even if returning to work may clearly put you at risk, these changes will mean you can still lose your disability benefit – as long as the assessor believes that trying a new therapy or treatment might reduce that risk. There’s no need for evidence that the treatment will help: you will lose support either way, making it much harder to manage if the treatment doesn’t work as hoped – let alone if it ends up making things worse.

>>> Imagine Bert, who suffers from severe schizophrenia, but is found fit to work and made to take behavioural therapy in the hope of improving his condition. He will lose his disability benefit, without the assessor having to look at several vital questions: how hard it would be for Bert to contact a psychiatrist? How long would an NHS appointment take to organize? Are there private options in his area – and could he afford them if so? What if the therapy doesn’t work, or takes a long time to adjust to? If the government’s rule changes go through, people like Bert who are desperate to work will find it nearly impossible to get an accurate assessment, affecting the quality of their support and actively preventing their efforts to get back into work <<<.  

The government is also trying to change the way people’s conditions are assessed by dividing health problems into two separate boxes: ‘physical’ and ‘mental’. So, for instance, when looking at what tasks people can do, only the ‘physical half’ of the test will apply to those with physical disabilities. The same goes for the effects of treatment: for instance., if you’re taking mental health medication, only mental health side-effects will be looked at.

This completely fails to understand the way that many disabilities and illnesses can lead to both physical and mental effects. This is also the case for many common treatments: such as those for schizophrenia, Parkinson’s disease and multiple sclerosis.

>>> Think of Emily, who suffers severe, chronic pain because of nerve damage to her leg. Emily is among the 49% of chronic pain sufferers who also suffer depression as a result of continuous pain. An assessor may see Emily as able to do some work as long as she takes strong painkillers for the rest of her life, meaning she could pass the ‘fitness’ test. Yet the painkillers may not deal with the depression caused by her condition. Painkillers have also often been shown to affect people’s wakefulness and decision-making. So taking the medication may affect Emily’s ability to do a job in a completely new way – yet because these new problems are cognitive, they would not need to be looked at by the assessor when making their decision. <<<

Pretending the effects of illnesses and disabilities can be separated in this way goes against all medical practice. Going even further, and using this method to ignore sick and disabled people’s needs, is at best hopeless policy, and at worst deliberate cruelty. We cannot let the government treat some of the most vulnerable people in British society in this way.  

The main way you can help is by spreading the message about these changes to ESA. The government have tried to sneak them under the radar – the last thing they will want is people talking about them! 
1) Email your MP (you can search by name or constituency at;
2) Share this blog post on twitter (using the hashtag #esaSOS), Facebook and other social media. Click on the buttons below this post to share on Twitter and Facebook.
3) Email your friends and family a link to this post – or simply talk to them about it! Again, the main way we can get the government to reconsider is by getting people to talk about the injustice of these changes.So please spread the word as far and wide as you can!

Thank you so much for reading this far. Now let’s make sure these unwanted, damaging benefit changes never see the light of day!  

If you want to do more, please sign #WOWpetition and call on the government to think again.  Ask all of your friends to sign too!

The full #Spartacus briefing on the proposed changes to ESA can be found here.


  1. Hmmm I think it likely the first issue, whether a treatment might help you, rather than effecting whether you get ESA at all will just effect whether or not you're put in the 'can work, with help' category or not, as after all all they're saying is a treatment might help you. They will not penalise you unless you accept no offers of treatment at all- which would show you have no desire to get well. If it doesn't work get your doc/advisor to agree that with you before you drop it.

    As for the second issue, the person must put on the form that they suffer from 2 separate conditions, for instance pain due to an illness and depression (regardless of whether one condition is the result of the other) and this should ensure they consider the effects of both conditions.You always have to spell it out repetitively on these forms and always have had to. I can see your concerns but think there are a lot of scare stories going round, so try not to panic before you have to. But I've written to my MP and asked him to look into it.

  2. If a treatment/help doesn't work the person might have to agree to try a new one, rather than just refusing all help.To do nothing to help your condition, you would have to reapply to be moved out of the 'can work with help' category into the ones declared entirely unfit for work. But everyone should/does want to eventually be fit to work/well, to the extent they can work, am I right? :) Otherwise is like jobseekers who aren't even trying.Not saying is possible for everyone, but everyone should be doing all they can to improve their condition.Otherwise, choosing to stay ill.

    1. Whistleblower,

      You don't understand what a violation and a bad idea that is. There are often reasons why people refuse treatment, I know someone who landed up in a wheelchair after a medical professional ran roughshod over them, ignored the the patient was describing a known condition and forcibly applied a treatment that was actually the worst possible thing to do.

      They literally could have killed that patient, I have seen doctors who know about the condition the patient had blanch at the idea that someone could be that stupid when told about what that person did. Do you really want people deciding between risking paralysis/death and benefits if they get someonethat ignorant who decides that they need to do X treatment and X treatment is actually dangerous.

      I know patients who've had doctors who prescribed things that produced Chemical burns and pressed the patients to continue using them because having great sheets of skin just peel off "isn't a concern".

      Not every treatment is a good idea to try, and refusing a treatment doesn't mean we're not trying, it often means that either the side effects are too severe, it's inappropriate or it would be a waste of our time and NHS money.
      We live with our conditions 24/7/365, most of the time we know more about them than specialists. I actually often have to recite the full diagnostic criteria, and the symptoms of mine for new specialists I see because many of them have never even heard of it.

      I know what sort of treatments won't help and I know what sort of treatments are dangerous for me, I need to have the ability to withhold my consent in order to protect myself from inappropriate and dangerous treatment, same as everyone else.

      To demand that every disabled person complies with whatever is mandated by a doctor requires the doctor to make NO mistakes (never going to happen), endangers the lives of disabled people and is a violation of bodily integrity.

  3. What a joke.
    I'm a former CPN who was trained to use CBT with some users who were experiencing major mental illness.
    Unlike anxiety and depression that can sometimes be helped with a short course of CBT, the approach with someone experiencing schizophrenia is very different.

    It is NOT a behavioural approach, it is cognitive behavioural. It is an open ended long term way of working. It can not be used with everyone; only the keyworker/CPN who has the advanced training can assess suitability. Just a small percentage of my former patients were able to engage with a CBT approach to assist with managing hallucinations and to improve medication compliance. It is extremely demanding on the CPN's time, both in terms of contact time with the patient and the CPN's own supervision by an even more qualified practitioner.
    Unless the ATOS HCP is a MH Professional who is a CBT Practitioner, any referral for "behavioural therapy" is a total waste of everyone's time.

    1. Right, Mark. I'm similarly concerned about unqualified people assessing suitability / referring for wheelchairs, artificial limbs, guide dogs, medications....etc etc etc. Total nonsense.