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Incapacity change identities revealed

3 July 2007
Benefits and Work can now reveal the identities of the people involved in a meeting at which it was decided to make it much harder for claimants with mental health conditions to be found incapable of work under the new Employment and Support Allowance.

As a result of that decision the number of activities in the mental health test was cut from 15 to just 10 and many descriptors were rewritten to drastically reduce the possibility of claimants scoring points

Working party
In April of this year we discovered that the DWP had removed the names of the people present at the PCA Mental Health Working party meeting on 30 November 2006, the minutes of which we had obtained using the Freedom of Information Act. (See: Incapacity change identities kept secret).

At the time we voiced fears that the private sector staff, and particularly Unum Provident and Atos Origin employees, might have played a leading role in the decision.

However, we have now obtained a list of those present and full meeting minutes and we can report that this is not the case.

Those present were:

Dr Moira Henderson, Principal Medical Advisor, DWP

Brigid Campbell, Social Security Advisory Committee

Dr Jed Boardman, Royal College of Psychiatrists and Sainsbury Centre for Mental Health

Miles Rinaldi, Head of Delivery, National Institute for Mental Health in England

Professor Geoff Shepherd, Director of Service Improvement, Cambridgeshire and Peterborough Mental Health Trust

Dr Bob Grove Department of Health and Sainsbury Centre for Mental Health

Dr David Henderson Slater, Consultant in Neurological disability/Rehabilitation Medicine, Oxford Centre for Enablement

Richard Birkin, Occupational Psychologist

Scant evidence
The decision to make such extensive cuts to the test appear to have been made on the basis of very little evidence - just 55 cases were evaluated and not all of these were mental health ones - and a relatively short meeting at which some were supportive of the test and others critical. The critical comments were as follows:

"David [Henderson Slater] said there was considerable overlap of the Mental Health criteria especially around "anxiety" and the doctors applying this new assessment needed to be better trained."

"Bob [Grove] agreed with everything that had been said and that some cases had enormous scores which significantly showed overlap."

"Geoff [Shepherd] said Panic attacks was not a function impairment and he did not agree that it should be included. Most people were mildly anxious when going somewhere new or experiencing something different. There was a need to combine anxiety and panic attacks."

The meeting then came to the following, apparently unopposed, decision:

"It was agreed to delete the descriptors Ability to communicate appropriately with other people, Emotional resilience, Maintaining appearance and hygiene and Panic attacks and incorporate some of them in other descriptors."

Still in doubt
And that's it. On that basis huge changes were made to a test that will profoundly affect the lives of millions of people over the coming years. However, the details of the changes were left to others to work out. So, whilst we now know who made the decision to make the test much harder to pass, we still don't know who rewrote it in the form in which it now appears and we are still unable to rule out the involvement vested interests within the private sector.