Deborah, her ATOS debacle, and the missing coat mystery

Deborah, her ATOS debacle, and the missing coat mystery

Deborah Ruby, who had her ESA stopped, despite her multiple chronic health issues.
Deborah Ruby, who has had her ESA stopped, despite her multiple chronic health issues.
Deborah Ruby struggled into this London Trussell Trust food bank with her voucher. She’s a 51-year-old lady with multiple health issues. These include, but are not limited to, arthritis in the lower spine, hips, neck and knees, depression, severe Irritable Bowel Syndrome and congenital heart problems. She has been separated from her husband for 12 years and has four children – the youngest of whom is still at school.

A social worker gave her a voucher for the food bank after her employment and support allowance (ESA) was stopped on July 25. This stoppage followed her ATOS work capability assessment in June. Atos Healthcare is of course making an early exit from its contract to carry out “fit for work” tests on disability claimants. If Deborah’s experience is typical, the ATOS assessment process is if possible leading to ever more unfair outcomes for individuals. She describes the worst sort of bureaucratic bungling, and a medical report that appears to bear little resemblance to Deborah’s account of the ATOS medical interview it was based on.

Given what Deborah says happened at the medical, it’s hard to see how she wouldn’t succeed in her appeal. But the likelihood of a successful appeal at some future date isn’t any consolation to someone in her position. For nearly eight weeks she’s had no ESA and no money for food. Her sister – the only sibling who could help – had been able to offer some assistance over the summer. But now she’s had to go back to her home outside the UK. So last week Deborah hit a full-blown crisis – and has no idea if or when she will receive any benefits again. Now that her ESA has been stopped, her housing benefit has also been stopped – pushing her into arrears.

Deborah says she brought along a letter from her doctor to the Croydon medical, describing all her medical conditions. She says that at the medical, she was having so much difficulty moving around – she needs two knee replacement operations – that the doctor had to help her on and off the couch. She was in pain throughout the assessment.

The letter that followed informing her of the decision and the medical report was both contradictory and wrong, says Deborah. While there was a statement at the top of the letter from the Department for Work and Pensions saying that she would be receiving an award and that they would write to her in due course, the assessment and medical report contained in the correspondence told her that she had failed the medical and had in fact been given zero points. She would have needed 15 points to keep her ESA award. According to Deborah, “the report said she could get on and off the couch and she was not in pain, and it said I had no problems putting on my coat myself – but I didn’t have a coat with me. The assessment referred to my depression and other illnesses with the exception of fibromyalgia – but they feel that I’m fit for work. It referred to my incontinence, and she (the doctor) acknowledged that, but said that I can still go out. It seems that in the report they put down the things they wanted to put. The doctor’s report also says ‘she was well enough that she made it here’ and I feel she glossed over and downplayed everything.”

Though initially confused about the contradictory letter, Deborah said that when a follow-up letter did not arrive within a few days, she then sent back a copy of the assessment form as part of an appeal, indicating where she disagreed with the doctor’s assessment. The DWP sent a letter back saying that it had read her challenge, but that it agreed with the ATOS decision. It told her to apply for jobseeker’s allowance (JSA). She has been back to her GP to get medical certificates saying that she cannot attend work-related programmes or work because of her health, and an NHS psychologist is also liaising with her GP ahead of the appeal. Meanwhile, Deborah is having to deal with letters from the council about her stopped housing benefits.

While it at least appears as if she has got past the reconsideration stages and lodged an appeal successfully, she has no idea when it might be heard and has been left stranded with no support while she waits.

According to the latest tribunal statistics, there has been a drop of 92% in employment and support allowance (ESA) appeals and a 93% drop in Jobseekers Allowance (JSA) appeals in April to June 2014 compared to the same period last year. A new system of mandatory reconsiderations before appeals was introduced by the DWP for ESA and JSA at the end of October 2013. Figures have yet to be published by the DWP to show how many reconsiderations result in a change of decision.

We do of course need to know much much more about the people who don’t get as far as an appeal. Precisely how many people are left destitute or dead because they’ve abandoned – or been abandoned by – the system at this most tortuous stage?

Bone marrow transplant patient could lose her Motability car under DWP rules

“Lesley” is petrified. She needs a bone marrow transplant at the end of this month. Trying to deal with Myelodysplasia – a serious blood disorder that causes a drop in the number of healthy blood cells – is tough enough already, and she is very anxious about the transplant. But now she’s worried she’ll lose her Motability vehicle at the very time she needs it most. The decision by the Department for Work and Pensions (DWP) to stop paying the mobility component of the Disability Living Allowance (DLA) or Personal Independence Payment (PIP) to the Motability Scheme when people end up in hospital for more than 28 days has added an extra level of concern.

The 47-year-old divorcee depends on the leased car for her 40-mile round trip to the NHS centre of excellence where she’s being treated. She expects to be in hospital for four to six weeks post-transplant. She has also been told by the hospital that she could be in again after that frequently as an inpatient and will have three visits a week as an outpatient. She’s advised that using public transport poses an infection risk post-transplant. She is unable to rely on family and friends who are at work for lifts, and can’t afford taxis.

The DWP tells people in receipt of DLA to let them know when they first go into hospital, and to tell them once they are discharged. They are then told to supply details of any subsequent inpatient stays. But “Lesley” says this just “adds to the stress when I just want to move on with my life – they are just putting obstacles in my way”.

She says Motability has been sympathetic to her circumstances and has said she can keep the car for a couple of months if DWP payments to Motability on her behalf are cancelled. But with the prospect of being in and out of hospital on the horizon for some time, she’s concerned that a possible pattern of stop-start payments may not be triggered quickly enough to ensure that the car is available when she desperately needs it. She believes that those with the most serious illnesses who have to spend longer in hospital risk losing out most under this change, which began in April 2013. “If I wasn’t very ill I would continue to get it (the mobility component), but because I am very ill, I don’t get it. In all the literature I am advised to not use public transport due to infection risk. How then would I get to hospital?”

Following the transplant her immune system is going to be “wiped out completely”. “If I travel (on public transport) with someone with a cold and I catch it, that would be extremely bad news – really dangerous. Getting public transport could effectively kill me yet I may be left with no choice. I have had to think long and hard about this transplant. All my family and friends work and I’m single, so cannot rely on others. It’s scaring me as it’s a dangerous procedure anyway and then I could catch a cold virus or infection from someone and die because I don’t have my own clean safe transport. The decision to change the rules in 2013 was a ludicrous one. Also I wasn’t warned about it when I started the car scheme. Suspending and reinstating the mobility component must cost a fortune in administration.”

There are two organisations which work closely together to deliver the Motability Scheme. They are Motability, a registered charity, responsible for oversight and Scheme policy, and Motability Operations Ltd, a not-for-profit private company that operates the Scheme under contract to Motability. A spokesman for Motability said in a statement: “To lease a car, scooter or powered wheelchair through the Motability Scheme, an individual must be in receipt of the Higher Rate Mobility Component of the DLA, or the Enhanced Rate of the Mobility Component of PIP. Motability has no role in determining who should receive disability benefits – that is solely the responsibility of the Department for Work and Pensions (DWP). In general, the DWP do not make payments of DLA care and mobility components after a disabled person has been in hospital for 28 days or more (84 days for children under 16). Payments resume once the disabled person comes out of hospital. From April 2013 onwards, the DWP has started to treat all hospital inpatients in the same way, whether they have a Motability vehicle or not. This means that if a customer spends more than 28 days in hospital, the DWP will stop paying the mobility component of the DLA/PIP to the Motability Scheme.”

The statement adds: “As soon as customers are admitted to hospital, they should notify the DWP of their change in circumstance. For hospital stays of more than 28 days, they or somebody acting on their behalf should contact Motability’s Customer Services Team on 0300 456 4566 to discuss their individual circumstances. Depending on the expected length of their hospital stay and, of course, their own preferences, we will discuss appropriate arrangements with them. Since this change was made by the DWP in April 2013, we have been contacted by a number of customers in this situation and have been able to leave cars with them in the expectation that they will come out of hospital and have their allowance reinstated by the DWP within a reasonable period.”

The DWP was approached for information about the cost of administering the change and the savings made since the change was implemented. It was asked how many disabled people had been affected after stays in hospital and if any cost/benefit analysis had been undertaken prior to the change. It was also asked if any challenges or complaints had been received, and whether there was a legislative basis for the change. No reply has been received to date.

Motability’s flexible and understanding approach to individuals affected by this change is admirable – but what happens if the person is unfortunate enough to need a series of extended hospital stays and the DWP isn’t paying for the car? The uncertainty involved isn’t making “Lesley’s” life any less stressful. Also, for how long will Motability continue take the financial hit as it strives to do the right thing?

The state owes citizens money they are entitled to – then they fall into debt

Manager of Greenwich food bank Alan Robinson has been aware for some time that the clients who come here for help need more than the food they’re given to see them through an immediate crisis. They also require longer-term support to tackle the underlying problems, which often include inadequate incomes and unmanageable debts. The local authority – The Royal Borough of Greenwich – is also mindful of this. The two organisations have submitted a bid for funding that would enable the food bank to “triage” clients with money problems.

If the joint bid is successful, the funding would come from the Money Advice Trust – which has today launched a new report saying that households are becoming susceptible to serious debt problems because they can’t afford basic household bills.

Alan said: “The Money Advice Trust is offering funding for initiatives that are innovative, but help meet people’s basic needs…approaches that would help them get relief from debt and educate people so they don’t get into debt. Greenwich Council had been bouncing this problem around internally, so they called me up and said could we work together and get a bid in.” The initial “triage” would take place at the borough’s food banks, which are part of the UK-wide network of Trussell Trust food banks. Clients with the most severe problems would be immediately referred to specialist debt advisors in the borough – either Christians Against Poverty (CAP), Meridian Money Advice, or Citizens Advice.

A second group assessed as heading for serious debt problems would get advice from trained volunteers, and Alan says the food bank may also employ a debt and advice specialist. A third group of people with the least severe problems would get help and encouragement on a range of issues, including advice on cookery classes, “smart” shopping and smoking cessation. The gateway to the advice would be food banks, but Alan says it’s possible that the scheme could be extended to other venues including children’s centres. The proposed scheme mirrors a recent announcement by the Trussell Trust that it is to launch a pilot scheme to give financial advice. The move comes after the food bank charity received a six-figure donation from money saving expert Martin Lewis. Lewis is quoted in the Guardian saying: “Those who go to food banks are already open to asking for help….If we can intervene at that point…it will hopefully cut down on the number of return visits.”

While what Lewis says is undoubtedly true, it’s crucial to remember what the Trussell Trust itself underlined in its June report Below the Breadline: The Relentless Rise in Food Poverty, published jointly with Oxfam and Church Action on Poverty. The report says that “cuts to social security since April 2013 have had a severe impact on poor and vulnerable families across the UK” and that “these cuts have been coupled with an increasingly strict and often misapplied sanctions regime – 58 per cent of sanction decisions are successfully challenged, suggesting that many people needlessly suffer a loss of income through no fault of their own”.

The report says the abolition of the Social Fund has stopped thousands of households from being able to access crisis loans. The Trussell Trust, “estimates that 49 per cent of people referred to food banks are there due to problems with social security payments or because they have been refused a crisis loan”.

The move by the Trussell Trust to launch the pilot money advice scheme and the bid to run something similar here in Greenwich are to be welcomed. But expert social security advice and help with challenging sanctions and speeding up back payments appear to be what clients need most. In essence, the state owes them money that they are entitled to. They’re not getting it, hence they are in debt and that leads to them not being able to pay their water bill or council tax. The most effective cure would of course be a humane social security regime, and an approach to sanctions that is fair and proportionate. A move away from zero hours contracts by employers would also be a significant move to transform lives. The problems faced by most of the people who visit the food bank are not fundamentally caused by lifestyle issues or bad choices. The vast majority of the food bank clients are innocent victims of an increasingly unfair and cruel welfare system.