The highly controversial ‘fit for work’ test is “far from satisfactory” for people with mental health problems, a damning new report has found.

The report – ‘In Safe Hands Now‘ – from the centre-left think tank IPPR found that reforms to the Work Capability Assessment (WCA) are ‘urgently needed’ in order to ‘ensure more decisions are correct first time around’.

The IPPR draw attention to a review of the WCA by Dr Litchfield where he compares the UK system to that used in the Netherlands. Sick and disabled people in the Netherlands are not assessed as being ‘unfit for work’ or ‘fit for work’. Instead, ‘specialist medical practitioners and vocational rehabilitation experts’ are used to determine a sick and/or disabled persons ability to work in ‘hypothetical jobs’. This is used to work out a persons ‘earning capacity’ and the level of support they will require to maintain or increase it. The system is designed to identify what sort of work a person can do, rather than simply deciding whether they are capable of working or not.

The WCA has been heavily criticised for its poor level of accuracy and for how those going through the stressful and demeaning process are ‘insensitively’ treated. Earlier this year the Work and Pensions Select Committee said that the WCA is so flawed it should be scrapped and completely replaced.

‘Fit for work’ tests are ‘not leading to effective and appropriate support to help people back to work’, the IPPR report finds. Despite the ‘ESA regime’ being designed to ‘curb the number of claims and suppress costs’, the costs of implementing the system ‘are soon to breach the welfare cap’, the report says.

Sick and disabled people who are not yet well enough to return to work, but may be at some point in the future, could at some point find themselves on the government’s ‘Work Programme’, or other ‘back to work’ schemes. The IPPR say that for people with mental health problems who are, or used to, in receipt of ESA or its predecessor (Incapacity Benefit), the Work Programme is a ‘poor place to end up’.

Official DWP figures show that people with mental health problems are far less likely to achieve a job outcome through the Work Programme than other participants. Of the 137,130 mentally ill people who have been through the back to work scheme, only 7,060 left the programme having secured sustained employment. Furthermore, 70.6% of participants with mental health problems said they had received ‘little’ support in managing and treating their condition. The IPPR say that it’s difficult to see how this wouldn’t affect a person’s ability to move off sickness benefits and into work.

The IPPR say that following reforms would help to improve the WCA so that decisions are right first time:

  • Additional evidence about people with MHPs should be collected by the assessor or the decision-maker if it seems likely that the application form and/or face-to-face assessment have not been able to provide a full and accurate picture of how the person’s condition impacts on them.
  • Before being able to evaluate work capability, assessors and decision-makers should be trained to develop the sufficient expertise and experience in dealing with people with MHPs to make a valid judgment on their ability to work.
  • There should be continuous monitoring of how the work capability assessment is conducted and communicated throughout, specifically focused on its impact on the wellbeing and confidence of participants with MHPs.

The think tank also say that existing back-to-work support is handing people with mental health problems from ‘one failing programme to another’, and at ‘no point are they receiving useful, personalised employment support’. The DWP should be:

  • Assessing support needed to work, not policing a gateway to benefits: in the Netherlands and Denmark, for example, assessment is used to determine entitlement to support, not just to benefits (including wage subsidy). In the UK,  despite the rhetoric, the WCA is still a test of what people can’t do, focused on benefits rather than employment.
  • Pursuing ‘supported employment’ strategies, not just supported job search: the current regime is too focused on labour market attachment, but other approaches are available, like programmes in Norway and Sweden modelled on the ‘place, train and retain’ approach.


Last edited on 22 August 2014 at 01:11am.