Criticism of the Work Capability Assessment

Criticism of the Work Capability Assessment (WCA), which is used by the Department for Work and Pensions in the United Kingdom to assess and reassess claimants of Employment and Support Allowance, has ranged over concerns about its design, its reliability, its fiscal effectiveness, and its links with the deaths of people with disabilities.

Design

The United Nations Committee on the Rights of Persons with Disabilities published a report on the situation facing disabled people in the United Kingdom. Of the WCA, it said:

Evidence indicates several flaws in the processes related to the Employment and Support Allowance. In particular, the Committee notes that, despite several adjustments made to the Work Capability Assessment, the assessment has continued to be focused on a functional evaluation of skills and capabilities, and puts aside personal circumstances and needs, and barriers faced by persons with disabilities to return to employment, particularly those of persons with intellectual and/or psychosocial disabilities.[1]

A review undertaken by occupational heath expert Professor Malcolm Harrington and a scrutiny group that included the National Clinical Adviser to the Care Quality Commission and the Chief Executive of the mental health charity MIND gave a negative picture of the WCA in 2010, with the The Guardian summarising Professor Harrington's opinion as being that the test was "impersonal", it "lacked empathy" and it was too reliant on "computer systems and drop-down menus".[2] In the executive summary of his report, he wrote that "the WCA is not working as well as it should. There are clear and consistent criticisms of the whole system and much negativity surrounding the process."[3][4]

When Atos gave its reasons for seeking to exit the contract to carry out the assessment, the firm announced that it had come to the conclusion that "in its current form, the WCA is not working for claimants, for DWP or for Atos Healthcare".[5] Conversely, Dr Paul Litchfield, who advised the DWP on the performance of the WCA in 2013 and 2014, described the test he had helped to design as "by no means perfect" but nevertheless adequate. However, in 2014 he cautioned that: "We have taken the WCA about as far as it can sensibly go in terms of modification and adjustment".[6] Professor Dame Carol Black advised the government on back-to-work policy between 2006 and 2016. She said of the WCA: "I don't think anyone thinks it has been a success", describing it as "badly placed" and too far from when the first sick note or fit-note is penned.[7]

Iain Duncan Smith complained that the system gave doctors a "binary choice", not an opportunity to deliver a more nuanced opinion on claimants' fitness for work.[8] In April 2016, the new Welfare Secretary, Stephen Crabb, said that the WCA had "never worked as intended. The WCA was a mess, it didn't recognise mental health issues and other types of disability".[9] Later the same year, the Shadow Secretary of State for Work and Pensions, Debbie Abrahams, said the test her party had described as "tough but fair" in 2010 had been "discredited".[10] When appearing on Question Time, the president of the Liberal Democrats, Baroness Sal Brinton, described the WCA as "not fit for purpose", adding "this process absolutely fails" and "we need to get rid of it". On the same BBC programme, Kier Starmer QC, a former Director of Public Prosecutions, said: "It is time for a real review of how these assessments are actually working".[11] In September 2016, Damian Green was asked by the BBC's Andrew Marr about the deaths of specific benefit claimants;[12] in reply, the Secretary of State for Work and Pensions acknowledged that "obviously there are individual cases where it looks as though the system is not working".

Reliability

Turnover of decisions

Parliament's Office of Science and Technology has analysed the WCA's performance; it found that "the number of fit-for-work decisions being overturned on appeal has led to questions about the reliability of the assessment process". Between 2011 and 2013, around 40% of claimants found 'fit for work' appealed to a tribunal and around 40% of those appeals were successful.[13][14][15]

A 2012 study of 28,000 tribunal hearings analysed the reasons for overturning the DWP's decisions:

In the same year, a parliamentary committee heard evidence from welfare advisors that, in nearly two out of three successful appeals to tribunals against fit-for-work decisions, appellants were seeing their points rise from zero in the original assessments — meaning that the original WCA had detected no relevant disabilities at all — to at least 15 points after the tribunals had independently assessed their claims.[16]

Outcome targets

Professor Malcolm Harrington, the first external reviewer of the operation of the WCA, was asked by a parliamentary committee whether he had ever found any evidence that Atos assessors had been put under pressure to reach targets. He replied:

They say not, and whenever I have gone anywhere, they say not. This is purely anecdotal, but there was one Atos assessment centre I went to where the bosses walked out and I was left with a couple of assessors having a cup of coffee at the end of the session, and they told me they were under pressure.[17]

In 2012, a GP posed as a trainee Atos assessor and recorded undercover video footage that was later broadcast by Channel 4's investigative current affairs programme Dispatches. In the film, trainers warned the NHS doctor that if on average he were to recommend more than one disabled person per day for the Support Group, he would be subject to an increased level of management scrutiny through a mechanism known as "targeted audit".[18] The undercover doctor was told:

If it's more than I think 12% or 13%, you will be fed back 'your rate is too high'

An assessor on "targeted audit" would also no longer be allowed to recommend a claimant for the Support Group without asking an authorised colleague for permission to do so. When the doctor asked an experienced assessor where these rules had come from, she replied: "DWP".

Both the DWP and Atos categorically denied ever having had any target for getting claimants off sickness benefits. However, both eventually admitted that Support Group "norms" were being used nationwide,[19] though they both denied that the purpose of "targeted audit" was to limit the number of claimants placed in the Support Group. Atos said that the audit process triggered by the breach of a "norm" was intended to ensure consistency across the firm's UK team: if the assessor's reports met the DWP's expectations, the healthcare professional would not be asked to change their recommendations.[20]

However, in 2012, the Work Programme firms responsible for training people in the Work-Related Activity Group said they had "ongoing concerns about the accuracy of the WCA" and rated earlier improvements to the WCA as only "4 or 5 out of 10".[21] In 2013, the same organisation complained that claimants who were "clearly unfit for any type of work-related activity" were nonetheless being put in the Work-Related Activity Group rather than the Support Group, and that "claimants with terminal cancer, whose life expectancies were shorter than the work-ready prognosis" had been referred to them for pre-employment training.[21]

Outcome bias

In May 2013, another doctor who had recently resigned from Atos blew the whistle on biases in the testing process, telling the BBC:

These assessments need to be done independently, impartially, considering all the evidence and with proper use of medical knowledge – and that's just not happening at the moment. Pressure is being put on healthcare professionals in many cases to come up with a particular outcome, really regardless of the facts of the case

He claimed that:

The news report drew particular attention to misleading interpretations of the test's eligibility criteria that the doctor claimed were being taught to new assessors as off-the-record rules of thumb during their initial classroom training (and used as benchmarks when assessors' reports were audited). An Atos executive interviewed by the BBC acknowledged that the guidance referred to "might seem somewhat odd" but said it had been "taken out of context" and was part of a much bigger set of questions considered during assessments.[22]

On the same day, an Atos spokesperson made it clear that the training curriculum was set by the DWP and duly followed by Atos, stating: "We do not deviate from government guidelines in our training".[23] The Employment Minister was asked by the BBC about the allegations of bias but he replied with a general explanation of the principles underpinning the Incapacity Benefit reassessment programme. Tom Greatrex MP wrote to the Prime Minister to bring to his attention the whistleblower's allegations that the core assessment was "skewed against the claimant". Downing Street made no reply but simply passed the letter back to the DWP, which issued a non-specific statement.[24]

In July, the former assessor gave an interview to The Guardian. In it, he described how he had first heard trainers advocating the "bogus" interpretations of the test's descriptors in 2011 during a one-day conversion course covering the new version of the WCA and its new criteria. In response to the article's description of auditors instructing assessors — at the point when a report of a face-to-face assessment had been written, but had not yet been sent to the DWP — to alter their reports and reduce the number of points awarded, Atos said:

There is no ethical conflict in advising a doctor that aspects of their work require further attention to meet the standards expected[25]

In August, the whistleblower expanded on his allegations in a first-hand account published by the British Medical Journal. He suggested that the DWP's alleged actions might have been at least partly driven by pressure to "reduce government debt". The DWP's senior doctors made no reply but the clinical director of Atos did respond. In relation to the claim that some Atos assessors had been led to interpret the test's criteria too harshly, she did not deny that the "bogus rules of thumb" had been used in training talks but she said that assessors were expected to follow the written guidance contained in the 255-page instruction manual issued to all assessors:

All reports must fully comply with the Department for Work and Pensions guidance contained within the WCA Handbook; all our practitioners are expected to be fully aware of this guidance and are responsible for ensuring that the advice they offer complies with it.[26]

The foreword to the WCA Handbook states:

This Handbook is not a stand-alone document, and forms only a part of the training and written documentation that a Healthcare Professional receives. As disability assessment is a practical occupation, much of the guidance also involves verbal information and coaching.[27]

On 22 July 2013, the DWP announced that it had recently "directed" Atos to "put in place a quality improvement plan following a DWP audit which identified an unacceptable reduction in the quality of written reports produced following assessments."[28] The DWP said it had carried out an unscheduled and "urgent" audit in "April/May [sic] 2013" that looked at reports written over the six months to March, in which time Atos had furnished the DWP with more than 300,000 reports. The DWP said it had found 164 reports that its in-house medical staff had said had scored only a 'C' for quality. However, during the period in question, the 164 reports had been deemed adequate by the department's on-the-ground decision-makers, who had used them to decide on claimants' entitlement to ESA — unacceptable reports are returned to the outsourcer for what the DWP calls "a rework". The department's press release tried to explain the paradox:

A ‘C’ grade report does not mean the assessment was wrong, and the recommendation given in a ‘C’ grade report may well be correct, but, for example, their reasoning for reaching that recommendation may lack the level of detail demanded by the DWP.[28]

The main practical outcome was that all WCA assessors had to undergo retraining and the WCA Handbook was rewritten.

Fiscal effectiveness

In 2012, the DWP's handling of the contract with Atos was the subject of a critical report by the National Audit Office (NAO).[29]

In 2013, the Public Accounts Committee of MPs chaired by Margaret Hodge heard evidence that over the previous financial year, Atos had been paid £112 million to carry out 738,000 assessments. At that time, 38% of appeals to tribunals were successful and the committee's view was that too many wrong decisions were being made, only for the decisions to be overturned later (while Atos was paid by the DWP, it was the Ministry of Justice that paid for the tribunal appeals, with £500 million being the potential cost of these appeals over ten years).[30] Hodge said that the DWP got "far too many decisions wrong on claimants’ ability to work...at considerable cost to the taxpayer" and added that this can "create misery and hardship to the claimants themselves". She also remarked: "We saw no evidence that the Department was applying sufficient rigour or challenge to Atos given the vulnerability of many of its clients, the size of the contract and its role as a near monopoly supplier. We are concerned that the profitability of the contract may be disproportionate to the limited risks which the contractor bears"[31] and concluded: "The Department's got to get a grip of this contract!".[32][32]

The Office for Budget Responsibility (OBR) found that between 2011 and 2014, no savings had been made in the sickness benefit budget, which remained at more than £13 billion a year.[33] Furthermore, because by 2015 many more claimants than forecast were being placed in the Support Group, the government's fiscal watchdog raised its estimate for annual spending on ESA by at least one billion pounds.[34]

In January 2016, the NAO published its evaluation of the DWP's health and disability assessment contracts.[35] It said the cost of each WCA had risen from £115 under Atos to £190 under Maximus (when a typical assessment lasted no more than 90 minutes and was carried out by a nurse) and it was sceptical about the value for money of the DWP's contracts with its outsourcers.[36]

Deaths

The DWP accepts that being found fit for work and ineligible for sickness benefit can, in some circumstances, harm a recipient's physical or mental health. For this reason, one of the WCA's eligibility criteria — the non-functional descriptor Substantial Risk — applies where there is, on balance, more than a small risk of harm if the claimant were to be declared 'fit for work'. In these circumstances, the at-risk person should be given the benefit.

There is evidence that the WCA has been linked to the deaths of hundreds of disabled people, particularly people with mental health problems.

Post-mortem case reviews

The DWP has looked into the deaths of at least 49 benefit claimants. Most died after undergoing a WCA. The department was compelled to publish their findings in May 2016 after a campaign by Disability News Service.[37][38] The conclusions of the heavily redacted reports included:

  1. A "persistent area of possible concern" was "a dislocation between policy intent and what actually happens to claimants who may be vulnerable"
  2. The Incapacity Benefit reassessment programme lacked a clear system for identifying vulnerable recipients
  3. DWP staff did not always check the DWP's database for indicators that claimants were at risk
  4. The WCA's medical criteria for identifying risk were not properly applied
  5. Claimants with cognitive problems were not filling in their claim forms in the manner that the DWP had envisaged (or at all)
  6. Requests by claimants for a reconsideration of the department's initial decision - while waiting for which, the claimant receives no sickness benefit - were not prioritised in a "common sense" way
  7. Appeal dates for tribunals took too long
  8. The failure to apply the department's Six Point Plan for dealing with people with suicidal ideas was "a recurring theme"

Inquests and media reports

There have been several media reports of unexpected deaths after assessments where the claimants seem to have been at risk of harm if found fit for work. The most widely reported deaths followed assessments that took place in the seven months from December 2012 to June 2013. The deaths themselves were clustered around the summer of 2013:

Tim Salter

Tim Salter was visually impaired as a result of brain damage from a previous suicide attempt. He killed himself after being found fit for work. At his inquest, the coroner said: “A major factor in his death was that his state benefits had been greatly reduced, leaving him almost destitute and with threatened repossession of his home”.[39][40]

Linda Wootton

Linda Wootton had undergone two heart-and-lung transplants and was left with a weakened immune system caused by the immunosuppressant therapy she was taking to prevent her body rejecting the transplanted organs. She died days after the DWP upheld its decision to declare her 'fit for work' (neither the assessor, the first decision-maker nor the second official who reviewed her case had deemed her to be at substantial risk of harm).[41][42]

Mark Wood

Mark Wood was receiving Incapacity Benefit and Disability Living Allowance because of long-term mental health problems, including a "phobia" of some types of food and overvalued concerns about his food's freedom from contamination. He had been losing weight for many months before his WCA. He died, weighing 35 kg, after he was declared fit for work and his Incapacity Benefit and Housing Benefit were stopped (the DWP continued to pay him Disability Living Allowance). His family believes that the stress of his forthcoming WCA and then afterwards the loss of the bulk of his income damaged his already fragile mental state, worsened what the DWP called his "eating disorder" and so contributed to his death.

The Oxfordshire Coroner delivered a narrative verdict in which he said the final pathological event was "unascertained", but he saw no significant evidence of neglect or self-neglect (neglect has a very precise legal definition), suicide, or unlawful killing (for which a high evidence threshold must be crossed before a coroner can deliver it as a verdict).

The DWP carried out a post-mortem case review then admitted that the decision to declare him fit for work had been wrong, but the department denied that its decision had contributed to his death.[43]

In response to the case, Tom Pollard of the mental health charity Mind said:

Unfortunately this tragic case is not an isolated incident. We hear too often how changes to benefits are negatively impacting vulnerable individuals, who struggle to navigate a complex, and increasingly punitive, system. We know the assessment process for those applying for employment and support allowance is very stressful, and too crude to accurately assess the impact a mental health problem has on someone's ability to work. This leads to people not getting the right support and being put under excessive pressure which can make their health worse and push them further from the workplace. We urgently need to see a complete overhaul of the system, to ensure nobody else falls through the cracks.[44]

Michael O'Sullivan

Michael O'Sullivan suffered from long-term depression and anxiety and was receiving sickness benefit in the form of Income Support until it was stopped by the DWP following a WCA. He committed suicide after being on Jobseekers Allowance for six months. After the inquest, the coroner said: "The intense anxiety that triggered his suicide was caused by his recent assessment...as being fit for work". The assessor — a former orthopaedic surgeon — admitted during the inquest that he had not fully explored the risk of suicide at the face-to-face assessment, despite suicidal ideation being described on the claim form.[45]

The coroner wrote to the DWP in January 2014. She was concerned that neither the Atos doctor nor the DWP decision-maker had sought information from Michael O'Sullivan's own doctors. The DWP wrote back, referring to the guidance issued to the Atos healthcare professionals who, before face-to-face assessments, scrutinised the paperwork submitted by claimants — guidance called the Training and Development ESA Filework Guidelines. The DWP confirmed that suicidal thoughts had been described on Michael O'Sullivan's application form but said "further evidence was not requested in line with the stated policy [in the Training and Development ESA Filework Guidelines] where the claimant has referred to suicidal ideation". These policy guidelines say: "Where there is evidence of a previous suicide attempt, suicidal ideation, or self-harm expressed in the [information on the claim form], the healthcare professional must request further medical evidence".[46]

The DWP said the specific action it would take in response to the coroner's concerns was to issue a reminder to the relevant members of staff. Michael O'Sullivan's daughter's MP said:

The coroner said there was a causal link between his intense anxiety, the assessment and the consequences. His daughter has been asking for answers to how that happened, what went wrong...and she hasn't got answers for three years...it really deserves to be looked at.[47]

The case had many similarities with an earlier death following a WCA, where a coroner had also written to the DWP about the lack of an attempt to contact the psychiatrist who had been treating a person with mental health problems who went on to commit suicide.[48]

David Barr

David Barr suffered from paranoid delusions and had a history of self-harm. He was taking anti-psychotic medication prescribed by his psychiatrist. He jumped from a bridge to his death after a risk assessment — by a physiotherapist — that led the DWP to deny his claim for ESA.[49] The department later admitted that its decision was wrong; it said he should have been categorised as being at substantial risk of harm.[50][51]

Epidemiology

A study published in the Journal of Epidemiology and Community Health in November 2015 found an independent correlation between the deployment of the Incapacity Benefit reassessment programme in England and an increase in reported mental health problems, higher levels of antidepressant prescribing and 590 additional suicides.[52] The DWP responded by pointing out that association does not imply causation: the rise in mental health issues when the WCA was deployed after 2010 could have been caused by something else entirely and the temporal association with the reassessment programme could just have been a coincidence. The researchers said they had found no other explanation for the rise.

Deaths after WCAs

In response to a campaign using the Freedom of Information Act, the Information Commissioner ordered the DWP to disclose the number of people who had died in the 12 months after their WCA since May 2010[53] – the DWP had sought to withhold this information, arguing variously that it was too time-consuming, the department was about to publish it anyway or it would not be in the public interest because the data might be misinterpreted. But in August 2015, the DWP was forced to reveal that between December 2011 and February 2014, 2,380 claimants had died after being declared fit for work. However, as Dr Ben Goldacre has explained, an imprecise question in the original FOI request and an unhelpful DWP response — which Goldacre characterised as "essentially a PDF and an excel spreadsheet full of red herrings" — meant that no firm conclusion could be drawn from these figures alone about whether the death rate of people found fit for work is any higher or lower than expected.[54][55][56][57]

Deaths and claims ending

DWP figures show that, between January and November 2011, 10,600 sick and disabled people died within six weeks of their benefit claim ending;[58] many disability campaigners believe that these deaths occurred after — and even because — the claimants were declared fit for work. The Daily Telegraph has questioned this: it posits that the 10,600 deaths include people who happened to die from natural causes, after which their benefit payments ceased. The newspaper said that when the DWP states "within six weeks", this "does not mean 'within the following six weeks': it means 'within six weeks either side'. What that means is that the large, presumably overwhelming, majority of those 10,600 people died, and then their claims ended because they were dead."[59]

United Nations report

In November 2016, the United Nations Committee on the Rights of Persons with Disabilities published its report on the situation facing disabled people in the United Kingdom. Of deaths after WCAs, it said:

The [DWP] initially stated that it did not monitor deaths that occurred after assessments. Evidence gathered during the inquiry indicated that, in 2012 and 2015, such information was released by the Department for Work and Pensions following freedom of information requests. Additionally, information originated from official sources indicated that 33 deaths of claimants who died after being assessed were examined. The [DWP] claims there is no causal link. The Committee is not aware of any attempts at objective, thorough, open and impartial investigation regarding those deaths by an independent body.[1]

The DWP responded by confirming that it did not systematically monitor or investigate deaths following WCAs. It admitted that it had reviewed the deaths of at least 49 claimants, but said it only did this a): when formally notified of a death by "a family member or solicitor", and b): where a link between the death and the DWP's actions has been alleged by the family member or their legal advocate. The department said that an internal review might "make recommendations for possible improvements" but would not "seek out or apportion blame" (internal reviews have though been used by the DWP to deny any culpability for deaths following WCAs).

The DWP drew the committee's attention to the role of the coroner in England and Wales.[1]

References

  1. 1 2 3 "Committee on the Rights of Persons with Disabilities". United Nations. November 2016.
  2. ↑ Ramesh, Randeep (23 November 2010). "Incapacity benefit tests face overhaul after damning report". The Guardian. Retrieved 12 April 2015.
  3. ↑ "Harrington Review 2010" (PDF).
  4. ↑ "Government response to 2010 Harrington Review" (PDF).
  5. ↑ "Outsource group seeks exit from UK £500m benefits contract after death threats". Financial Times. Retrieved 14 September 2015.
  6. ↑ "Litchfield Review 2014" (PDF).
  7. ↑ Lauren Applebey (20 October 2016). "Dame Carol Black:"The work capability assessment has not been a success". SHP.
  8. ↑ Nicholas Watt; Patrick Wintour (2 October 2015). "Iain Duncan Smith: ‘It is too easy to go out there and emote’ (interview)". The Guardian. Retrieved 9 October 2015.
  9. ↑ "Secretary of State for Work and Pensions Stephen Crabb on his new job, 'gay cure claims' and the bedroom tax". Western Telegraph. 8 April 2016.
  10. ↑ Jon Stone (26 September 2016). "Labour would scrap DWP's controversial Work Capability Assessment 'fit to work' tests". The Independent.
  11. ↑ "Question Time". BBC. 27 October 2016.
  12. ↑ "The Andrew Marr Show". 18 September 2016.
  13. ↑ The Committee Office, House of Commons. "House of Commons – Employment and Support Allowance and Work Capability Assessments – Work and Pensions Committee". Publications.parliament.uk.
  14. 1 2 "Decision Making and Mandatory Reconsideration" (PDF). Social Security Advisory Committee. July 2016.
  15. ↑ "Appeals against DWP 'fit to work' decisions more successful than ever". The Independent. 10 September 2015.
  16. ↑ "Public Accounts Committee". parliamentlive.tv. 19 November 2012. Retrieved 14 November 2015.
  17. ↑ "Professor Harrington: evidence to work and pensions committee". 14 May 2014.
  18. ↑ Amelia Gentleman (27 July 2012). "Atos assessors told to keep disability benefit approvals low, film suggests". the Guardian.
  19. ↑ "How Norms Become Targets". centreforwelfarereform.org. Retrieved 14 September 2015.
  20. ↑ The Guardian (London) 9/12/2013 How Atos comes under pressure to declare disabled people as fit for work
  21. 1 2 Can the Work Programme work for all user groups? (pdf) (Report). House of Commons Work and Pensions Committee. 15 May 2013. Retrieved 16 January 2016.
  22. ↑ "Disability benefit assessments 'unfair', says ex-worker". BBC News. 16 May 2013.
  23. ↑ Ramesh, Randeep (16 May 2013). "Atos benefit claimants face biased medical assessments, doctor alleges". The Guardian. Retrieved 12 April 2015.
  24. ↑ David Clegg (5 July 2013). "Iain Duncan Smith blasted for ignoring the warnings of an Atos whistle-blower who quit in protest at controversial welfare tests". dailyrecord. Retrieved 14 September 2015.
  25. ↑ Gentleman, Amelia (31 July 2013). "Why I blew the whistle on Atos fitness-for-work test". The Guardian. Retrieved 12 April 2015.
  26. ↑ Dr Angela Graham (18 September 2013). "Atos Healthcare replies to Greg Wood". BMJ.
  27. ↑ "Work Capability Assessment handbook: for healthcare professionals". Department for Work and Pensions.
  28. 1 2 "Hoban – taking action to improve the Work Capability Assessment". www.gov.uk. Retrieved 14 September 2015.
  29. ↑ National Audit Office (October 2012). "DWP Contract Management of Medical Services" (PDF).
  30. ↑ Ted Jeory. "£500m bill for appeal battles over benefits". Express.co.uk. Retrieved 14 September 2015.
  31. ↑ "Department for Work and Pensions: Contract management of medical services". UK Parliament. Retrieved 14 September 2015.
  32. 1 2 "MPs criticise disability benefits tests". BBC News. 8 February 2013.
  33. ↑ "Office for Budget Responsibility". Office for Budget Responsibility. Retrieved 14 September 2015.
  34. ↑ Welfare trends report (Executive summary) (pdf). budgetresponsibility.org.uk (Report). Office for Budget Responsibility. 2015. Retrieved 2 February 2016.
  35. ↑ National Audit Office. "DWP Contracted-Out Health and Disability Assessments" (PDF).
  36. ↑ Rajeev Syal (8 January 2016). "Maximus miss fitness-to-work test targets despite spiralling costs". The Guardian. Retrieved 14 January 2016.
  37. ↑ "Suicide of benefit claimants reveal DWP flaws, says inquiry". The Guardian. 13 May 2016.
  38. ↑ "DWP FOI releases for May 2016". 12 May 2016.
  39. ↑ Luke Traynor (28 December 2013). "Benefit cuts blind man committed suicide after Atos ruled him fit to work". mirror. Retrieved 14 September 2015.
  40. ↑ "Disabled Kinver man killed himself after being left "almost destitute" when his state benefits were axed". stourbridgenews.co.uk. Retrieved 14 September 2015.
  41. ↑ "Atos Assessments: Widower claims system 'unfair'". BBC News. 30 May 2013. Retrieved 15 December 2015.
  42. ↑ "Atos Benefits Row: Transplant Patient Linda Wootton Dies After Being Judged 'Fit For Work'". The Huffington Post UK. Retrieved 14 September 2015.
  43. ↑ De Graaf, Mia (29 March 2014). "'We were wrong': Government admits it should not have axed disability benefits of Asperger's sufferer who starved to death just five months later weighing five-and-a-half stone". Daily Mail. London.
  44. ↑ The Guardian (London) 28/02/2014 Vulnerable man starved to death after benefits were cut
  45. ↑ "Coroner rules Michael O'Sullivan killed himself after being found fit for work". Daily Mail. 21 September 2015.
  46. ↑ "Regulation 28: Michael Brendan O'Sullivan". 13 January 2014.
  47. ↑ "Question Time". BBCTV. 27 October 2016.
  48. ↑ "Government welfare advisor did not know about 2010 suicide 'triggered by work assessment'". ITV News. 9 November 2015.
  49. ↑ Craig McDonald (22 September 2013). "Heartbroken dad blames benefits axemen for driving his ill son to commit suicide". dailyrecord. Retrieved 14 September 2015.
  50. ↑ "Parents of 'fit for work' suicide man back call for prosecution". Disability News Service. 28 July 2016.
  51. ↑ "Documents show WCA suicide death mirrored 2010 tragedy". Disability News Service. 4 August 2016.
  52. ↑ B. Barr; et al. (16 November 2015). "‘First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study". Journal of Epidemiology & Community Health. Retrieved 20 November 2015.
  53. ↑ "Freedom of Information Act 2000 (FOIA) – Decision notice" (pdf). Information Commissioner's Office. 8 June 2015. Retrieved 9 January 2016.
  54. ↑ BBC (London) 27/08/2015 More than 2,300 died after fit for work assessment – DWP figures
  55. ↑ The Guardian (London) 27/08/2015 Thousands have died after being found fit for work, DWP figures show
  56. ↑ "How DWP has confused everyone by releasing the right data for the wrong question on benefits deaths.". Storify. Retrieved 14 September 2015.
  57. ↑ Editorial. "The Guardian view on welfare reform: death and the benefit system". the Guardian. Retrieved 14 September 2015.
  58. ↑ "Incapacity Benefit: Deaths of Recipients" (PDF). Department of Work and Pensions, UK Government. 9 July 2012. Retrieved 12 April 2014.
  59. ↑ "The '10,600 people died within six weeks of being declared fit to work by Atos' stat is simply wrong". The Daily Telegraph. London. 9 July 2014.
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