Details have begun to leak about the Dispatches investigation into the Work Capability Assessment scheduled to air on monday night, then followed by a Panoram investigation into the same subject. Dispatches report that they have sent an undercover GP, Dr Steve Bick through the complete Atos training process filming undercover.
As news leaks, reputable news outlets are reporting that this shows this must be proof of targets built into the WCA system, presumably in the contract the DWP issued to Atos. However, this is not quite the case, what is being reported based on evidence from undercover investigation is 'targets that aren't targets', ie statistical norms. What this means is that there are effectively targets built into the system, but they are targets that are not technically targets because the targets seem to be being imposed by a potentially false baseline average, for which there appears to be no source of original data or evidence at this time.
This means there are essentially two possibilities; either the government, DWP, ministers and Atos have all repeatedly lied on record about the existence of targets, or they are telling the truth and there aren't actually any targets, because they aren't called targets, they are called statistical norms.
Atos are an international IT company, their business has been built upon using systems of statistical norms to determine trends. This can be seen as acceptable if for example Atos were running the contract for a telecoms system. A company who want to understand the different types of phone calls made at different times would clearly benefit from this kind of statistical analysis, which is presumably why telecoms giants use the Atos systems. However, human beings, particularly sick, disabled and vulnerable human beings do not fit neatly into any kind of statistical system. It is impossible to predict who will come through the door in any given day to see an HCP for their WCA, quite unlike telephone calls which tend group into averages - the way we see reflected in the kind of special deals offered by British telecoms companies who use such data to offer cheap calls after 7pm.
The consequences of getting the baseline figures wrong to work out an average for telephone calls might be significant financially for businesses, and impact on consumers by skewing the 'special deals' based on these averages, but they do not have the potential to have a devastating harm on individual lives in the way those exact same averages do when used to assess sick and disabled people for eligibility for benefits.
So, what really happens on the frontline for those being assessed for benefits and those doing the actual assessments?
A system of statistical norms is used to ascertain how many people a health care professional assigns to the different eligibility groups in Employment Support Allowance; the support group for those most unwell and not expected to perform any work, the Work Related Activity Group for those expected to be able to do some work at some point in the future, and those found fit for work. Using these 'norms' or averages, Atos monitor closely each HCP's performance, and as explained by Dr Bick, any who assign more people to those groups than the norms suggest they should are then audited.
Although I have been unable to find any evidence that HCP's are fined or formally disciplined for putting too many people in the support group, it is clear that frontline workers see this as a punitive process and are constantly attempting to juggle the requirements of the claimants they assess with the requirement to stay within a statistical norm. This average appears to be based on national rather than regional data, so an HCP assessing people in Croydon would be held to the exact same average that an HCP assessing people in the Outer Hebrides would. That's quite an extreme example, but demonstrates that using a system of averages creates a skewed picutre as it does not account for regional variations in population size, health conditions and the local economy.
At this time, no-one knows what original data these statistical norms, or targets that are effectively targets, but just aren't called targets, are based upon. It may be that data originated from the DWP, based upon guesstimates from the old Incapacity Benefit claims, but it may be that Atos only ever had access to an average data sample to build their national averages upon. Frankly, unless the DWP and/or Atos radically alter their stance and start communicating clearly about the details of the WCA system and outsourcing process then we may never know the answer to this key question.
The next question is of course whether these 'norms' take any account of different conditions, ie are there different sets of norms for people with Mental Health conditions, fluctuating conditions, sensory disabilities or Learning Disabilities? The answer is presumably not, as HCP's, confirmed by DWP and Atos quotes are outlining a simple one system of averages based upon crude numbers of total people seen.
That would lead us to wonder, how can a norm possibly be a norm for an overall client group without accounting for all these different conditions? Perhaps the DWP or Atos will see fit to share the answer to that question, but I shan't be holding my breath waiting.
Then that leads us to some even bigger questions, the DWP record outcome data for WCA's, to use as part of the official statistics relating to the benefit ESA. This data is of course based on outcomes from a system which uses Atos assessments held to unverifiable in origin norms, decisions almost always confirmed in practice by the DWP.
So, if the whole assessment system is based on a system of averages that have no regional or condition related breakdowns in them, then that flawed system is used to measure the official figures of those eligible for benefits we then have some very serious questions to ask about the validity of those final figures. Figures remember that seem to be built on an average assumption of how many people should receive a particular level of benefit, without ever leading us to the original data, if any, used to predict these outcomes.
This could mean that four years on from the introduction of a benefit which has caused terrible distress and fear to sick and disabled people having to claim it, been implicated as a factor in multiple suicides and used to make presumptions about work and growth figures has been based on nothing more than a guesstimate, that became an average, that became a norm, which became a target that isn't a target.