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Failing the incapacity test - Guardian Letter Page

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Fri, 16/10/2009 - 2:44pm
John
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Letters

Failing the incapacity test

I was shocked to read Patrick Wintour's report (Sickness test cuts number eligible for new benefit, 14 October). As an inner-city GP I am beginning to see first-hand the heavy-handedness of this new policy. Patients with mental illness seem to be particularly affected. Three patients come to mind: a middle-aged woman with long-term psychosis who denies her illness but is clearly grossly dysfunctional; a Kurdish refugee tortured in Iran who suffers severe post-traumatic stress disorder and is very depressed; a man in his 40s, who has drunk alcohol heavily all his life, in crisis having begun to acknowledge the abuse in his childhood. All have failed the incapacity test. In my opinion none are capable of work.

The Department for Work and Pensions no longer asks GPs for our opinion. My impression is that the assessment is very mechanistic, the questions framed to elicit a yes/no response and not suited to assess the subtlety of mental illness in which patients are often unable to articulate their difficulty. While I accept the therapeutic benefit of work, I suggest the method of assessment needs refinement, particularly for those with mental illness. I'm sure my experience is not unique. I fear for the consequences: destabilising patients and increasing pressure on those already hard-pressed mental health and primary care services.

Dr Tim Greenaway

Manchester


• It will not come as a surprise to many of the 300,000 adults with autism in the UK that the majority of new applicants for employment and support allowance are failing in their claims. One year on from the introduction of this unnecessarily complex and unfair system, 100,000 adults with autism are living without a job and without vital benefits – they have effectively been written off.

The majority are experiencing a multitude of problems including getting a sicknote, filling in complicated forms, poor medical assessments, being misdirected to the wrong benefits and not even being asked about their disability. With only 15% of adults with autism in full-time, paid employment, steps must be taken to increase understanding of autism among Jobcentre Plus staff and make the employment and benefits system fair for people with this lifelong disability.

Mark Lever

Chief executive, National Autistic Society


• The answers to questions asked at these medicals are condensed to fit into a small number of tickboxes on a list. Letters from GPs and consultants are usually ignored. Many people who have been through the system have discovered, when they have received a copy of the findings of the medical, that some of their answers have also been ignored, and the opposite recorded. People going through the process, who have received good advice, put in an appeal. The panel conducting the appeal do consider medical evidence given to them and the original verdict is often overturned.

The treatment of mentally ill people is particularly bad. None of the doctors or nurses conducting the interviews have any specialist training in mental illness. They don't understand the often fluctuating nature of the problem, or take into account possible adverse reactions to stress. The whole system of medicals administered by private company would be considered a joke were it not for the number of sick and disabled people whose lives are being adversely affected.

Name and address supplied


• Deborah Orr (G2, 15 October) is spot-on – until her last sentence. Of course no one, including an ironing lady, ought to be paid less than £8 per hour in London. However, what is the salary of MPs for? They need to be reminded very loudly that their salary alone – without allowances or expenses – is more than that of 93% of the population. Of course it is peanuts compared to that of the bankers who have brought the world's economy to its knees, and to the money vacuumed up from the rest of us by whingeing tax avoiders, but that is no criterion. Indeed, the fact that our MPs have come to think of themselves as poor is symptomatic of our major problem: that they are lobbied so relentlessly by the rich. ("Please don't tax us, it wouldn't be fair! We'll bash you if you tax us! We won't give you a directorship/consultancy if you tax us!")

Marie Parker

London 

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