Leading charities slam ‘cruel’ back to work
tests for terminally ill cancer patients
Terminally ill cancer patients, and people undergoing chemotherapy, are being threatened with
benefit cuts if they do not attend back-to-work interviews, warn leading charities, Macmillan Cancer
Support and Citizens Advice.
A new report by the two charities has found the Employment and Support Allowance (ESA) process,
introduced last October to encourage ‘job ready’ people to return to work, is failing seriously ill and
disabled people, despite assurances from the government that they would be safeguarded from the
Findings from the report, Failed by the system, show:
Terminally ill cancer patients, and people receiving non-oral chemotherapy, are being required to
undergo medical examinations and attend work-focused interviews, when they should be
automatically exempt from both.
People undergoing, or recovering from radiotherapy and inpatients are being refused ESA when
they should automatically qualify for the benefit.
Cancer patients suffering from the long-term effects of cancer or cancer treatment are failing the
medical assessment and being refused ESA.
Patricia Watson from London was on a career break and about to start a new job when she was
diagnosed with terminal bowel cancer. She says:
“I was so shocked when I received a letter asking me to go to an assessment centre during my
third cycle of chemotherapy. I was told that if I didn’t attend the interview my benefits would be
stopped. No one was thinking about my condition or applying any common sense, I just felt part
of a conveyor belt system.”
According to the report, poor knowledge of ESA rules among Jobcentre Plus and DWP medical staff,
inadequate administration systems and a lack of understanding about cancer and the effects of
treatment, is resulting in ESA claims being incorrectly handled. Some terminally ill people are dying
before they get the financial support they needed.
Since April 2008, Citizens Advice Bureaux in England and Wales have dealt with over 85,000
enquiries about ESA and Macmillan’s benefits helpline has taken over 600 calls about the benefit
since May this year.
Mike Hobday, Head of Campaigns at Macmillan Cancer Support, says:
“It’s cruel and completely unacceptable that people who are terminally ill or going through
gruelling treatment are being made to jump through hoops to get money they should receive
automatically. The safeguards to protect cancer patients clearly aren’t working, and the ESA
system is riddled with problems. The DWP must address these issues without delay to make sure
people living with cancer are spared unnecessary distress and financial hardship.”
Lizzie Iron, Head of Welfare Policy at Citizens Advice, says:
“Citizens Advice Bureaux are reporting significant evidence of a range of problems with delivery of
the ESA system which are causing real hardship to the most vulnerable when things go wrong.
People claiming ESA are frequently seriously ill with urgent needs. It is important that the claiming
process works smoothly so that people do not get stuck in the system or are unable to get
through on the phone. DWP and Jobcentre Plus must rectify these problems quickly and put more
safeguards in place so people do not continue to suffer.”
Citizens Advice also publishes the first of a series of papers on ESA today. Limited capability sets out
concerns that the number CAB
enquiries relating to poor administration of the new benefit is higher
than expected, and that there has been an accompanying sharp increase in CAB qualitative evidence
on these issues.
To read the reports, visit macmillan.org.uk/failedbythesystem
{http://macmillan.org.uk/failedbythesystem} or www.citizensadvice.org.uk
{http://www.citizensadvice.org.uk}
Note:
The report is based on case reports from Macmillan and Citizens Advice benefits advisers helping
people living with cancer claim ESA.
ESA was introduced in October 2008 to replace Incapacity Benefit and Income Support.
To claim ESA, people have to take part in a ‘work capability assessment’ during an initial 13-
week assessment period. This may include completing a questionnaire and/or going to a medical
assessment. People deemed to have a limited capacity to work, are placed in a ‘support’ group
and do not have to undertake work-related activity. If they are found to be able to work, they are
placed in a ‘work-related activity’ group and have to attend work focused interviews.
The work capability assessment primarily determines whether the claimant is entitled to ESA. The
test contains a series of questions, called "descriptors", that relate to physical and mental
functions, and from which claimants score points. It focuses on specific physical functions, such
as reaching, bending and continence. A claimant must score 15 points to be deemed to have
limited capacity for work.
During the 13 week assessment period, claimants are paid up to £50.95 if they are under 25 and
up to £64.30 if they are 25 or over. After this period, those in the work-related activity group are
paid up to £89.90 and those in the support group are paid up to £95.15. If someone isn’t eligible
for ESA they can claim Jobseeker’s allowance.
Macmillan and Citizens Advice are recommending: Jobcentre Plus ensure contact staff and
advisers are fully trained and aware of the ESA rules;
An independent review of the work capability assessment to determine if it is effectively capturing
the problems and disabilities faced by people with cancer; Jobcentre and ATOS medical
assessors are equipped to ask claimants the right questions to gather accurate and substantial
evidence about their cancer treatment so that they are correctly assessed for ESA;Macmillan
Cancer Support funds positions in 68 Citizens Advice Bureaux to provide a specialist service to
people affected by cancer.
People needing help with their ESA application can speak to a Macmillan benefits adviser on
0808 808 00 00 or find a local Citizens Advice service at www.citizensadvice.org.uk.
{http://www.citizensadvice.org.uk.}
Citizens Advice is publishing further papers on ESA which will look at problems with the work
capability assessment, decision-making and appeals and the use of sanctions in the ESA
process.
Approximately one in five people living after cancer treatment develop significant long-term
emotional, psychological and physical problems that seriously affect their quality of life (e.g.
depression, incontinence, psychosexual problems, heart disease, new cancers).
Approximately 90,000 people of working age are diagnosed with cancer each year in the UK,
according to the Department of Health’s Cancer Reform Strategy, Dec 2007.
There are 774,000 people of working age in the UK who have had a cancer diagnosis according
to King’s College London and Macmillan’s Cancer prevalence in the UK, 2008.
Notes to editors:
1. The Citizens Advice service is a network of independent charities that helps people
resolve their money, legal and other problems by providing information and advice and by
influencing policymakers. For more information in England and Wales
www.citizensadvice.org.uk {index.htm}
2. The advice provided by the Citizens Advice service is free, independent, confidential, and
impartial, and available to everyone regardless of race, gender, disability, sexual
orientation, religion, age or nationality.
3. Most Citizens Advice service staff are trained volunteers, working at over 3,300 locations
across England and Wales.
4. Advice and information www.adviceguide.org.uk
5. Volunteer hotline 08451 264264 (local rate)
6. Citizens Advice Guide to your rights, second edition: January 2008 - over 600 pages of
practical, independent CAB advice. An invaluable resource for any bookshelf - available
from all good bookshops; price £11.99; ISBN: 9780141034089
7. Follow Citizens Advice on Twitter: twitter.com/CitizensAdvice
{http://twitter.com/CitizensAdvice}
8. Subscribe to Citizens Advice press releases via RSS news feed:
www.citizensadvice.org.uk/pressoffice {index/pressoffice.htm}
Citizens Advice is an operating name of the National Association of Citizens Advice Bureaux.
Charity registration number 279057,
VAT number 726 0202 76,
Company limited by guarantee.
Registered number 1436945 England,
Registered office:
Myddelton House, 115-123 Pentonville Road,
London N1 9LZ
PDF version
One-in-four cancer patients in the UK will be forced back to bed this Christmas because they cannot afford to put the heating on, a charity warns.
Macmillan Cancer Support says suffering from the cold can also affect recovery.
It is calling on the government to extend the winter fuel payment to cancer patients in need.
And it wants them to have full access to the new mandatory social support that energy companies will have to offer by 2011.
Around 19% of cancer patients undergoing treatment in the last year are in fuel poverty, double that of the general population.
Fuel poverty is defined as when a family needs to spend at least 10% of its income on heating and lighting the home.
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 Inside my husband and I had to make choices between eating or heating; we chose to eat and I sat shivering in bed under two duvets  Cancer patient Laura
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Professor Jane Maher, chief medical officer at Macmillan Cancer Support, said: "I see cancer patients suffering from exhaustion during and after treatment all the time.
"Add the factor of 'feeling cold' to exhaustion and you are left with seriously demotivated cancer patients that can do little other than go back to bed to stay warm and conserve energy.
"Cancer patients who are depressed or demotivated are less likely to be active or engage in exercise, yet going about 'normal, daily activities' could improve their well-being and reduce their likelihood of long-term health problems," she added.
Ciaran Devane, chief executive of Macmillan Cancer Support, added: "The current system is completely failing cancer patients and needs to be brought bang up to date."
Laura, 37, from Cambridgeshire was diagnosed with a rare form of cervical cancer last January: "I was at home with cancer, without a job and on an income of just £60 a week.
"Outside there was snow on the ground.
'Real concern'
"Inside my husband and I had to make choices between eating or heating; we chose to eat and I sat shivering in bed under two duvets."
Jean Slocombe, senior cancer information nurse at Cancer Research UK, said: "These survey results are of real concern.
"Nobody with a serious illness should be put in a position where they have to worry about being able to keep warm, especially if this may affect their recovery."
A spokesman for the Department of Work and Pensions said: "Winter fuel payments were created so that all those aged over 60, who are particularly vulnerable to the cold weather, could afford to turn up their heating in the winter months without worrying about the cost.
"There are other benefits designed specifically to meet the year-round costs, including heating, that arise as the result conditions such as cancer and their treatment.
"Disability Living Allowance is paid weekly and more generous.
"Help is also there to make homes more energy efficient through the Warm Front scheme for those on DLA and through cold weather payments in prolonged cold snaps."
From 27 October 2008, Employment and Support Allowance replaced Incapacity Benefit and Income Support claimed on the grounds of incapacity for new customers. The new system considers what an individual is capable of, and what help and support they need to manage their condition and return to work.
The Government proposes transferring all existing incapacity benefits customers to Employment and Support Allowance by 2013. Cash levels of existing benefits will be protected. We have begun the process of aligning the rates of incapacity benefit with ESA for those receiving age additions.
Work Capability Assessment
A new test, the Work Capability Assessment, was introduced in October 2008 for Employment and Support Allowance claims and is applied to all those people claiming the allowance. It assesses what an individual can do – rather than what they can’t do. The assessment looks at people’s physical and mental ability, including conditions such as learning disabilities and other similar conditions.
Following this assessment most individuals will be given support and employment advice to enable them to return to work where possible.
People whose condition causes very severe limitation of their ability, who are not able to engage in any work-related activity, will get a higher rate of benefit. They will still be able to volunteer to get support and employment advice if they want to.
From 2010, this new, more accurate Work Capability Assessment will begin to be applied to existing incapacity benefits customers.
This measure is part of The Welfare Reform Act 2007.
The Government has signalled its intention to undertake further welfare reform, as set out in the White Paper “Raising expectations and increasing support: reforming welfare for the future”. This work is being taken forward through the Welfare Reform Bill 2009.
Further details on the support available to people on incapacity benefits can be found at Pathways to Work.
http://www.dwp.gov.uk/policy/welfare-reform/employment-and-support/