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Archive for July 2013

Atos: “Leave Your Clinical Skills, (and Your Principles) at the Door”

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Deputy Medical Director of Sally’s Atos Centre:

 “You’d better throw your principles out the window otherwise you won’t be able to work here.”

 

 My previous post outlined my conclusion that Atos acts as a ‘shield’ for the government, and that by having them as a ‘middle man’ between claimants and the DWP facilitates the deflection of criticism that should rightly be aimed at warped government policies. In this recording for LBC Radio Sally, a former Atos employee, describes her experience with that ‘horrendous organisation’, which she alleges cares as little for its employees as it does the vulnerable people pushed through its WCA process.

Clinical skills not required

This timely appearance of a radio interview with ex-Atos nurse ‘Sally’ goes a long way towards validating my assertion. Sally is yet another ‘whistleblower’ emerging from this firm, and her testimony is even more damning of the bad practice that is rife within, indeed is deliberately built into, their process. It is one she describes as being factory-like, with

“…no regard for your clinical skills…and most of the people who go there haven’t got any because they’ve been out of practice for so long.”

For example most GPs occupied in an Atos role, she asserts, are “…retired or semi-retired, nearing their time…”. Considering the high remuneration for doctors taking up these positions its not unreasonable to suppose that many facing retirement might see it as somewhat of a ‘pension booster’.

 Aside from GPs she criticises the substandard quality of many of the (highly paid) doctors who tend in one way or another to be among the less competent, or less experienced, of medical professionals. This, she says, is because the majority (estimated by her as between 90-95%) are foreign nationals unable to secure NHS employment, or who have failed exams that might qualify them to work legitimately in our healthcare system.

Fiddling the data

Sally also confirms previous allegations about how ratios are set, the ‘targets’ that pre-determine how many claimants should go into each group, so that considerable file ‘juggling’ must be done to make sure those targets are kept to. That revelation met with a gasp of shock by the interviewer, she goes on to say “If you didn’t get those figures right, within your file, then there was repercussions on you…”, and likely ‘disciplinary’ action taken. Its glaringly obvious to anyone that if you’re working to targets you’re not authentically assessing the patient, you’re focusing instead on how people’s data can be manipulated to fit the rigid categories set for you. If you’re led by that then you can’t possibly be led by the evidence in front of you, the claimant’s unique health circumstances.

 The part most relevant to my post, however, is when she questions why the DWP does not employ the doctors and nurses directly, a common sense idea, which, considering the huge profits creamed off by Atos, would be more economically sound.

I think the answer to that is now plainly clear.

It is clear too, that those medical professionals employed by Atos are not there for utilisation of their medical skills, but merely to lend an aura of respectability to a process that has no medical legitimacy, nor even medical relevance, whatsoever.

Written by bigleyma

July 28, 2013 at 11:10 am

ATOS and the DWP – A Performance With Smoke and Mirrors

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Just a Few Bad Apples Reports

The government has been forced by public opinion, alongside a veritable tipping point of overturned decisions, to turn a critical eye on their WCA administrator, Atos. They’ve announced that Atos must produce a performance improvement plan’ since too many of their HCP’s reports are below desired standard. Not, they quickly emphasise, that they are ‘wrong’, simply that they are not putting forward their case clearly enough. The ‘reasoning‘ underpinning a portion of ‘recommendations’ lacks ‘detail’, it seems. No mention of outright misrepresentation, or glaring errors, just the ‘quality’ of report-writing that is not robust enough to underpin the concluding recommendation (upon which DWP officers make their decisions).

Since all emphasis is on substandard ‘report writing’, with no suggestion that decisions derived from them were incorrectly made, I can only interpret this move as an attempt to make those reports ‘foolproof’ against tribunal scrutiny rather than to have them reflect more honestly the applicant’s authentic circumstances with regard to their impairments.

Progress?

Many among the disabled activists and those campaigning on their behalf see this news as a positive development. And it certainly is ‘something’, rather than ‘nothing’. As others have pointed out it is pathetically little, and is nothing like the wholesale denouncement that most would wish for. Sadly, even this last perception is wide of base when it comes to the WCA, and its construction and delivery.

In this situation the position that Atos hold in the system of administration of welfare to the sick and disabled is akin more to ‘useful corporate idiot’ and proof of this is available for anyone to see in the government’s own ESA Regulations.

The Convenient Shield of Atos

Atos is the government’s shield in the symbiotic relationship between them and the DWP. From this relationship Atos draws status, legitimacy and above all massive profits. In this way it is similar to the companies who administer the Work Programme, which itself has been proven to do little more than line private pockets with massive amounts of public money (its actual results assessed as “worse than doing nothing”).

Sadly Atos’ activity, by contrast, definitely does more than nothing. It helps to cast people, whose only offence is to be ill, off health related benefits and either into destitution, or to join the competitive arena of seeking work against the able-bodied and healthy. The latter will, after a year, proceed onto the afore-mentioned, and certified useless, Work Programme, where they are likely to be ‘parked’ in favour of those it is more easy to find work for.

Atos Just Make the I.T., That’s All

What the government get in return from Atos, which is a ‘black box’ in itself, since scrutiny is inhibited by ‘commercial confidentiality’, is a defensive buffer against criticism of their policies. Atos are, in the final analysis, only the administrators of the government’s instrument. The government, through their ESA Regulations, say “This is how you assess people”, “These are the criteria to be used”. The computer driven LIMA system is simply the interface through which the government’s set criteria is ‘operationalised’, made digital. The WCA, as delivered, is an IT construct that is merely the government’s word made technological flesh, the digitalised manifestation of DWP-designed instructions. Because: Atos is an IT company. That’s what they do. They apply their undoubted expertise and experience to produce computerised IT ‘solutions’ to meet real world criteria. They don’t invent the criteria themselves, its provided to them, in this case by the UK government’s DWP.

The DWP Created the WCA

So what’s happening now? Its taken deaths, suicides in increasing numbers, at least two solid years of intensified activity by mainly sick people, who are derided as ‘extremists’ for their efforts, to arrive at this point. This point at which the evidence is so damning, so incriminating, that the facade of legitimacy of the WCA can no longer stand. The outrage that Atos draws from a sizeable portion of the public has become publically visible. But the shield which is Atos, which protects the government, which deflects from government criticism of their instrument, their descriptors, their model of sickness/disability, their deliberately designed construction of what they  will acknowledge as a sick or disabled person in need of help, still stands.

The Slickness of the Hand Deceives the Eye

Direct all your ire at Atos, they say, have said, these past years. It is the administration which is flawed, not the foundation, they claim. But that is not the case. In truth Atos are simply IT specialists who have accurately interpreted their government bosses’ instructions and are now ‘taking one for the team’. And its not a particularly harsh ‘one’ at that; some reports are not up to scratch, its a ‘quality control’ issue, bring in more ‘experts’, retrain the assessors. What a wonderful misdirection, a stage magician’s sleight of hand using smoke and mirrors. Atos is as insubstantial in the WCA process as smoke. The cards are, and have always been, the government’s own, designed, printed and laminated by them in the dark, shadowy recesses offstage. Their construction of the WCA (with the help of dispreputable insurance company, UNUM) will never be seen as long as a company like Atos is available to take the flak. And if Atos are ‘phased out’, as it seems is being prepared, the new Atos will then be the expediter of the government’s hidden programme. A programme that has a compound objective:

  • To choke off the outflow of public money to the sick and disabled, and, as a direct consequence, deter people from perceiving themselves as ill, worthy of support, and therefore inhibiting their take-up of entitled benefits. But possibly incentivising them to take up private insurance instead. (See Unum below)

  • To pull away the safety net of social security, without disturbing the inflow into government coffers of National Insurance contributions. (Another magician’s trick, coincidentally UNUM’s choice of visual metaphor for their ‘Backup Plan‘ tv ads -‘Whip away the tablecloth, but leave the crockery undisturbed’)

  • To change the very definition of sickness/disability itself, limiting qualification for benefits to only the most, and I mean most, seriously impaired – the paraplegic, those with only six months to live (I struggle to find any other categories deemed worthy, at this point).

And meanwhile, even more public money is directed into corporate coffers, through the commissioning of ‘consultants’ Price-Waterhouse-Coopers, brought in to ‘provide independent advice’ on this purported ‘quality-assurance’ issue.

Fortifying the Bad Decisions

Does anyone really think this government agenda, this pogrom programme is going to be affected in any way by cleaning up a few reports, improving grammatical and ‘reasoning’ skills? Its more akin in actuality to a further sharpening of the blade that is already being used to cull the sick. This is what Grayling meant when he resolved to address the problem of so many overturned decisions at tribunal. Its not about getting the decisions right at assessment stage, as any reasonable person would conclude. Its about making the bad decisions stick.

Atos are the necessary blind that disguises government intent. The sad thing is that all that is required is to draw back that blind and the intent is there for all to see, in the government’s own ESA Regulations. “No need for bending, kneeling in the modern workplace”. I’ll leave you to contemplate that absolute gem of contorted, deluded thinking by your government, and consider whether you think it meets the rigours of your own experienced reality.

Written by bigleyma

July 24, 2013 at 2:59 pm