Disability Employment Gap — House of Commons, 2016-06-08
Topic: Labor
Joanna Meriel Stevens (Labour, Centre-left): I am pleased to be able to speak briefly in the debate and to follow the hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile). I want to use the opportunity to describe the experience of one of my constituents, who came to see me because of her concern and frustration about the Fit for Work scheme that is mentioned in the motion My constituent is a highly trained occupational therapist with decades of experience. She was employed by Fit for Work, the company under the umbrella of Health Management Ltd which is part of Maximus, the company to which the Government have awarded a lucrative contract to work with people with disabilities to get them back into work When the Secretary of State for Work and Pensions was the Secretary of State for Wales, he announced that the Fit for Work service was to be provided in Wales. The service was to provide support and advice to employed people if they had been or were likely to be off work for four weeks or more. According to Government statistics, about 48,000 Welsh workers a year are off sick for that length of time. Fit for Work was to be gradually rolled out across Wales and England. It was seen as a particularly important scheme in Wales, where a higher than average proportion of the workforce is employed in smaller companies, which do not have occupational health services to support absent staff The then Welsh Secretary said: "The Fit for Work initiative will give tens of thousands of people across Wales the support they need to return to their jobs more quickly. This is clearly good for the Welsh economy." GPs in Wales were to offer patients a referral to the service, which included an in-depth assessment, followed by a personal return to work plan and managed support to get back to their jobs. That was in June 2015 My constituent came to see me because, as she put it, both as an employee of Fit for Work and as a taxpayer she was concerned about how that contract was being delivered. She started working for Fit for Work in November 2015, a few months after the Secretary of State’s announcement, at the centre in Nantgarw in the constituency of the shadow Secretary of State, my hon. Friend the Member for Pontypridd (Owen Smith). However, by April 2016 Fit for Work was making staff redundant because of insufficient referrals of clients, and the centre was closed My constituent asked me why the Government were not supporting a service that they had instigated. Twelve months after the start of the scheme the public, GPs and employers did not appear to know about it on any kind of meaningful scale. It was inadequately advertised, so it is little wonder that the number of referrals was too low. She told me that Fit for Work did only a few employer engagement activities. The implementation was poorly managed and badly promoted. Matters even got to the stage where highly qualified medical assessors—case managers like my constituent—were taken off assessments with clients and told to ring round employers to tout the service Fit for Work had been predicated on 13,500 referrals a month, but the service was getting only about 450 referrals. Not only had it been badly advertised and implemented, but the process that case managers implemented was not effective in helping people achieve the aims of the scheme. My constituent described it to me as very standardised and commoditised. Speed and light touch were its hallmark. The assessments were expected to be carried out very strictly, which had the effect of diluting the wealth of professional experience that my constituent could bring to her role. Assessors were expected to complete six assessments a day. She told me that she struggled to even do two or three properly because of the time it took. Everything is done over the telephone. Calls are meant to take 45 minutes and the referrals were supposed to be for people who had, for example, back pain, depression or anxiety and had been off work for four weeks. However, some of the people being referred had been off work for two years and their problems were much more complex I was just thinking about how one would try to gain, in 45 minutes, not only the trust of the person but sufficient information to understand properly their condition and the context they were living in. To do the assessment properly, my constituent felt it required preparation, including: reading all the information from the employer and the GP; making the telephone call; gathering the information from the client; considering all that evidence; considering what a return-to-work plan might look like; transcribing that information; and giving recommendations and an opinion within the production of that return-to-work plan. She told me that to do that properly would take three hours The targets set for the Fit for Work programme had the effect of removing much of her clinical judgment from the process. Fit for Work auditors would listen in on the calls with clients and tell the case manager whether the call they had made had passed or failed the requirements of the process—not whether it would deliver a proper return-to-work plan. It was very difficult to pass the test. She described the scheme and its implementation as being entirely data-driven, rather than people-driven. On his appointment, the Secretary of State said, laudably, that he wanted to ensure his Department realised there was a human being behind every DWP number. This direct account from someone who was employed to deliver his Department’s scheme flies in the face of that My constituent left me with a message for the Secretary of State. She says she is convinced of the need for this service. It could help a lot of people to get the right help and get back into work sooner after illness or injury. Her team was a fantastic group of highly skilled, empathetic and knowledgeable health professionals. They had very many valuable strengths and experiences to make people’s health and wellbeing better, allowing them to return to work at a time that was right for them. They were not utilised. They lost their jobs, the centre was closed and that support did not materialise.