Oral evidence: Personal Independence Payments, HC 1116
Oral evidence, 20 March 2014.
Witnesses
Lisa Coleman, Senior Policy Officer, Atos, Robert Devereux, Permanent Secretary, Department for Work and Pensions, Dr Stephen Duckworth, Chief Executive Officer, Capita PIP, and Jason Feeney, Benefits Director, Department for Work and Pensions, gave evidence.
Chair
Right; welcome. I going to go straight into this. In my constituency, I have certainly had more cases relating to the delays in PIP than anything else over recent months. It has been absolutely amazing that in the past couple of weeks, miraculously, people who have been waiting six or seven months for an assessment have suddenly been given a date. I wonder whether there is a connection to today’s hearing, but I am very pleased for them that they have finally got a date. This is not another bit of bureaucracy, Mr Devereux; this is about people’s lives, and it is about the most vulnerable who really depend on this either to live independently or to be able to work. I want to start with Atos. I have seen the tender document that you submitted, particularly for lot 3, which is for London and the south of England. In that tender document, you committed and said that you would deliver the PIP service through an extensive estates network with 56 NHS hospitals, 25 private hospitals and 653 physiotherapy practices. You said that, didn’t you?
Lisa Coleman
We said that we would have access to those sites, yes.
Chair
You said more than that you would have access; you committed. Do you want me to read to you from the actual thing? The document is chock-a-block full of your commitments. You said: “We can deliver the PIP service through an extensive estates network comprising 56 NHS, 25 Private Hospital and over 653 Physiotherapy Practices.” You then went on to name a whole lot of NHS trusts where you said: “We have agreements in place”. You named NHS trusts, but did you have agreements in place with them?
Lisa Coleman
At the point of the tender document, we were clear that what we were talking about was bidding for all four lots. As you know, we ended up winning lot 1 and lot 3.
Chair
I am looking at lot 3, which happens to impact on a number of people sitting around this table, where you specifically stated that you had agreements in place with these sites. I am first looking at the NHS hospitals. I am asking a simple question: did you have agreements in place with the NHS hospitals, as you said you did?
Lisa Coleman
At the point of writing that tender document, we could not have agreements in place with them because we had not signed a contract with the Department.
Mr Bacon
In document 4, part 5, at pages 72 and 73 of your tender document, it states: “We have agreements in place whereby the contractual commitments of a failing partner can be picked up by another”. Are you saying that that tender document was incorrect?
Lisa Coleman
No, absolutely not. I know that there have been accusations that we lied in the tender document, but we did not lie in the tender document. What we set out was what we were talking to the trusts about at the time.
Mr Bacon
Can I just be clear? The reason why I interrupted the Chair just then was because your last sentence was that you could not have had agreements in place at that point. My point is that your tender document said: “We have agreements in place”. You just said a moment ago that you could not have had agreements in place. I am trying to figure out which of the two is true: the sentence you uttered just now or the sentence in your tender document. They cannot both be true, can they?
Lisa Coleman
So what we had—
Mr Bacon
They can’t both be true, can they?
Lisa Coleman
No, absolutely. The way you have described it, they cannot both be true. We had an agreement in place with those trusts and the suppliers that we were talking to at that time to say that we were working with them. We did make a mistake, but we drafted that tender document in a three-week period. It was a very short procurement. We had agreements with them to say that we could name them in the tender document. Once we knew what the scope of our contract would be, we would then put those contracts in place. We were very open with the Department about exactly where we were.
Chair
Can I just quote to you from page 9 of your tender document? It states: “Each partner has contractually agreed to providing accommodation to the required specification.” Was that true, or was that not true? Just say yes or no.
Lisa Coleman
So what we were able to do at that point—
Chair
Was it true or not true?
Lisa Coleman
It was true that we had agreed the specification with them that—
Chair
No. You said that you had “contractually agreed to providing accommodation”.
Lisa Coleman
Yes. Our suppliers are providing accommodation to us.
Fiona Mactaggart
At that point, you said that there would be 740 assessment sites across London and the south-east of England, when in fact there are 96.
Lisa Coleman
We have got 96 now. At that point, we talked about having access to 750. If we took on—
Chair
No. Let me take you through them. Gloucester Hospital NHS Trust was one of the ones you said you had a contractual agreement with. In your tender document, you said that you had a contractual agreement. The Gloucester Hospital Trust says that there was no contractual agreement. Are they lying, or are you lying?
Lisa Coleman
No, they are right. At that point, we did not have a contractual agreement.
Chair
Well, then why did you put in your—
Lisa Coleman
What we talked to them about was agreeing the contractual terms. Should we have won those lots, we would have contracted with them on. We were open with the Department about exactly where we were with all our suppliers.
Chair
To be honest, Ms Coleman, you were not. You should not have put into your tender document that you actually had a contractual agreement. Did you write to the trust? Is it true that you wrote to the trust and apologised for naming them?
Lisa Coleman
We incorrectly named one, and we wrote to it and apologised. We actually contacted all the trusts that we named and got their agreement. Unfortunately, we named Cambridge—
Chair
To be honest, that is just not true. Let me take you through them. I have done Gloucester. North Essex Partnership Trust said, “The trust did not give explicit permission to be named in the tender document.” Did you name them? Yes, you did. Mid Essex Health Trust provided e-mails that showed that their negotiations ended before the tender was submitted to DWP, and you named them. Ipswich said, “The trust did not enter into any agreement in principle to deliver PIP assessments.” Those are trusts stating publicly in answer to FOIs—that is how that information came out—that you did not have agreement, yet you named them in this document. I could go on. Oxford University Hospital Trust did not agree; they said no. Norfolk and Norwich—yours, Richard—did not agree. In fact, only four out of all those you named agreed. You misled people. In the contract document, you misled DWP about where you were in getting contractual agreements to be able to run the contact. You misled people, didn’t you, Ms Coleman?
Lisa Coleman
No, I disagree. I am happy to share with you the documentation out of here—
Chair
I want you to share it in here in public. One of our great concerns as a Committee is the issue of how we sign up to these contracts and how the public gets duped and doesn’t get value for money. Do you want me to quote to you all the times within the tender document when you said “agreed”? I will go through it, because I will not have this nonsense talked. “The estate required for all four Lots has already been identified, and in virtually all cases is ready to use now.” You said that, didn’t you?
Lisa Coleman
Yes.
Chair
Was that true?
Lisa Coleman
Yes.
Chair
No, it wasn’t. How could it have been true?
Lisa Coleman
When we contracted with the providers, they were either in the process of putting the accommodation in place or the accommodation was already available. One of the things we wanted to do was to look at how to deliver the service in a different way and add value by using existing NHS accommodation that was not delivering value to those trusts. That is one of the advantages of what we put in place.
Chair
But you hadn’t got agreements. You claimed in your tender documents that you were ready to go with 700-odd locations that would have been close to where people had to go, but you hadn’t got those agreements.
Lisa Coleman
At the point of the tender document, we couldn’t sign a contractual agreement because we didn’t have a contract.
Chair
Then you should not have said that they were ready to go and that you had contractual agreements. You used the term in the tender document that you had a contractual agreement with trusts. You have since said that you did not. You have only managed to work with a quarter of the trusts you named in the documents. If one or two had fallen out, I could have accepted your argument, but only a quarter agreed to be there.
Lisa Coleman
We had sufficient coverage. If we had used all 750 sites, each of those sites would have been doing about three assessments per week. The coverage that we have right now gives us the sites we need. It means that in 40% of cases people are travelling less than 45 minutes, based on our latest analysis. At the point of going live, we did not need 750 sites.
Nick Smith
Can you go back to that? You said 45 minutes in—
Lisa Coleman
The analysis that we have done so far—we are doing some more—shows that about 40% of people are travelling less than 45 minutes, and another 20% travel less than 60 minutes.
Chair
Did you fill in the subcontractor declaration that DWP required of you?
Lisa Coleman
I believe so, yes. We would have done.
Chair
What do you mean by “I believe so.”? If you had filled in the declaration, each of your subcontractors would have had to sign up to say they were going to deliver the service. I go back to the fact that only a quarter of NHS trusts had signed up. The two private hospitals you mentioned in the tender document haven’t signed up either, have they?
Lisa Coleman
It is not unusual that, between the point when we do a tender—
Chair
Is it usual to lie in a tender, Ms Coleman?
Lisa Coleman
Absolutely not, no. We did not lie—
Chair
So how can you say that you have got a contractual agreement, when you hadn’t?
Lisa Coleman
We said that we had access to—
Chair
You said you had a contractual agreement. You cannot say something different today from what you said in your tender document.
Lisa Coleman
I can refute it again if you would like me to. We did not lie in that tender document. We gave a view of exactly where we were at that point in time and with the list of suppliers. We have got the backing information that says that we corresponded with all of those suppliers, and they were happy for us to name them. Yes, you are right that we did not take them all through to completion, but we did not need to. It is not unusual for that to change before we have actually got a contract. We did not contract for all four lots: we contracted for lot 1 and lot 3. We had the people in place that we needed when we started.
Nick Smith
Ms Coleman, it seems that you are playing fast and loose with the truth, but may I come back to the point you were making about distance to attend? You said that it takes up to 45 minutes for 40% of people. What percentage take more than an hour to get to one of your places?
Lisa Coleman
At the moment, it is around—I am using the stats we have got now, but we are doing some more analysis—
Nick Smith
Answer my question, please.
Lisa Coleman
I will. Currently, we are seeing 40% at less than 45 minutes, about another 20% up to 60 minutes and then over an hour is the remainder, so that is about 40%.
Chair
Say that again.
Nick Smith
Slowly please.
Lisa Coleman
It is 40% less than 45 minutes—
Nick Smith
Yes, we got that. How many people take more than an hour?
Lisa Coleman
About 40% take more than an hour.
Chair
Again, in your contract, what did you commit to? Just tell the public.
Lisa Coleman
We talked about what we thought we could achieve—
Chair
No. What did you commit to? When you submit your tender, it is not just chatting about something; it is saying, “This is the specification that I will deliver.” That is what you are responsible for.
Mr Bacon
What did you commit to in the tender document?
Lisa Coleman
I have got to be honest: I would have to look at the document—
Mr Bacon
I am looking at it. It is surprising that you are not familiar with it. It says that “because PIP claimants have heightened mobility challenges we have designed a solution which means that between 75% and 90% of claimants will be within 30 minutes’ travel of a local centre.”
Lisa Coleman
And that is absolutely right. We are not there yet. I am not going to sit here and say that we are; we are absolutely not.
Chair
Why did you commit to something that you then failed to deliver?
Lisa Coleman
We did not have data around where those claimants would come in from at the point of putting the tender document together.
Chair
Say that again.
Lisa Coleman
We did not have the data. These are new claimants. We don’t know. What we were able to use—
Chair
Oh, come on! Don’t tell me that. This is ridiculous. You have been in this field—
Fiona Mactaggart
That is very far from what you said.
Lisa Coleman
It is, yes.
Chair
You have been assessing claimants since 2005. To sit there and say, “We didn’t have any idea about where they would be and what they would be”—
Mr Bacon
Actually, you say in your tender document: “The large number of local centres that we have”—I think “we” means your company in that sentence—“means that approximately 90% of claimants will be less than 30 minutes’ travel from a convenient consultation centre, with the remaining 10% under 60 minutes.” You could not have written that sentence unless you knew something about where your local centres were and how many of them you had.
Lisa Coleman
You are right. What we were able to do at the point of tender—we had the data, you are right, as we have been doing disability living allowance for a number of years. We had the data about where the existing DLA population currently is. We reviewed that data and made some assumptions based on using that population and looking at where we knew the centres were that were being provided by the people that we thought that we could contract with. That is what we talked about at that point. What I have shared with you is what we are seeing right now. That does not mean to say that we are happy with that—of course, we want to improve that further.
Mr Bacon
Can I just check something about the quality of the assessment centres? These are assessment centres for people who have disabilities. In Norwich, you have one that is not accessible for people who are disabled.
Lisa Coleman
I believe that you are talking about the WCA centre in Norwich.
Mr Bacon
I am talking about St Mary’s House.
Lisa Coleman
I think that that is the centre we use on a WCA contract; that is not the centre that we use on the PIP contract.
Mr Bacon
I have a photograph here of a lot of disabled people protesting outside it because they cannot get into it. I have been corresponding with DWP for quite a long time about it, as have other Norfolk MPs. The most recent response from DWP, which is dated end of February 2014 is: “It would not be a cost-effective use of public funds to relocate the Norwich medical assessment centre at this time.” What I am interested in is: why would you choose a building to do disability assessments that was not disabled accessible?
Lisa Coleman
I think it is important that I clarify that we don’t use that centre on the PIP contract. That’s a WCA centre only.
Mr Bacon
Only?
Lisa Coleman
Only. We are not actually using any of the accommodation that we use for WCA. That is one of the things that we were able to build into the design from day one on PIP. We were very clear that we wanted to ensure that any of the challenges that we had about disability access to some of the sites—Norwich, for example, is one that has been there for a number of years in advance of when ESA was introduced—
Mr Bacon
But you are telling disabled people to Cambridge or Ipswich, which isn’t a lot of help when you are disabled.
Lisa Coleman
Again, I think you are talking about the WCA cases there. What we do on PIP is we were looking very much to do something very different and to look to send people to local sites that they were very familiar with. An example that I can give you is that I was listening to some contact centre calls just recently, and a lady was concerned that she was going to have to go to Truro. We were able to say to her that she was able to go to her local site, which was the local GP practice, which she recognised and she knew. That is what we have tried to do. I accept that we are not there in terms of the travelling times yet. We do need to bring more centres on site, and that is what we are doing.
Fiona Mactaggart
But you are saying that, at the moment, 40% of your customers are travelling for more than an hour by public transport. My experience of disabled people trying to use public transport is that just making one journey, let alone making an interchange, can be very challenging for people with intellectual impairments, mobility difficulties and so on. We are saying that nearly half of the people who are trying to get to your centres are making a journey that would take an able-bodied person more than an hour. Let’s be honest, because a disabled person will usually take longer and will have to arrange things like access to platforms and all those things that add to the journey time. How can you be satisfied with that?
Lisa Coleman
I don’t think I said that I am satisfied. What I said is that we want to improve that further. What we looked at was the 750 sites based on full volumes under mandatory reassessment. We are not there yet. We need to improve.
Chair
I am going to read out two of your quotes just to get it on the record. First, on page 76: “We have agreed with our partners that their accommodation…will be available throughout the term…and they have agreed to this requirement.” That’s not true. “Each partner has contractually agreed to providing accommodation”. I have read that one before. I want to quote you because all the misleading in the contract led to Ministers then misleading Parliament on false information that you gave them. When Lord Freud answered a parliamentary question from Lord Alton in the House of Lords on 22 July, he said, “Atos have demonstrated through their supply chain contractual arrangements that they have full geographic coverage with an additional capacity of at least 15% in each of their supply chain partners, as well as back up options across their network, should volumes prove higher than expected.” That wasn’t true in July, and it remains untrue today, doesn’t it?
Lisa Coleman
We still have access to more sites than we are using right now with the supply chain.
Austin Mitchell
That is a tautology.
Lisa Coleman
We do need the practitioners to go in them, though. So what I don’t want to do is open an empty site. That wouldn’t add any value to anybody.
Chair
Well, why do you have a contractual arrangement with them?
Lisa Coleman
Because what that allows us to do, where we have the capacity and where we have people in that geography, is actually use those sites, but what we need to be able to bring together is the claimant, the practitioner and the location. So we have the locations right now. The assessments are taking us a lot longer, so that means we are not able to optimise them because we have not got as many practitioners as we need—
Chair
I am going to ask you one more set of questions, which is on the assessment. The assessment is taking a ridiculously long time. In my constituency I have two cases of people who are terminally ill with cancer and miraculously, literally last week, they finally got appointments for assessment. They had been waiting for, I think, six or seven months. I will come back to that later. When you put forward your tender document, and when you committed to it contractually with the DWP, you said that you had enough health professional staff, didn’t you?
Lisa Coleman
Yes, based on what we understood of the assessment.
Chair
Have you?
Lisa Coleman
Right now, based on the duration and volume of the assessments that are coming through to us that we cannot deal with in advance of a face-to-face assessment, we do not. That is one of the things that we are trying to improve. The assessments are taking twice as long as we expected—we didn’t know that was going to happen—and we are seeing 20% more people going through to face-to-face assessment than we expected or understood at the time of the tender as well.
Chair
So why did you put in your document: “In Lot 3”, which is the one that lots of us are concerned about, “our solution reduces the recruitment effort to 63 direct HP recruits. The balance of the capacity requirement, equal to 840 HPs, is sourced from an increased utilisation of our supply chain partners’ resource pool of HPs”? That wasn’t true either, was it?
Lisa Coleman
That was true actually.
Chair
If it were true, you would not have to be recruiting now, would you?
Lisa Coleman
There are two things. One is yes, we have to recruit, because we are doing a lot longer assessments. That means we need more people to do audit—
Chair
To be honest, you cannot say that either, Ms Coleman. With the greatest respect, if you look at the NAO Report, the number of cases coming through the system is not greater than the number that was anticipated when this was modelled. It is just not true.
Lisa Coleman
You are right. They are coming through at the same level, but they came through later than we expected, so we were not able to get the HPs trained quick enough. They could not do enough cases to learn quickly enough. What we are now seeing is the actual assessment—
Nick Smith
They came through later, but you still did not have people trained quickly enough?
Lisa Coleman
There are three factors, really. One is that the assessments themselves are taking twice as long as we expected. We expected them to take just over an hour and they are taking two hours, and two factors are involved in that: one is the actual face-to-face part of the assessment, and the other is making sure that we write the reports up to the right quality standard. The second part is that, of the cases that are coming through, we expected that around 25% would be dealt with at the front end of the process, so through a paper-based review. What we are actually seeing is that around 96% or 97% are having to go to face-to-face assessments and that takes longer.
Nick Smith
But somehow there are four times as many people.
Lisa Coleman
In effect, if we wanted to do it the other way round, it would mean the same thing. We need double the capacity we expected because everything is taking twice as long, and there are more of them to do.
Fiona Mactaggart
I was wondering whether that was because of the issue that was raised by our earlier witnesses about evidence from previous DLA assessments not being used in this process.
Lisa Coleman
Evidence is certainly a contributing factor. One of the things that we saw when we did the controlled go live—and if I may, I would like to come back to the terminally ill cases, because we are processing people under terminally ill cases and the special rule cases. We have ring-fenced people, so—
Chair
You are not. My two cases, if I could find them among my documents, are both terminally ill with cancer.
Lisa Coleman
I am happy to take those offline, but—
Chair
Don’t take them offline—don’t make a statement to the Committee that I know to be untrue from my constituency case load.
Lisa Coleman
We are processing 98% of cases for the terminally ill within the two-day requirement that we have.
Chair
Hang on a minute, I’ll take the two Barking and Dagenham cases. This is just a nonsense. It really makes me so cross, because this is my original point. These are really people in terrible, terrible need. One woman was diagnosed with ovarian cancer in June 2013. She is having chemotherapy and she also has a debilitating brain condition. She applied for PIP in August 2013, seven months ago. Miraculously, last week, she got a date for a medical assessment in Atos for 28 March. Another case is of another woman who was diagnosed in April 2012 with bowel cancer, which has spread. She applied for PIP in September 2013 and had not heard anything. Then, miraculously, last week, she was given a medical assessment appointment on the first of the fourth. That is a seven-month wait. You sit there and tell us that you are doing 98% of cases, when this is an example from just one constituency MP—I have other cases, but those are the two that should have been on your fast-track system. I just do not believe it.
Lisa Coleman
I will absolutely look into those cases.
Chair
No, it is not a question of that. Don’t make these general statements if they are obviously not true.
Lisa Coleman
We demonstrated this to the NAO when they came and had a look—we have been fully transparent. We are processing terminally ill cases and special rules within two days.
Chair
It is not true, Ms Coleman.
Chris Heaton-Harris
How long have you been processing terminally cases in two days?
Lisa Coleman
All the way through. If you go back to the statistics, the statistics show it. I do not know those two cases. Like I say, I am really willing to have a look and see whether they fell under special rules, because I would be very interested to see whether they did, but we are processing terminally ill cases and special rules cases within two days. It is absolutely right that we have got backlogs on normal rules, but definitely not on special rules.
Chair
Can I just give you one final opportunity, before I go to Mr Devereux? Can you confirm or not whether you had got agreements in place at the time of submitting this tender document to the DWP? Did you or did you not have agreements in place, as you said you did in the tender document, with all the NHS trusts and the private hospitals, to deliver services? Did you have contractual agreements in place?
Lisa Coleman
We did not have signed contracts at that point, no. We could not, because we did not have a signed contract with the Department. We had agreements in place about the scope of services that they would deliver, and we had agreements in place about what that would look like.
Chair
With all of them?
Lisa Coleman
No, because we did not need all of them.
Chair
I would just say to you, Ms Coleman, misleading a Committee is very serious.
Lisa Coleman
I am not misleading the Committee. We did not need all of them. When it came to contracting, a number of things changed between the point when we put the tender document in and the point when we contracted.
Chair
You only, in the end, have got agreements with four out of the 16 NHS trusts that you claimed in this document you had agreements in place. You have not got an agreement with the two private hospitals.
Lisa Coleman
We do not use the—
Chair
So to tell the Committee you had agreements in place to deliver and to say that what you said in this document is true is not actually correct.
Lisa Coleman
One of the private health providers that you—
Chair
Is it correct?
Lisa Coleman
It is correct that we had agreements in place at that point, based on what we knew. We did not have a contract. We could not sign contracts. We did not have a contract. We did not know what lots we were going to win.
Meg Hillier
A case has been raised with me about somebody in Tynemouth undergoing cancer treatment. They made an application in January with you. You acknowledged receipt by 15 January, so that was good, and advised that a claim would be decided by 14 February; but a month later, on 18 March, your parliamentary liaison team—because by then the local MP had taken this up—acknowledged that a home assessment had yet to be arranged, and failed to deny that the constituent may have to wait until June ’14 for a payment. You have been telling us that you have been trying to improve. Is that what improvement looks like?
Lisa Coleman
No. None of us would say that the delays that we have got right now are acceptable—far from it. What we are now able to do, which we have not been able to do until quite recently, is actually give claimants a much better view of how long those delays are going to be. That is where we were very uncomfortable—we just did not have the right information to tell them. We can now say that to people, and set their expectations. That was clearly unacceptable, but what we are able to do is give people an expectation of when we can see them. What we are also doing is building our capacity in parallel and taking a number of actions to make sure that we can deliver more face-to-face assessments.
Chair
Mr Devereux, just on this, and then we are going to go more general, because this does go to the heart of how you manage and determine contracts: what checks did DWP complete on what Atos were telling you in their tender document? What checks did you carry out?
Robert Devereux
The process that we have gone through is to take what people say in a document and then seek to assess it against a variety of conditions: one about what price they are saying, one about the quality of what is going in there—how do we know about it. The teams then have a look through it—go through and seek to make the best assessment of it. If you want to know the precise checks we have done, I will have to go back and check for you. I have not brought that with me.
Chair
I would suggest to you that you did not check whether or not they had the capability and capacity in place to deliver the contract, and it led you, for example, to give Lord Freud the wrong information when he gave a parliamentary answer to Lord Alton in July.
Robert Devereux
Perhaps I may just say: what is the single thing that is causing most of the problems you have heard about today? The single thing that has caused most of the problems is that the test—the assessment—that is being taken is taking much longer than we had anticipated.
Chair
Everything is taking longer, not just the test. Everything is taking longer. It is a nonsense to say it is just the test. Everything.
Austin Mitchell
The assessment is taking longer. The delays are enormous.
Chair
Can we stick to this point? I will tell you why I am really interested in this.
Robert Devereux
I am trying to answer the question.
Chair
Answer this question.
Robert Devereux
The answer to the question is that in both cases we were testing whether or not there were, on the ground, enough people to do this work. If you then, as I have observed, find that the actual amount of time that it takes to do this is much larger than it otherwise would be, then in practice the volume of resource on the ground is not large enough. So what is going on at the moment is that we do not have enough, as it were, delivered capacity there; but that is because of facts that are now apparent about how long the test takes. Both the Department and the suppliers went in with an expectation of how long it would take, together with some margin around that, but it is taking much longer in practice.
Mr Bacon
But if you had tested the process end to end and had given yourself enough time to test it, you would have found that out. Can you think of any other examples of where the Department or other Government Departments did not test things end to end, which subsequently led to problems?
Robert Devereux
In many of the examples in your own excellent book, you talk about things being switched on right across the entire stock of things, such as with tax credits.
Mr Bacon
Tax credits, yes. The Criminal Records Bureau is another one with no adequate testing.
Robert Devereux
The Report concludes that we are about to do 3.6 million assessments over the next four or five years. We have done 5% at the present time, so we are currently in the early stages, as the NAO said. The level of service is not what we would want to have, but we have not in any way gone down exactly the same track that you were coruscating about in respect of the other ones where the entire shooting match was turned on. I have an issue to resolve here to ensure that the unacceptable backlog is brought back down again, but I have not tipped the entire stock of DLA into this straight away. I have not sought to do all the reassessments straight away. We have made adjustments to the profile to try to avoid precisely the things that you have correctly observed about the past.
Fiona Mactaggart
You have taken in all new claimants.
Robert Devereux
I have.
Fiona Mactaggart
And the consequence of that is that people who depend on being assessed that they are qualified for PIP in order to access other benefits, such as carer’s allowance, are waiting not just weeks but months for their cases to be determined. As a result, they are getting into debt and are not accessing other services that they genuinely require. How are you going to change that within weeks, not months or years? At the moment, it feels like, “Oh, we’re all trying very hard,” but the person who cannot pay a carer, who is racking up debts with Wonga and who is not getting access to other services cannot wait that long.
Robert Devereux
When the Chair started by saying that this is about real people, I absolutely agreed with that. This level of service is not the level that I want to continue with. We are trying, with both providers, to have more health care professionals brought to bear on the problem, because the amount of work is more because the test takes longer. It takes a finite time to acquire people, but those people are now being acquired so that we can start to clear more cases than we send to the providers, and in due course—
Nick Smith
How much trialling of these assessments took place?
Robert Devereux
Two sorts of trialling were done. The principle thing that we did in the period between the policy being announced and actually going live was to work very closely with medical professionals and disability organisations to try to define the test in the first place and to construct a replicable test. We are in danger of glossing over all the things that we have had to do, but one thing was to construct a test that you can actually get a health care professional to do and that will reliably come up with the right answer. That took us a long time. We went through a number of consultations and did a lot of testing.
Nick Smith
So that’s what the test looks like. Let’s be specific. How often did you trial the assessment itself? How much effort did you put into that—the real gubbins?
Robert Devereux
The Report correctly identifies that our plan for the roll-out, which we had already changed by delaying national roll-out and by pushing—
Nick Smith
Mr Devereux, you are not answering my question. How much trialling of the test itself did you do?
Robert Devereux
We had done very little of it—hundreds of cases. The process actually started in the controlled roll-out in April. By the time it actually got through to the providers, it was relatively few, but we knew that when we started.
Nick Smith
What do you mean by relatively few?
Robert Devereux
It is measured in hundreds.
Nick Smith
Just hundreds?
Robert Devereux
Yes. Can I make another observation? Any time that you introduce a brand new system—
Nick Smith
How many hundreds?
Max Tse
Figure 11 on page 31 of the NAO Report shows how many people have gone through each step of the process.
Nick Smith
Can you please remind us of that, Max?
Max Tse
By 10 June, which is the end of the April to June first phase of trialling, around 9,000 people had started claims and around 360 had had decisions made.
Nick Smith
So 360 was the basis for your roll-out of the assessment programme.
Robert Devereux
It was not the basis of the roll-out because, as you will all immediately detect, that cannot possibly be the case. We established, whatever was in the tender documents, exactly how many people we believed were necessary to be present in June and that the suppliers were capable of producing. We were testing and checking that, as the NAO concluded we did. So we went live knowing a whole bunch of stuff about the early part of the process and making a judgment about the capacity of the system to do the latter part of the process. You are absolutely right; we did not run a process that had an entire year of running that north-west control period all the way through to the far end, doing all the appeals and so on. We did not do that.
Nick Smith
But it is that assessment that you say is the crux of the difficulty you have today.
Robert Devereux
That is, indeed. We are all happily, with the benefit of hindsight, now able to say that that was obviously the area, but—
Chair
It is so obvious—
Robert Devereux
I am sorry; you roll your eyes, but let me just check a moment. The assessment that we are doing here is not, on the face of it, dissimilar from WCA and some of the tests that the providers do in other areas. The judgment we were making is that we have a view about it and we do not know precisely what it is, but there are two things we know about assessments: one is that, in the hands of people doing it repeatedly, people speed up quite quickly. If you look at the evidence on the WCA, for example, when we introduced the requirement to write a written statement, the time that professionals took to write it went right up to about 80 minutes or so, but then it came down over the next few months back to about 50. You can make big changes through repetition. Right at the start of a process you would be hard pressed to be confident that you knew how that worked. Our judgment was that, actually, because there was some margin in the system—because they had indeed recruited people ahead of time—that would be enough. That has turned out to be false. If it had not been false, we would not have a backlog.
Chair
I want to get on to general things, but do you mind if I just finish with the Atos contract? We can then go on to the more general things, but otherwise we will lose it. I just want to understand from you. It seems to me, in any way that you read it, that Atos told you in the contract that it had a list—a supply chain—of NHS trusts and private hospitals that it was contractually committed to and that would deliver the service, right? So it had the sites and the people, because the trusts bought not just sites, but people. It has been put to me that you—DWP—knew that it did not have that, although it was in the contract, and that you suggested that it put that in anyway because it would make the tender look better. Is that true or not?
Robert Devereux
I have not heard that allegation; I would be astonished if it was true. It is not in my interests to have a supplier falsify information.
Austin Mitchell
It does look as though you were in so much of a hurry to get this thing up and running that you did not bother to check the assertions in the contract or to assess the difficulties and the time scale of the assessments and the number of assessors. The Report states quite specifically: “The Department adopted a challenging timetable for introducing a large programme.” And paragraph 16, on page 8, states: “The Department…left little time to test whether it could handle a large volume of claims.” In other words, you were in a rush to get the thing up and going, so you did not check adequately.
Chair
Just on this contract.
Robert Devereux
Well, you are conflating several things here. By the time that we got to that critical decision to turn on the national roll-out, we had a good idea of how many people we believed both parties needed to have deployed, and in which buildings they were operating and whether they were disabled-friendly to get into. We had done all those calculations. Whatever the story is about what we had or had not done in the tender, the reality was that, at the point we pressed that button, we knew how many people they had and whether they were in the right glide path to deliver this service, on the assumptions that we had about how long the test would take.
Chair
But if you enter into a contract, Mr Devereux, when the person submitting for the tender gives you contractual commitments, there are two things: one is due diligence—
Robert Devereux
I have not contracted on the tender, have I? I have contracted on a contract. The question you are asking me, which I will happily go away and check, is, “In the contract that I have given, what factors have I brought to bear on the things you have just been grilling Atos about?”
Chair
And I would like you to come back on that.
Robert Devereux
And I am observing that, by the time we got to the critical decision—when the Secretary of State and I were sitting together to decide whether we should turn this on—the evidence that we had from both providers, tested by internal audit and looked at by the Major Projects Authority, did not conclude that this was a crazy proposition and that we were in a hurry and should not carry on. We actually decided that this was a reasonable judgment for a reform which, let us be clear, is an important reform. I do not want, and Ministers do not want, benefits determined simply on paper evidence—
Fiona Mactaggart
But Ms Coleman herself claimed that one of the reasons why the tender document included these claims, which have been challenged, I think rather effectively in this Committee, was that it was only a three-week process.
Robert Devereux
The process that we were going through—very deliberately, as the NAO recognised, but it is right at the back, so you have probably not seen it—is such that the Department has actually learned from its ability to do contracts. It thought about this. It put in place a framework arrangement, and rather than just going with single source, it put in multiple lots. We have gone through these steps. The steps provided for a period of time in which people could bid. I come back to the critical point. Whatever the exchange we have had about the nature of the tender document, the question about performance hinges on whether or not there were enough people at the point at which we turned on the—
Chair
Can I just ask you another question, because this is, I think, what astounds most ordinary people? Atos, since 2005—again, this is from an answer to a parliamentary question—has had £750 million-worth of contracts just from DWP, so you would have thought there would be some experience in contracting with Atos in DWP. You have taken a decision to relieve it—or it has walked away—from doing a number of the contracts that it is engaged in on assessments for ESA. It has walked away from that. You have said to us this morning that this work is very similar to the ESA work, which is why you thought you did not have to pilot it. What on earth was going through the brains of people in DWP responsible for advising Ministers on whom to give contracts to that you thought Atos, which was were failing in one area of work and giving it back to you, would be ready to provide an effective service, which it clearly has not, in another area of work? What went through your brain? I just don’t get it. I cannot imagine myself being a Minister or official in that Department and thinking, “They’ve failed here, but we’ll give them two of the biggest contracts we’ve got in DWP.” One was for nearly £207 million; the other was for £184 million, give or take a bit. Two huge contracts, yet Atos was failing on a very similar contract in a very similar area of work.
Robert Devereux
The assessment about people’s capacity and disability is a different test; I was observing that it is similar in terms of its length. With the process we went through, we ended up with—I think, from memory—a number of people on the framework. We had loads of bids for these out of that framework, and we were assessing them as to quality and price. Our assessment was that these were better, not least—
Chair
Mr Devereux, can we just have an honest conversation? It was failing on delivering on a contract that required a very similar sort of assessment. I know it was a different tender, but can’t you have regard to its failure to deliver on a very similar contract when determining whether it has the capability—which it clearly does not have—to deliver on this contract? What on earth are we about if we cannot get this contracting right? You are dooming this attempt to bring in outside providers to deliver public services. It is the worst ad for using private contractors to deliver public services—it really is; it’s awful. It is a real dereliction right the way through.
Robert Devereux
At the risk of repeating myself, both these providers have been seeking to provide enough capacity to do a test of a certain length—
Chair
But they were failing.
Robert Devereux
At one point you said that they are clearly failing on this contract. The reason why we have a backlog at the moment is that the right number of people have been deployed to do a test that is half as long. On this particular one here, the issue is to do with the amount of time that has been taken. On the other Atos one, we are, as you know and as Ministers have announced, seeking to bring in further suppliers, but we were making a judgment based on the bids in front of us.
Mr Bacon
What I do not understand is why you did not include on your risk register directly—this is paragraph 3.26—the risk that providers would underperform. Paragraph 3.26 says: “Given the challenging timetable for implementing the programme and achieving savings, the Department relied on assurances from assessment providers about their readiness for roll-out.” It goes on to say that the Department “tracked the risk that assessment providers would not provide appropriate assurance”, so you wanted to make sure that they had given you enough warm words, or that is what it sounds like. But the Report goes on to say: “It did not include directly on its programme risk register delays caused by assessment providers, or assessment providers failing to meet contractually agreed performance levels.” Surely that would be a really obvious thing to include on the risk register. I understand why you would include risks about the delivery of IT systems, the readiness of the Courts Service and so on but, surely to goodness, if you are issuing a contract like this, the risk that the contractor will not provide properly is a central risk that should have been included directly right at the beginning on the programme risk register.
Robert Devereux
It is, absolutely. I am afraid that this is a piece of the Report and its language about how the risk is calibrated that I wanted to spend some time on. In practice, the effort going into this is on exactly the things you would have expected if I was worried about the provider not delivering. The things I was checking, consequent on the words I actually had—whatever words you would have preferred me to have—were exactly the same as you would have done: have they got the people; have they got the buildings; do they have a training programme; has it been properly approved? This discussion about whether the nature of the words on the risk register are right or wrong is, I think, misleading. The actions, even under the risk that you have just defined, were identical to the ones we were actually doing. We used a particular form of words that actually said, “Do we have enough confidence that they will deliver?” I could have worded it differently, but I would have done the same things, and that is exactly what I did.
Chair
I will bring in Amyas and Meg and then we are going to go more generally, but it is complete nonsense. What were your four things? Have they got the people?
Robert Devereux
Have they recruited the people, do they have appropriate training in place, do they know how they are going to deploy them, have they got the buildings?
Mr Bacon
They told you they had and they didn’t.
Robert Devereux
No, with respect, I come back to my central point. The thing we were tracking was whether or not they actually had the numbers of people we expected they would need.
Chair
But you knew they didn’t on this other contract, which is your contract. You knew they didn’t.
Robert Devereux
If you keep chopping around, I can’t answer the question. On the question that you have just asked me—about whether I knew this—I was tracking precisely the things I said, and the answer to this question, as demonstrated by the heads on the ground, is correct. The thing that has happened is that the amount of time that it takes to do this test and the quantity done face to face is much higher than the Department or the suppliers expected—[Interruption.] And, if I may continue, the margin that we knew was already there—because both providers recruited ahead of the volumes that they were expecting—turned out to be too small for the change in the length of the test. So there is one central factor here. The test itself is taking much longer, and you cannot adduce from that reality that somehow or other the provider—
Austin Mitchell
We have just had a statement from welfare support organisations that assessments were being done by phone, yet you say they are taking an enormously long time and you didn’t expect it.
Chair
We will come back to the phone issue.
Robert Devereux
I heard that and I did wonder to what extent the lady—
Chair
We will come back to that. Let’s just deal finally with the contract.
Amyas Morse
I have a question for Robert Devereux about the tender. Was there a question that you felt you didn’t understand the status of the resources available to Atos at the time? The tender was addressed to you. Did you feel that you understood, or didn’t understand, the level of conditionality or whatever? Did you feel it was clear and open to you or not?
Robert Devereux
That is the same question the Chair asked me five or 10 minutes ago, and the answer is that I need to write to you to say what I was actually basing my assessment on. If your hypothesis is that I blindly read this and thought, “That looks fine; tick—”
Amyas Morse
No, that is not my hypothesis. I was giving you an opportunity to say whether you thought that or not.
Robert Devereux
Lisa says that there were a number of exchanges about clarifying what was in the tender with us, and the judgments that the Department makes are not reached simply by reading this in a locked room on our own and eventually being misled in the way you have expressed it. I have offered to come back and tell you the sorts of checks that we were making on it, so I will do that.
Meg Hillier
Jason Feeney, when he went to the DWP Committee, talked about the assumptions being wrong. To quote from that Committee’s report: “Jason Feeney told us that Department for Work and Pensions’s original estimates were ‘that it would be a 12 to 15-week timeline in terms of getting through the process, right through from application and initial phone call to the decision’”. I have a dossier of information from MPs saying it is taking six to seven months and we have gone through some of that. The report goes on: “However, in practice ‘the process is taking longer than that in most cases’ because ‘the assumptions we made about how long different parts of the process would take have not been reflected in live running’”. You go on to explain the reasons: the first phone call; the fact that it is taking claimants longer to return the form; and that the providers are not delivering it. Although we focus on the Atos contract, you have acknowledged that there is a problem with that. I can quote a number of cases of people who have been waiting in very difficult conditions: people waiting for liver transplants—that is somebody in Ilford. There are other people with non-Hodgkin’s lymphoma who need to go to hospital for treatment and cannot get carer’s allowance without it; someone with throat cancer—these two cases are in Scotland. A number of people have had appointments cancelled. These are all problems with contractors, but some of these people could be fast-tracked through. Have you given any thought since April to taking information from existing systems to fast-track this and save some of the misery they are living through?
Jason Feeney
Yes. The statement I made to the Select Committee on 11 December still stands. We are still in that position. I hesitate to introduce new information and new data as to where we are today. We have seen significant improvements on terminally ill cases and we have concentrated a lot of energy and focus on improving that and fast-tracking those cases. Those clients are not required to fill in a claim form; they are not required to go to a face-to-face assessment if they have been diagnosed as terminally ill—by “terminally ill” we mean that they have a life expectancy of less than six months. It is important to be clear what we mean by terminally ill. We have a fast-track process for those very vulnerable customers and our performance on that is significantly better than when Max and colleagues examined us back in October. In terms of other customers, I have made it clear that we expect the process to take 12 to 15 weeks. It is not taking that. We expected it to be three to four months; it is now six months-plus for many customers. We are not happy with that. We acknowledge that. We are taking a number of steps in the Department and with providers to increase the capacity to address the fundamental issues of the number of cases that we see face to face, and the number of cases that are assessed on paper and the length of time it is taking health care professionals to become familiar with the assessment. So, in answer to your question, in terms of using additional information, the whole process of PIP—we talked about it in the first session—is that we are trying to get as much information and medical evidence as possible at the early parts of the process so that the health care professional, when they sit down opposite a claimant, has a deeper understanding and we get a better assessment and a better decision at the end of the process.
Meg Hillier
Clearly, Mr Feeney, that is not working. Some of these cases could be fast-tracked. With someone with rapidly progressing MS—another case from Aberdeen—eventually the doctor was able to say that they were terminally ill with a six-month prognosis. Someone who has a degenerative illness is not going to get better enough to work. It is fairly obvious; a medical consultant could write a letter about something like that. We had some compelling evidence from Mencap about people with a learning disability. If a client has a lifelong condition, there are ways of finding that out without needing to have an assessment. Building in the cost of a reassessment every two years is an expensive approach, but there is no attempt to fast-track people. Some of these people will be under 16 and only just beginning to come through, but if you have a child of 15 or 15 and a half, you are going to be really worried about this process taking several months and no money coming in during that time. If that child was born with a disability, they are not going to get better. It is quite straightforward, surely, to put them straight on to PIP. I agree with reassessments for a lot of people, but for somebody in that situation, it is just an expensive waste of time.
Jason Feeney
There are an awful lot of points there. For those people who are what we call rising 16s—people who are 16 who have been in receipt of child DLA—they continue to receive DLA, so they are not waiting without money. They continue to receive DLA until we assess them on to PIP. You mentioned earlier in your contribution about people who will not get better to work. That is not what we are assessing in PIP. We are not assessing people’s ability to be able to work. If people are diagnosed as terminally ill, having started the process under what we call normal rules—that is because they have a disability and a condition—we fast-track from that point. You threw quite a lot of points at me there, but that is three or four that I wanted to come back on.
Meg Hillier
Yes, sorry—I have been waiting to get in. On things like the phone call and the fact that that slows things down, you must have realised that that would be problematic for a lot of clients at the beginning. Did you build time in for that?
Robert Devereux
When we designed this, we didn’t go about it trying to make the process more cumbersome than it was previously. We were trying to make sure that people know, first of all, whether they are actually going to be entitled to the benefit at all. Some of the questions we are asking at the start are to make sure that people have the right benefit to apply for, rather than filling in 54 pages and being told, “Actually, you failed on a nationality claim,” or something like that. The first part of this is trying to sift it through to get things straight, and making sure that people are properly signposted. The form then goes out when we know that these are people who are, at least in principle—
Chair
That was what you were trying to do.
Meg Hillier
It is not working.
Robert Devereux
I was being asked about why I had a phone call. That is a “trying to” question.
Meg Hillier
But it is not working.
Robert Devereux
Sorry, what is not working?
Meg Hillier
The phone call. If, for example, you have a learning disability or are perhaps a very nervous person on the phone, you often have to have someone with you to help—that is setting up an appointment; we heard this evidence earlier. You have to have someone at your elbow to help you through that process. You have to have an awful lot of other paperwork to prove things, including things such as a passport to prove nationality, but not everybody will have one of those. Those could all be dealt with as a paper situation when someone’s clearly got a disability that is very likely to mean that they will be able to have an appointment.
Robert Devereux
You have said twice now that you don’t see why everybody should be assessed face to face. The answer is that they may not need to be assessed face to face.
Meg Hillier
But 96% are being, because of these problems.
Robert Devereux
One of the things that we are working on with the providers is why so many are going down to face to face. Actually, the first question is: what is the quality of the paper evidence? Returning to a question I was trying to answer earlier on, the lady at the end was observing that in some cases they have a phone call from the provider. If you are doing a paper scrutiny and you just want to check something with the claimant, it is perfectly legitimate to call them. That doesn’t mean I have just done a face-to-face assessment over the phone; it means I have gathered some information to prevent precisely the face-to-face assessment that you correctly say we do not need to do. One of the things the Department is trying to do is to work out what extra effort can be put in to make sure that all those people who really could be determined on paper—as that is what we used to do with DLA—can be done that way, thus reducing the burden on face to face. As I have said repeatedly, that is the key constraint in the current system.
Fiona Mactaggart
Mr Devereux, were you surprised, as I was, by the evidence from Citizens Advice about the problems that having to do this via an initial telephone call were creating for their clients?
Robert Devereux
Was I surprised? I might ask Jason to explain this, but it is worth repeating the arrangements for what you can do if the phone call is not for you. I don’t think we have got into that.
Fiona Mactaggart
What she was saying was that having the identification process and all that up front is creating a barrier for people who approach their citizens advice bureau for help.
Robert Devereux
If I might hypothesise, would you prefer me to make a 50-page form available as the alternative to having a phone call?
Fiona Mactaggart
Yes, via a citizens advice bureau I would, because citizens advice bureaux do not hand out 50-page forms to people who aren’t the real people. It seems to me that there is a partnership here with the voluntary organisations that you are used to and that you have for other benefits.
Robert Devereux
I observe that we have put in a brand new benefit. I might hypothesise that, by design, for a lot of people having a knock-out question at the phone call stage is actually quite straightforward. If your observation is that we may have gone slightly too far and that a stack of forms at the CAB might be a good idea, that is a very good bit of learning that we can go away and have a think about.
Fiona Mactaggart
Good. One of the things that I feel about the NAO Report is that it does not sufficiently highlight the problems that are within the Department, rather than within the providers or with people. If you look at figure 12, you will see that the Department is taking three additional days from the start of a new claim to print and post evidence-gathering forms, which is 300% over what was expected. There is quite a bit of emphasis in the Report on the fact that the people who are applying are taking three additional days to send it back, but no emphasis on the Department doing that. The Department is taking six additional days to make a decision for non-terminally ill clients, which is a 60% increase, and—I suspect partly as a consequence of all this—there are twice as many calls to the inquiry line as you expected. What are your plans to get rid of those bits of inefficiency, which are your responsibility, not that of your contracted partners?
Robert Devereux
First, the entire thing is my responsibility.
Fiona Mactaggart
Yes, but you have direct levers to control, Mr Devereux.
Robert Devereux
We are talking about a new benefit. We have written down the “should take” times; those examples are not reaching them, and we are working on them. Let me give you some examples, because we are capable of doing this. In the past year, we managed to take out six days—nearly a third of the time it takes to process JSA and ESA volumes, on much bigger numbers than this—and we did it with fewer staff. The Department knows how to improve service and reduce phone calls, and that is precisely the process that we are going through.
Fiona Mactaggart
I am asking you what you are doing about it.
Robert Devereux
Forgive me, we are a few months into the brand new process, and day in, day out, we are working—
Chair
Why doesn’t Mr Feeney answer that, because he is dealing with it?
Jason Feeney
I am happy to answer. At the beginning of the process, when we started taking those phone calls, 80% of the calls we took had a mismatch between the data we captured from the claimant and the records we held centrally inside the Department. It could be something simple. For example, we capture nationality on the PIP system, and if that nationality is not recorded on the central system, it is thrown up as a mismatch. Some 80% of the claims were throwing up a mismatch, but it is now down to 20% because we have automated some of the matching and overwriting. I could give you further examples about the decision making at the back end. We are improving as we go along, and that continuous improvement is shaving minutes, hours and days off the bit of the process that we do at the beginning and the bit we do at the end.
Chair
You are improving, but people are waiting a heck of a long time.
Jason Feeney
I agree.
Meg Hillier
I asked colleagues whether they had cases that they thought were pertinent to this inquiry. A dozen colleagues wrote to me and others stopped me in the corridor, so I have multiple cases. The average time is seven months. That is mostly for an assessment, but some payments have come through in that time.
Robert Devereux
At no stage in this hearing have I said anything other than that is true and regrettable. The question we were asked was about whether we are making progress and whether we are changing it. Getting those months down depends on a raft of activity in the Department and the providers, and we are doing that work. Jason has given you some examples of what we are doing.
Nick Smith
Mr Feeney, I wonder whether you can help. Vicky Pearlman from the CAB said that there was a big issue with collating evidence and that some health and social care practitioners were not providing enough evidence. She gave a figure of just 1% across the board. Can you tell us more about what you are doing to ensure that evidence providers do a better job to provide the evidence you need for the casework you are looking at?
Jason Feeney
There are a couple of things. First, as I said earlier, the whole process encourages people to get as much evidence as possible early on in the process—before we get to the point of the assessment. We have not seen evidence being produced later in the process, often post-decision or at appeal, as we did with the work capability assessment, which caused some of the difficulties with WCA. The whole design is geared up to getting that evidence earlier in the process.
Nick Smith
Okay, I accept the point that you are trying to get information earlier rather than later. We have heard about the problems that happen later. What have you done to get the evidence earlier?
Jason Feeney
It is not essential that the health care professional has additional medical evidence. They can conduct the assessment without the evidence.
Chair
Well, they could, because it might save the face to face.
Jason Feeney
The more medical evidence there is, the more chance it will be a paper-based assessment rather than a face to face.
Nick Smith
So what are you doing about that?
Jason Feeney
The Department’s chief medical adviser is working with the professional bodies to encourage health care professionals, which is a broad group of people—
Nick Smith
So he is still working on it. It is work in progress.
Jason Feeney
We are still trying to encourage those people to respond to requests for further medical evidence. As was said in the earlier session, the assessment providers pay GPs for the time it takes them to produce evidence.
Nick Smith
What about OTs, physios, speech and language therapists, social workers—all those people?
Jason Feeney
We are working through the professional bodies to encourage them to do that.
Nick Smith
When did you start that, what stage are you at now and when do you expect to have an agreement?
Jason Feeney
I will have to write to you about that because it is being handled by the Department’s chief medical adviser.
Nick Smith
Did you not anticipate that you might need to get evidence with those other health professionals when you set up the process?
Jason Feeney
Yes. If you look at the work we did in designing it, the implementation stakeholder forum—the advisory group that we had to design the test—contained a broad range of health care professionals. It was always understood that we would need their co-operation and support. We had that, but the agreement and support from professional bodies is sometimes difficult to replicate in day-to-day practice.
Nick Smith
So you got it from the GPs. How did you manage that?
Jason Feeney
We paid them to provide the service.
Nick Smith
Did you not anticipate that you might have to pay other health professionals to provide the same service?
Jason Feeney
That is not something we routinely do.
Nick Smith
Do you think that you will have to do it in the future?
Jason Feeney
I wouldn’t like to say at this point in time.
Nick Smith
Ms Coleman talked about how long it takes for a patient or claimant to get to an assessment centre, and she said that 40% take an hour or more to get to an assessment centre. Do you have any data on that? Do you agree with Ms Coleman’s statement?
Jason Feeney
I agree with the assessment that Lisa provided.
Nick Smith
Again, Ms Pearlman says that there is an issue with the complexity of the original form. She said that that means there are more face-to-face assessments. Are you going to do anything with the form so that the paper-based assessment will be right first time, rather than requiring future face-to-face assessments?
Jason Feeney
Yes. We have made changes not just to the form, but to the covering letter. In the last month we have also introduced a flier that we send out so that there is another piece of information saying, “These are the types of further medical evidence that it would be really helpful if you had to hand.” As part of that, as well as the information on medical evidence, we are providing additional information to claimants on the length of time that we expect the process to take.
Fiona Mactaggart
Are any of those items available in an easy-to-read format?
Jason Feeney
Yes.
Nick Smith
Why didn’t you do that first time round?
Jason Feeney
Do what?
Nick Smith
All the things that you are now talking about.
Jason Feeney
Similarly to what Robert was saying, when designing the form and covering letter, we involved a broad range of stakeholders, including some of the organisations that were represented in the first session. We engaged with more than 6,000 organisations. We had an implementation stakeholder forum of more than 20 national third-party and disability representative organisations, all of whom contributed to what makes a good design for the form. We learned the lessons from the WCA, and we took on board some of the recommendations from Professor Harrington on the amount of transparency and opportunity that the claimant needs to be able to tell their story. It isn’t just a tick box; it’s a mix of easy-to-complete tick boxes and free text. We learned the lessons from WCA and Harrington in designing that, and we took on board lots of comments and made a number of changes in response to the findings of the implementation stakeholder forum, but in any new process, when you are introducing something as new and complicated as this, you will not get it right on day one. It will take you several months to get it right.
Nick Smith
I get that, but because you have identified lots of changes that you have since had to make, it seems as if you could have done a better job and tested it better first time round.
Chair
You could have piloted it. I am going to bring Capita in because Stephen has been sitting patiently and I think we recognise that he has a different model. Stephen, can you tell us whether that model of home visits allows you to make money out of it? Does Capita still make money out of the contract?
Dr Duckworth
The length of the assessment period has resulted in an additional investment by Capita that is about 50% over and above the sum that we originally anticipated. Over the lifetime of the contract, it will become profitable, but at this stage we are not making money.
Chair
Because you will just get faster at doing it over the lifetime of the contract? Why would it change? I am probably being silly about this, but explain it to me.
Dr Duckworth
There will be an increase in the speed and performance of the health professionals. At the moment, in the home environment, health professionals are able to do three assessments a day. In the clinic environment, they are doing four assessments a day. The opportunity that we now have to enable our health professionals to do overtime on Saturdays and Sundays increases those figures. The experience we are seeing in the home that is different from the clinics is also important. The fail-to-attend rate—claimants not being able to turn up for whatever reason—is much lower in the home-based environment than at clinics. That is having a very positive effect.
Chair
When did you let the Department know about the backlog?
Dr Duckworth
We started to discuss it with the Department towards the end of August or early in September.
Chair
And you could not have done that earlier? We are all getting slightly hot under the collar for the claimants, because for them—you will know this more than most, Stephen—this is a hugely important way in which they can maintain their independence, and for some it is a way of getting to work. So it was really important to sort it out.
Dr Duckworth
In response to the question why we did not start talking about it earlier, the “go live” was in June and it was six to eight weeks before we received our first referrals from the Department.
Chair
So there was a delay in referring.
Dr Duckworth
Other than for those who were terminally ill, yes.
Chair
There was a delay in referring.
Dr Duckworth
There was a delay in the application process at the front end.
Robert Devereux
There is a chart in the Report that I am just trying to find—
Chair
Do you want to answer that, Mr Feeney, while Mr Devereux is looking?
Jason Feeney
We went live with national new claims on 8 June. As the figure in the Report says—I think it is either figure 10 or figure 12—there were the initial problems that we have discussed with the telephones taking three or four days, or longer than we expected. The bulk of the time between June and the referrals reaching the assessment providers is taken by the claimant taking four to five weeks to fill in the form. There is not a delay in referral—it is a built-in part of the process. We did that on the advice of disability organisations to allow people time to get the support that they need. If people say that four weeks is not long enough, we give them a further fortnight to return the form. It is a natural part of the design that there is a gap between going live on 8 June and taking claims and their reaching the assessment providers at the beginning of August.
Meg Hillier
Some of the problems with all this are quite simple to solve and relate to the general poor admin involved—I am talking to Capita and Atos, although part of this is for Jason Feeney and Mr Devereux. If someone is going to have a liver transplant, what is the point of having a face-to-face assessment—what can an assessor determine that a consultant cannot? It seems that that could be fast-tracked—why is that not the case? Colleagues have provided me with these cases. Another is of someone who had a brain haemorrhage and was referred on leaving hospital. They are all waiting for assessments, but surely the one thing you need to know is that they have that medical condition—from the consultant. Surely that is enough.
Robert Devereux
One observation: this is not a test for a medical condition. I could have a liver transplant but not be entitled to PIP.
Meg Hillier
Not afterwards, perhaps, but while you are waiting for it and are not able to work.
Robert Devereux
It is not a benefit for being out of work, it has to do with people’s disability condition. Do you want to add to that, Jason?
Jason Feeney
It is exactly that—it is about how your condition affects you in terms of daily living or your mobility. People will have a range of conditions with differing degrees of severity, and their individual capability to cope will be different. The assessment is not about asking whether someone has X or Y condition; it is about how that affects their daily life—
Meg Hillier
Which I fully appreciate when it is all up and running properly, but given the fact that there is this a huge backlog, surely there is some financial reason—and some human reason for the people suffering in the meantime—to find some sort of fast-track system. There is a real cost-shunting going on. We are hearing that the discretionary housing payment is taking things up—that is DCLG money—and we are hearing about charities stepping in. I have heard cases of people being supported by family members on other benefits—
Robert Devereux
We agree with you. We have already identified one of the things we are seeking to do, both with providers and internally, which is to identify all those things that we could do on paper, using the exact same sort of logic you have applied, but only in respect of the proper test. If it is self-evident that somebody is going to get this benefit, there is no earthly reason why we should waste time assessing them. However, we have to make sure that it is still done rigorously and properly, because understandably, you want to make sure that the right people are being paid, too. We are going to get most traction earliest by finding those people in the backlog who, on paper, we can rapidly determine could be put on to the benefit. That would go quite a long way towards answering your question.
Meg Hillier
One other point is that it seems that as soon as an MP gets involved and points these things out, things get—sometimes—speeded up. Going on to the point about poor admin by Atos and Capita, let me give you some examples. One involves a man from Ilford, who is waiting for a liver transplant. He applied for PIP on 27 June. Atos said that it received the claim in August. Now, after some intervention by the MP and the Minister, he has an appointment for assessment on 10 March, but no payment yet. There was some delay in even the form getting to Atos, which is an interesting one. A number of constituents in Leicester have been advised to ring up each week to see whether there is a cancellation. I am not sure who has the Leicester contract—
Dr Duckworth
That is us.
Meg Hillier
That is clogging up the helpline, and it’s just not efficient, is it? In Corby, Capita has the contract. There are numerous cases of Capita cancelling constituents’ home assessments and in one example, the home visit was originally arranged and then cancelled 24 hours before the appointment. There are repeat examples of that. Eventually, when it was rearranged, and someone had taken time off work, no one turned up.
Chair
One more, Meg.
Meg Hillier
Another case is from Wolverhampton. Capita offered an assessment date in a letter dated 29 January, but the assessment offer was between 6 and 11 January. That is just incompetent admin. What excuses have you got for that?