‘Atos doctors could be struck off’, The Observer, 14 August 2011

August 14, 2011

From The Observer, 14 August 2011 (story by Daniel Boffey, policy editor)

Twelve medics at the disability assessment centre are under investigation by the GMC over allegations of improper conduct

Twelve doctors employed by the firm that is paid £100m a year to assess people claiming disability benefit are under investigation by the General Medical Council over allegations of improper conduct. The doctors, who work for Atos Healthcare, a French-owned company recently criticised by MPs for its practices, face being struck off if they are found not to have put the care of patients first.

The Observer has found that seven of the doctors have been under investigation for more than seven months. The other five were placed under investigation this year following complaints about their conduct.

It is understood that the majority of allegations concern the treatment of vulnerable people when the government's controversial “work capability assessments” were carried out, but the GMC refused to comment on individual cases. The development will add to fears over the pace and radical agenda behind the government's welfare-to-work policy, which led to protests in Westminster in May by thousands of disabled people. It will also raise concerns about ministers' commitment to Atos Healthcare, which was recently granted a three-year extension on its contract.

The government has repeatedly publicised figures showing that the “vast majority” of claimants for employment support allowance (ESA), which has replaced incapacity benefit, are fit for work. But four out of 10 of those who appealed the decision by Atos – whose parent company is run by a former French finance minister, Thierry Breton – to deny them benefits are successful on appeal, a process that costs the taxpayer £50m a year.

Last month Atos, whose staff assess around 11,000 benefit claimants a week, was savaged by the cross-party work and pensions select committee after it found that many people had “not received the level of service from Atos which they can reasonably expect”.

MPs further claimed that a combination of the company's conduct and the test itself had prompted “fear and anxiety among vulnerable people”.

One GP who attended an Atos recruitment fair told the Observer she feared doctors could become “agents of the state” who were deprofessionalised by involvement in a system that did not make patient care its first concern.

Campaigners for the disabled seized upon the development, claiming the government needed to go back to the drawing board. Richard Hawkes, chief executive of the charity Scope, said: “If the government wants to get disabled people off benefits and into work then it needs to get its assessment right. The test should be the first step on the road to employment. But disabled people's confidence in the work capability assessment is extremely low – and today's news will send it to rock bottom.

“The test is massively flawed. Now it appears that it is being carried out by a large number of doctors who are under serious investigation.”

Neil Bateman, a solicitor who handles ESA appeals, said on two occasions his clients had been successful because, among other reasons, the doctor assessing them had qualified in Romania and registered with the GMC but had not been licensed to practise in Britain.

Citizens Advice told the Observer it was compiling a dossier showing the problems being faced by those assessed by Atos staff, who can be nurses or physiotherapists in cases where there are no potential neurological disorders. It said it regularly found inaccuracies in many of the medical reports featured in ESA appeal papers that could affect people's chances of receiving benefits. It also found a lack of consideration for those being assessed.

A spokesman said a barrister who was unable to practise because of cancer and lymphoma had described the assessment as being like an “interrogation” led by a computer. The assessor moved the client's legs, which caused her great pain, even though the client had warned that this would happen. In another case a claimant with learning difficulties who went for an assessment was found fit for work because he had found his way to the assessment centre on his own.

When asked about this by Citizens Advice, he reluctantly explained that he had got up very early, taken the bus to the town centre, and then kept asking passersby for directions. He couldn't follow their instructions, so he would show the letter, walk in the direction they pointed, then ask again until he arrived.

Two doctors employed by Atos have already been taken by the GMC to an independent panel for adjudication on their fitness to practise. Dr Alexandros Mallios, who it was claimed had not carried out a proper examination of his patient during an assessment, was cleared by the panel last October. Dr Usen Samuel Ikidde, who qualified in Nigeria, was given a formal warning in January, to lay on his records for five years, after he was found to have worked for Atos while on sick leave from an accident and emergency department.

An Atos spokesman said: “Atos Healthcare is committed to providing a high-quality, professional service and requires these standards of all its employees. While we cannot comment on individual cases, any complaint made about an employee is taken extremely seriously.

“In addition to our own rigorous internal investigations we will co-operate with any external investigation to ensure all facts are properly established and the appropriate action taken.”

The Labour government introduced work capability assessments in 2008 when it replaced incapacity benefit and income support for new claimants with employment and support allowance. The government has accelerated the changes and started retesting all 1.5 million incapacity benefit claimants to see whether they are eligible for the new benefit.

A GMC spokesman said: “We can and do take action to remove or restrict a doctor's right to practise if there have been serious failures to meet our standards.”

8 thoughts on “‘Atos doctors could be struck off’, The Observer, 14 August 2011”

  1. “An Atos spokesman said: …… any complaint made about an employee is taken extremely seriously.”

    No they don’t.
    They certainly did not take my complaint about the doctor who did my assessment “extemely seriously”. They pretty much ignored it.

    These people typify the modern day corporate culture of talking big on customer care, but in reality they don’t deliver on their promises until they are compelled to do so.

    1. Me too. The doctor claimed that 30mg doses of codeine are available over the counter. On complaint, his medical supervisor agreed. Both also said they were only for moderate pain. I also had trouble with my balance. They decided I did not have vertigo as there was no evidence, despite the fact I was leaning on the wall for support. They did comment, saying they could not comprehend why I leaned on the wall for support.
      When You complain, they just deny it happened and take the doctor’s word for it.

      1. I read this comment with some alarm. I suffer bad pain (muscles, some joints and nerve pain). I have attended a pain clinic (with a very understanding Specialist). Unfortunately my condition makes me sensitive to different drugs; even starting with the lowest dose possible, whether it be painkillers, anti-epilepsy drugs etc, I have problems with them. Many courses of drugs have had to be abandoned because of the unbearable side-effects that make this illness worse. I am now on doses of codeine 30mg, paracetamol, anti-inflammatories ( which do help pain but plays havoc with my stomach so have to keep discontinuing them), and low-dose amitriptyline 25mg. These drugs just take the edge off the pain but certainly does not alleviate it – I cannot tolerate higher doses. It is a difficult position that affects many ME sufferers. To judge that someones pain is not ‘severe’ because the dose of medication is not ‘sky-high’ is ludicrous. The medical assessors clearly do not understand that ME is always a balancing act – from relieving pain balanced with feeling more dreadful.
        Even though I suffer troublesome pain, my main symptom is the crippling exhaustion – that is the most disabling symptom. I feel it at the time of carrying out a ‘small task’ but feel it even more later, when I often feel I’ve been hit by a sledge hammer.
        The truth of the matter seems to be that the DWP aim is to prevent the sick from receiving a sickness benefit, no matter how genuine the claimant and thus save a vast amount in Welfare payments. The medical assessments are obviously trying to look for ‘anything’ to justify not declaring someone ‘too sick to work’ and it is an absolute insult. There is no dignity, no self-respect, no self-worth in having to be supported by the State, but sadly there are people who are too sick to work – ‘we’ who are affected, have to accept this sad fact and so should the government.
        Incidently, my assessment for Benefit is due, so every day for months now I live in fear and feel sick with dread. What an existence.

  2. Shouldn’t ATOS be made to pay the costs of every successful appeal?

    That should make them keener to do a better job at the outset.

    Every interview in a police station is recorded; shouldn’t the same procedure apply to these assessments?

  3. A lot of the focus has been on the poor assessment process currently undertaken by ATOS but what about the responsibilty of the DWP and the even worse interrogation by the tribunal panels held by the Ministry of Justice. Although, a high number of claimants go on to have their appeal upheld, others don’t and still can’t work. Just because there are a higher number of successful appeals doesn’t mean that they are any less humiliating, harrowing and that there are many that still fall through the net and are let down by the system now and how it was before.

    It seems more about saying the right thing with advice from CAB and other organisations so that you fit the descriptors for a specific type of disability model rather than being unfit for work because your illness results in limitations.

    1. It’s essential to not only say the right thing at your appeal, but also to be very well informed about the latest biomedical research evidence. Submitting a carefully selected list of relevant research papers for consideration by the appeal panel (which were ignored by the ATOS doctor) did no harm to my appeal and probably helped me to win it.

  4. Guardian Letters.
    Cc: Daniel Boffey, Policy Editor

    One shouldn’t tar every Atos medical assessor with the same brush (Atos doctors could be struck off, Guardian, 13 August 2011), nor should it be turned into a witch hunt but I have a feeling that if you enquired just a little deeper (maybe using covert recording of those having to undergo a Work Capability Assessment test), you might discover that there are rather more, who deserve a coat from this brush, than the dozen or so who are known to have behaved improperly, including those who are not doctors and may not even be considered by the GMC disciplinary procedures.

    I do hope that Atos is not permitted to continue in the same way without a truly independent enquiry and the spokesman’s claim that they will “co-operate with any external investigation to ensure all facts are properly established and the appropriate action taken,” is thoroughly tested. I also hope that those who have have been alerted, some not for the first time – including professional bodies, MPs and journalists – won’t lose this opportunity but have to return to it again after so many more claimants have been put through unnecessary distress, often several times over.

    Yours sincerely
    Dr John H Greensmith
    ME Community Trust.org

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