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The costs and problems of sourcing medical support information for ESA

Yesterday, the BBC reported that GPs in south east Wales had been told to stop writing letters for patients appealing against decisions to stop benefit payments because it is an "abuse of resources".

Said the BBC:

"Patients have been asking doctors for evidence that they are not fit for work. But Bro Taf local medical committee, representing GPs, says writing letters stops doctors seeing ill patients... But one patient who spoke to BBC Wales said the situation had a huge impact on her. Fiona Howells, who lives in Ferndale in the Rhondda, said her doctor had initially agreed to write a supporting letter for a £20 fee, but then withdrew that offer. "For your doctor to be put in a position where they are unable to support you is bad enough, but for that recommendation to be made by other doctors is just absolutely shocking," she said. "It makes you ill, to be honest. It just leaves you in despair.""

Watch Sue Marsh's blog for updates

Charging for medical support information

Even when people are able to get their GPs to supply medical support information, they face another issue - having to pay for that information.

Last year - after ESA claimants raised this issue with us - we asked people to let us know how much they were being charged by GPs surgeries and consultants for the medical evidence and letters of support which people need for their work capability assessments, or to fight Atos work capability assessment decisions at tribunal level. The results there were of concern and people continue to report the struggles they have to pay those fees. (There is a list of fees that people can be charged for accessing their medical records here).

The welfare advisors we spoke to then said that clients were being asked to pay £20, £30 and even £50 for medical evidence and that some clients really struggled to pay such fees - it's hard to find that money out of already-small benefits. Their concern was that some people would find themselves in a situation where they couldn't pay for the evidence that they need to support ESA claims.

They were also concerned that more and more surgeries would charge to provide medical evidence as more and more people appealed work capability assessments. You can see some of these concerns on this thread here. More and more people are appealing their ESA decisions, too, so the pressures are increasing. And let's not forget that the pressures on people's budgets are even worse this year, now that the bedroom tax has been introduced and council tax benefit cut.

Citizens Advice raised this issue of cost in "Right First Time?", their January 2012 indicative study of the accuracy of ESA work capability assessment reports. Their comment in that paper: "In many cases, NHS doctors will charge an average of £30 (we have evidence of consultants charging £200 an hour) for medical evidence and few people on low incomes can afford to pay this much out of an income of £67.50 ESA (assessment phase rate) per week."

Medical information for people with mental health conditions

And don't forget either that the DWP has won leave to appeal an Upper Tribunal decision which would have put the onus on the DWP to source medical information for people with mental health conditions at the start of their ESA application.

The original case was brought by the Mental Health Resistance Network last year, when two claimants represented by the Public Law Project argued that Atos work capability assessments discriminated against people with mental health conditions.

The courts agreed – but the DWP didn't: “we disagreed with the Upper Tribunal’s original ruling and are pleased that the Court of Appeal has given us permission to appeal,” the department told us in an email. "We already request claimants supply any evidence they feel will be relevant to the assessment in the ESA50 questionnaire."

Unfortunately, as we've seen, that medical information can be difficult and costly to get.

Which all points to ESA claimants finding it harder and harder to source the all-important medical information they need to make their applications.


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