New Left Project

ATOS: Notes on a Neoliberal Scandal

Readers of the New Left Project will most likely be familiar with the emergence of a new ruling class ideology, Neoliberalism, in the 1980’s. This revival of 19th century laissez faire economics originated with the ‘New Right’ of the Thatcher–Reagan era but found its clearest expression in 1989’s ‘Washington Consensus’ documents that envisaged a global economic order of free markets, established, paradoxically, through active and even militaristic state interventions. This hegemonic – but recently faltering - ideology seeks to introduce market mechanisms, logic and decision-making into every aspect of society:  the provision of welfare, the civil service, policing, the family, and even our very minds. I write here about one microcosmic example of this process – the use of multinational corporation ATOS Origin to replace the functions of the NHS and DWP - because I believe it is indicative of processes at work on a global scale. Similarly, the corporation’s treatment of disabled people, their supposed client group, parallels treatment meted out across the global village. Just as Subcomandante Marcos of the Mexican Zapatistas has said his mask is in fact a mirror, in which every oppressed group can see itself, so the expensively designed logo of ATOS is a mirror in which every multinational can see its own reflection - perhaps just ever so slightly warped.

Our story begins in 2008, when the Labour party began a process whereby disabled people receiving government help and support would be medically re-assessed with the explicit and pre-decided aim of cutting that support, regardless of the results of the assessment. While this move was originally part of a wider ideological gambit to funnel wealth away from the poorest and most needy in our country to New Labour’s corporate paymasters, the sudden collapse of the American mortgage loans system necessitated that this funnelling proceed at double time.

2010’s incoming Conservative / Liberal Democrat coalition enthusiastically agreed with the strategy and they decided to start by targeting Incapacity Benefit, a benefit given to people unable to work due to a disability. In order to ensure that these new assessments did not arrive at the ‘wrong’ conclusion – that the current levels of help were adequate or even insufficient – the NHS was calmly bypassed and a contract worth many hundreds of millions of pounds was tendered out to the private sector. A multinational IT corporation that specialised in ATM software, ATOS Origin, won that contract.

The ATOS Assessment

From the beginning ATOS made it clear that they would use the Logical Integrated Medical Assessment (LIMA) system – a computerised spreadsheet whereby the assessor simply asks questions that appear on the screen and ticks a box according to the patient’s reply. In contrast to most assessments used in education, health or child protection, this system allows the assessor to be a robotic cipher rather than an expert with any prior knowledge of the patient or their condition. Indeed, the assessor need hardly exchange a word with the patient, even though contemporary assessment models strongly recommend acquiring a rounded, rich and social impression of the patient. The LIMA programme was developed originally by an American ‘welfare reform’ corporation Unum Provident1, who have since been banned from operating in two American states and in New Zealand amid fierce allegations of medical incompetence and racism2 3.

The results of using ATOS and the LIMA system to assess disabled people have been predictable. An enormous number of disabled people - 75% of those assessed4 - including the terminally ill, people with cerebral palsy, multiple sclerosis and complex mental health issues like schizophrenia5, have been told that they must now start looking for work. If this search is unsuccessful, they may face the government’s forced welfare-to-work scheme, or simply have their Job Seekers Allowance taken away altogether. But disabled people have been fighting back, joining with trade unions, students and environmentalists, angrily protesting the neo-liberal assault on their lives. And now things are starting to look sticky for ATOS.

The Controversy

This summer it was revealed that ATOS faces having twelve of its assessment staff struck off for improper conduct. ATOS do not always use qualified doctors here. They refer ambiguously to their assessors as ‘healthcare professionals’, and have recruited from as far afield as Romania and Sudan, as fewer and fewer British doctors agree to freelance. The British Medical Association’s own website warns doctors in particular of the ‘vexatious complaints6’ ATOS often receive. The Observer newspaper has discovered that the General Medical Council (GMC) is investigating ‘the treatment of vulnerable people when the work capability assessments were carried out7’. One doctor has already been given a formal warning when he was found to be secretly working for ATOS while on extended sick leave from an accident and emergency department.  The Observer spoke to another doctor attending an ATOS recruitment fair who came away fearing she could become an ‘agent of the state8’, or, as the paper put it, ‘deprofessionalised by involvement in a system that did not make patients its first concern9’. The GMC refuses to comment on investigations in progress but it did warn ATOS that ‘regardless of the type of work a doctor does… you must make the care of your patient your first concern10’. The Nursing and Midwifery Council (NMC) also confirmed they are investigating complaints concerning ATOS.

Furthermore, recent figures have revealed that the Work Capability Assessments (WCA) have failed in their task of saving the Department of Work and Pensions (DWP) money – an extraordinary 40% of subsequent appeals to a tribunal have overturned ATOS decisions, with the figure rising to over 70% if the patient receives some help from a companion or advocacy team11. This in turn has cost the Government over £50 million a year. The chief executive of the charity SCOPE has warned that ‘the tests are massively flawed. Now it appears that it is being carried out by a large number of doctors who are under serious investigation12’. Some appeals are quickly settled, such as the case where ATOS employed a Romanian doctor found not to have registered in the UK, operating unlicensed. Other appeals have revealed more disturbing practices, such as the case of a patient with cancer and lymphoma who described the WCA as an ‘interrogation led by a computer13’. The ATOS staff refused to believe she found walking painful and moved the client’s legs around against her will until it ‘caused her great pain14’.  

In another case that the Guardian newspaper uncovered how a man with learning disabilities got up especially early for his assessment and took the bus to his local town centre, showing the ATOS address to passers-by, asking them to tell him which rough direction to walk in. His disability meant he had great difficulty with spatial cognition and map reading, but patients run the risk of having their benefit cancelled if they do not attend assessments on time. After several hours of walking around the town, prompted by strangers down each road and turn, he eventually arrived safely, but was duly told he was obviously fit for work because he had found his way there on his own.  No wonder that an online ‘Register of Shame15’ has been published where patients who have undergone the gruelling computerised assessment can write about their experiences and ‘out’ the collection of ‘healthcare professionals’ that freelance for the corporation. Indeed, the disabled forums DWPExaminations and CarerWatch and the websites AtosRegisterofShame and AfterAtos have been so damaging to ATOS’s reputation that all four have either received threatening letters from ATOS lawyers or have had their site shut down by its hosting company, following legal pressure from ATOS16.

These disturbing patient experiences have been validated by a government report into ATOS, published in November 2010, led by parliamentary health adviser Professor Malcolm Harrington, who concluded that the test is ‘mechanistic, impersonal and lacks empathy17’. According to the Professor, one suicidal woman was told by the Atos doctor to ‘stop crying and hurry up because I need to go and pick up my children from school18’. He also discovered that ATOS management lay down strict targets for each assessment, even specifying that assessments last between 46 and 49 minutes. He found that doctors ‘felt constrained by these targets when interviewing complex cases19’ and ‘the lack of time allowed, to devote to particular cases’20. Could this be because ATOS are paid per assessment and must perform so many each day? His report was partly catalysed by the huge number of successful – and extremely expensive – appeals tribunals, or what the Professor called ‘poor decision making and a high rate of appeals21’. His report noted two particular tendencies: the lack of any trained experts to assess learning disabilities like Downs Syndrome, Autism or an acquired brain injury; and the tendency for ATOS decisions to override the contradictory recommendations of local job centre staff, who have been simply overwhelmed by the sudden appearance of severely disabled and chronically ill people forced to find work during a recession.

This culture of suspicion and animosity towards disabled and chronically ill people has saturated the ATOS organisation and has led to a further scandal, exposed in August. Employees have been found making callous and dismissive comments about their patients on social networking sites, forcing a reluctant internal investigation. One member of staff described patients on his Facebook page as ‘parasitic wankers22 ’. Another employee posted ‘Thank God it’s Friday in this Godforsaken place with the down-and-outs!23’ When the weekend was over and she had to return to the drudgery of providing a public service to vulnerable, marginalised people, she wrote ‘Oh God, it’s another day here with the down and outs. Arghh! Help me!24

While these comments are shocking, more than anything they reveal the profound ignorance of ATOS staff. Workers in the NHS, Social Work Departments and schools deal everyday with people from all backgrounds and are generally unfazed dealing with the scruffy and dishevelled public.  Put simply, they have seen it all before. ATOS staff, on the other hand, have no training, no experience and no clue. Their comments are not so much sadistic as incompetent. In terms of foolishness they remind me of the ATOS protest I attended on May 11th 2011 outside their Edinburgh York Place offices where staff stuck their hands out the windows and gave the assembled disabled protestors a hearty ‘eff-off’ V-sign, to a crescendo of cat-calls and whistles. But then ATOS does usually produce software for cash machines.  

The Investigation

The avalanche of complaints, protests and investigations, along with several high profile protests and direct action by disabled groups like Disabled People Against the Cuts (DPAC) and Black Triangle have helped lead to a second investigation into ATOS practices by a House of Commons Work and Pensions Committee. The committee quite bluntly asked three senior ATOS executives why they are ‘feared and loathed25’ by disabled people.  ATOS executive Lisa Coleman, who manages the firm’s lucrative contracts with the state, said that this hatred was actually down to disabled people ‘not really understanding the role that ATOS plays26’.

The Committee raised the high rate of successful and expensive appeal tribunals against ATOS; Coleman bizarrely claimed that this was because evidence of health problems was not being revealed by disabled people until the final appeal stages. However, the Committee chair and Labour MP Anne Begg said that there was evidence of the exact opposite – that evidence offered by patients, such as NHS doctor’s reports, was being rejected during ATOS assessments out of hand.  The Committee also asked if the ATOS contract with the state really included a special clause barring any financial penalty or sanction for ATOS if their performance was substandard. The three senior executives bashfully confirmed that this had indeed been written into their contract. Anne Begg summed up by saying ‘this adds to the suspicion that you are a private company, you’re driven by the profit motive, and the incentive is to get the assessment done, not to get it right27’. Poor Lisa Coleman, with all those £100mlln contracts to manage, said those accusations were ‘very disheartening28’.

The Role of the Media

Disabled people have also taken on the newspaper many regard as the propaganda wing of the coalition government’s welfare plans – the Daily Mail. Over the summer a coalition of disabled groups drew attention to a series of inaccurate and sensationalistic articles that are alleged to have originated as press releases from Conservative central office to reconstruct public opinion. Two articles have been reported to the Press Complaints Commission. One headline claimed ‘76% of those who say they’re sick can work29’ and the article went on to label disabled benefit claimants as ‘cheats’ and ‘scroungers’. It had no mention of the subsequent appeals statistics or how ATOS were awarded the contract.  Moreover the article made no distinction between the ATOS verdict and the real ability of the patients to find work.

Another Daily Mail headline on the 26th of January 2011 said hundreds of thousands of disabled people were ’trying it on30’, faking illness or wheelchair use, followed by the headline ‘time’s up for the shirking classes: Just one in 14 incapacity claimants is unfit to work31’. The concept alone of a ‘shirking class’ is comical but the statistic is a fantasy – even the figure that ATOS uses is actually one in four, changing to just under a half of claimants after an appeal.  Another Daily Mail headline said ‘Tough new benefits test weeds out the workshy’ – possibly channelling the use of the badge ‘arbeitsscheu’ (workshy) by the Third Reich to describe disabled people because they were economically unproductive. After all, the Mail did have something of a fondness for the regime in the 1930’s32.

The claim that the Government has been acting in consort with the right-wing press to demonise disabled people to smooth the path for welfare cuts may seem paranoid, but the relationship has attracted the attention of the UK official statistics watchdog (UKSA), disabled campaigners and left-wing MPs. The Commons Work and Pensions Committee have written to the Government expressing this very fear and the UKSA has backed their criticisms. The Committee called on the Government to take ‘more care’, make sure their figures were ‘factually correct’ and ‘avoid pejorative terms like shirker and scrounger which are irresponsible and inaccurate33’.

The UKSA added that the Government’s press releases ‘could be improved in a number of respects’. The committee cited one story, published by the Daily Mail, quoting figures supplied by the Government, claiming that Disability Living Allowance (DLA) ‘had been abused by those who are fit to work’. The inference here is that DLA is a benefit paid to people who cannot work. However, DLA is entirely different from Incapacity Benefit: it is paid to disabled people who are both in work and out of work. In fact, DLA is paid if a person needs to hire a carer or if they need mobility equipment, like a scooter or wheelchair. Employment status is simply not an eligibility criterion, either way. This fact did not stop the Daily Mail claiming that some people were therefore ‘living off their disabilities’ and that the cost to ‘the taxpayer’ was ‘shocking’. If this sounds suspicious, it is. A parliamentary report covering 2009/10 found that less than 2% of the entire Disabled Living Allowance Budget is lost due to fraud, wrong assessment or computer error34.

In its determination to portray disabled people as fakers and fraudsters the Government has fabricated some statistics altogether. In May the Government delivered a press release to ‘selected newspapers’ claiming that DLA claims had risen by 30% over the last 8 years, which was ‘not affordable and sustainable35’. Furthermore, this dramatic rise meant that DLA would have to be abolished and replaced with a smaller allowance called a Personal Independence Payment. This would mean the retesting of all claimants once, again with the pre-stated aim of cutting the number of claimants by 20%. This would, of course, be undertaken by the private sector.

However, closer inspection of the report’s maths revealed that the rise was in fact only 23%, of which 7% was due to Britain’s aging population, and 3% due to the increased number of children receiving aids and support, making the real figure 13%36. When the error was made public, documents containing the figures were suddenly shelved until August – after the Government’s controversial welfare reform bill had been debated. Disabled Blogger Mason Dixon pointed out that the figures were eventually published during the London riots ‘while most of the media was occupied37’ thereby preventing its use by opposition MPs or charities.  

The saga of ATOS Origin is very much a saga of our neo-liberal times, and the slow but steady erosion of the corporation’s credibility and power parallels the long, slow demise of the umbrella ideology. No doubt the replacement of neoliberalism with a form of democratic socialism suitable for the 21st century remains a long way off. But this tale is vintage stuff - an authoritarian and chauvinistic government using extra-legal means to facilitate the infiltration of the state by private enterprise, resulting in the transfer of wealth from the poor to a tiny elite.

On October the 22nd disabled people are planning a new wave of protests38 across the country and will be again supported by students, trade unionists and environmental groups, among others. On the 30th of September they will target the ATOS recruitment fair held that day in Islington, North London.  Linda Burnip, co-founder of DPAC, said ‘it is important to target recruitment because we think people should know who they are going to work for, and what disabled people think about them, and hopefully it will put them off working for ATOS.39’ Hopefully those potential ATOS employees will remember the medical maxim ‘first, do no harm’ and choose right over wrong. A live studio audience were exhorted to do just that by none other than Iain Duncan Smith, Conservative millionaire and one-time army officer in the former colony of Rhodesia. Equally hopefully, however, potential employees will not be influenced by Duncan-Smith’s actions, because after his brave words he dashed ahead of a disabled audience member, who was already waiting to use the studio’s accessible toilet, and deftly slipped in first. The disabled man, Mr Sean McGovern, observed that Duncan-Smith ‘could flout the rules and regulations because he can, because of who he is40’ - much like ATOS. Disabled activist and blogger Kaliya Franklin of The Broken of Britain suggested that in recompense Iain Duncan Smith should ‘inspect the standard of accessible toilets, cleaning them himself when needed, to show strong leadership and set an example41’.

His office has yet to comment on her suggestion.
 

1. ‘New Labour, the market state, and the end of welfare’, Jonathan Rutherford, Sounding magazine, 2007

2. ‘The Unum Provident scandal and Judicial review, John H. Langbeim, Yale Law School, http://www.cfids-me.org/disinissues/discandal.pdf

3. ‘Life & Health Financial Services’, Marcella De Simone, July 2002, Vol. 106, Issue 30, p41

4. ‘Benefit applicants: 75% fit to work or drop claims', BBC News, 28 April 2011  

5. Unfit for Purpose - Scottish CAB evidence on ESA, Citizens Advice Service, May 2010

6. http://www.bma.org.uk/employmentandcontracts/fees/medicalservicesdoctors.jsp

7. ‘ATOS Doctors could be struck off’, Daniel Boffey, The Guardian, 13 Aug 2011

8. ibid.

9. ibid.

10. Ibid.

11. Unfit for Purpose - Scottish CAB evidence on ESA, Citizens Advice Service, May 2010

12. ‘ATOS Doctors could be struck off’ Daniel Boffey, The Guardian, 13 Aug 2011

13. ibid.

14. ibid.

15. http://victimsofatoscorruption.wordpress.com or visit http://www.facebook.com/pages/Atos-Register-of-Shame/158520787554395

16. ‘Websites and forums targeted by fitness to work company’s lawyers’, Disability News Service, 25th Aug 2011

17. ‘Harrington review: Assessments must be fairer’, 19 Aug 2011, Disability News Service

18. ‘More evidence that Atos Origin cheats benefits claimants’, Nick Sommerlad, Nov 25 2010, The Mirror

19. ‘Sick? Computer says no’, Nick Sommerlad, Nov 25 2010, The Mirror

20. ibid.

21. ‘Harrington review: Assessments must be fairer’, 19 Aug 2011, Disability News Service

22. ‘ATOS forced to investigate after employee’s parasite comment on website’, Disability News Service, 12 Aug 2011

23. ibid.

24. ibid.

25. ‘MP asks ATOS bosses why their company is feared and loathed’, Disability News Service, 28 July 2011

26. Ibid.

27. Ibid.

28. Ibid.

29.  ‘76% of those who say they're sick can work' The Daily Mail, 28th July 2010

30. ‘Protestors call on the Daily Mail to stop the lies about benefits claimants’, Disability News Service, 5 Aug 2011

31. ‘Government given dressing-down over fitness to work figures’ Disability News Service, 12th Aug 2011

32. ‘Hurrah for the Blackshirts’, Daily Mail, 8 July 1934,

33. ‘Government given dressing-down over fitness to work figures’, Disability News Service, 12 Aug 2011

34. http://research.dwp.gov.uk/asd/asd2/fem/fem_oct07_sep08.pdf

35. ‘Figures undermine government’s case for DLA cut’s’ Disability News Service, 12 Aug 2011

36. ibid.

37. ‘Government delayed uphelpful DLA stats until summer break’, Disability News Service, 19th Aug 2011

38. Visit http://www.hardesthit.org.uk or www.facebook.com/thehardesthit for more information on times and an up to date list of event locations.

39. ‘New wave of protests to target fitness to work company’, Disability News Service 26th Aug 2011

40. ‘Minister caught using accessible toilet after TV lecture on right and wrong’, Disability News Service, 19th Aug 2011

41. ibid.

 

About this article

Published on 26 September, 2011
By Christopher Read