Wednesday, 11 September 2013

Hoban Meeting Update

So, yesterday, as most of you will know by now, representatives from Spartacus finally got to meet with Mark Hoban to discuss Employment and Support Allowance and Work Capability Assessments after almost a year of trying.

Other online groups representing sick and disabled people had felt very strongly before the meeting that it should be made explicitly clear that WCAs should be scrapped. They are unfit for purpose and no amount of tinkering with descriptors or processes will change that.

We agreed, but felt that for that approach to be credible, there had to be alternative suggestions in place. Happily, in just 24 hours, all of the online groups representing sick and disabled people were able to agree to this solution in time, meaning that we could go into the meeting with the whole weight of the online campaigning community behind us.

We agreed that we would raise the issues people had agreed in extensive consultations on my blog to be the most important and "listen" to what the minister said on these issues, suggesting things that could at least make the process safer in the meantime until we were able to put together an alternative proposal.

With this in mind, here is a summary of the issues we raised and Mr Hoban's responses. We feel that the meeting was remarkably productive in this sense.

"Before any further discussions took place, Sam explained that there was widespread support for abolishing WCAs. The system causes stress, fear and anxiety, it is not trusted and we doubt that any amount of "reform" would now be able to change that.

Sue opened the meeting by saying that we hoped we could break down the oppositional, partisan and confrontational stance that has often blighted discussions over ESA. She asked for genuine engagement. She pointed out that we had only ever tried to present helpful, evidence based research, aimed at showing how WCAs affect real people. She suggested that we all had experts and networks that could be valuable in re-designing a new system.

Mr Hoban appeared to listen carefully. He and three civil servants all took notes during the meeting. They did seem to genuinely want to discuss issues openly with us. We're delighted to say that the meeting had none of the frustrating stonewalling or fudging of some parliamentary debates.

45 minutes passed in the blink of an eye and sadly, though we did ask the questions, there was no time to pin down answers on where things stand on mental health assessments/champions and the decision to divide physical and cognitive conditions when it comes to scoring points during an assessment. However, the Chief Medical Officer gave us his card at the end of the meeting and we agreed to chase up or define any issues that we weren't clear on, so this will be an opportunity to clarify.

Mr Hoban appeared to particularly agree on gathering medical evidence earlier in ALL claims. Civil servants confirmed that an ESA113 was only sent to GPs in limited circumstances. Mr Hoban agreed that medical evidence was crucial at the earliest stage and accepted that sending an ESA113 in ALL cases as soon as the claim is received might be a solution. They accepted that GPs don't always return this evidence and agreed to do more to make sure that they do. 

Sue suggested that explaining and suggesting the use of "Reliably Repeatedly and Safely" on the ESA50 form more often would be very helpful and Mr Hoban appeared to agree that this would be a helpful change. He particularly agreed that there is a need for more guidance to help people complete their forms in a way that would ensure they give the information needed to make decisions. He told a story of one of his own constituents who had filled in the form particularly badly. He said he thought he could have done a better job himself after just 5 minutes with the constituent and that it was clear much more guidance could be included to help with the process. They committed to looking again at what could be done with some urgency. 

We asked about universal audio recording of assessments and urged that this was the only way to truly know that assessments had been conducted fairly and accurately. Mr Hoban was not entirely convinced that this was the case and cited examples of HMRC losing audio files, which had created even more suspicion. He didn't rule it out however, and did say that letters would be amended to say that the option was available to all claimants.

We asked about the Evidence Based Review (EBR) and trials of new descriptors for Mental Health and Fluctuating conditions. It was clear from the civil servants that this was taking longer than they had originally envisioned. It had proved harder than anticipated to develop robust descriptors that claimants could
be compared against and which could be tested; some of the original submissions had been too vague to be of practical use. They did agree that so far it is clear that lessons can be learned from this alternative assessment. Sue asked what would happen if the new descriptors were more generous to claimants and would cost more to implement. Would they say it was just too expensive or would the Treasury veto any changes? Mr Hoban confirmed that they would do what was right. There was no financial limit on how generous a new set of descriptors might be and these will be based on evidence not cost. He cited examples of more people going into the Support Group and how that had cost over a billion pounds extra in the first year, but that it had been accepted financially. 

Mr Hoban was particularly concerned by how long it was taking to assess people. He said that he was concerned about what is right even when improvements are difficult to implement and is keen to learn what works and doesn't work so that the process can be improved. He wants to see a test that is robust, is the right test and has credibility. If changes are identified that would improve the system, then the DWP accepts that. He said that the EBR is a good example of that, as it has proved harder to run than
originally anticipated but the DWP will use the evidence from the EBR to improve ESA. There are no financial limits from the Treasury, and no consideration of cost will be used to decide which descriptors are the best to use.

Sue mentioned concern about targets. Mr Hoban said DWP set no targets. He said they are only concerned about quality. If an assessor was an outlier (ie putting more claimants into the Support Group or WRAG than colleagues) then it is not that the assessor is an "outlier" that matters but that a need to check his or her assessments are right was all that mattered; if the assessments were correct then it doesn't matter that the assessor was an outlier. Mr Hoban was very clear that targets are the wrong thing, and that they have no place in a credible system. We suggested that Atos are using "norms" either way, even if not part of DWP guidance and it might be worth re-iterating with Atos that this shouldn't be the case. 

Sam mentioned concern that assessors are saying they are told to presume zero points and award points grudgingly. We want to see an inquisitorial approach, not adversarial. Sue said that the balance of comments from claimants is that the HCPs are trying to trip people up. but maybe all that is needed is to remind Atos that their role is not to be denying people points or benefits.

Mr Hoban agreed with this and said that this is what DWP guidance to HCPs recommends; the HCPs are to gather the evidence as it is. Sue pointed out that whilst this is indeed the written DWP guidance, anecdotal evidence from HCPs suggests that this is not the case during in-house training. Again, taking this issue up with Atos may be helpful. Mr Hoban appeared to agree to this. Mr Hoban mentioned that WCA is just one part of the information that decision makers use; this is why Decision Makers do increasingly disagree with HCPs based on other evidence although we don't know what the 'right' number would be given that high levels of disagreement would also be concerning. 

Sue said how pleased we were to discover that such a high proportion of claims were successful based on paper assessments alone, with no need for a stressful and costly WCA. She suggested this should be even more widespread and almost certainly could be if more GPs returned evidence in time. Mr Hoban appeared to agree that this was the best way of conducting assessments where possible. 

On Mandatory Reconsideration, leaving people without income we pushed very hard, coming back at Mr Hoban several times to try to get some kind of compromise. We argued that it isn't consistent to give claimants 4 weeks to get evidence in when the DWP has as long as they want for reconsideration. Mr
Hoban indicated some agreement and agreed to review this 6 months
He said they need to see how it works in practice. We argued that in the meantime people are going without money, and would it not be better to give them this money during those first 6 months, and then review it. However Mr Hoban felt that as it was appropriate for these people to sign on for JSA, then there is no poverty issue. Sue pointed out that many would not be able to do that - herself included as her husband works. They would simply lose nearly £500 a month while they waited indefinitely. 

Stef pointed out concerns over the appropriateness of Jobcentre Plus conditionality agreements, and the
concerns over the high percentage of successful appeals that were not borderline but instead had been severely under-awarded points initially when they should have very easily got over the 15 points mark. Sue pointed out that a very high % (16%) of Fit for Work decisions are inaccurate and that few disagreed that the system is flawed as it stands. 

Unfortunately, Mr Hoban still insisted that these people had been found fit for work and it was reasonable to expect them to make other arrangements, time was running out and we had to leave the issue. 

We devoted the final part of the meeting to arguing very robustly that Mr Hoban consider an alternative to WCAs that would be developed by all online groups in unity. We requested a follow-up meeting to present this alternative to ESA/WCA designed by the online disabled community. Mr Hoban agreed that he is very willing to listen to constructive and fully-worked out proposals. He was concerned that given the difficulties that large charities experienced in designing workable descriptors, that we need to be aware of the challenge we have set ourselves. He did however say that if someone has an alterative that works, that is fully worked out and includes an indication of why it would be effective, then that alternative should be presented. Michael Meacher pushed him on a follow up meeting. Mr Hoban concluded that if an alternative could be put together, they are always willing - including this meeting - to listen to ideas that are constructive."

So, we did our very best for you all. We felt quite pleased that the meeting had been so constructive and we had managed to cover so much in the short time available. If nothing else, some of the clarifications make it easier to know where things stand and what changes the government are considering in the short term to make the system safer and fairer. 

Everyone now has the chance to design a better system that is robust and which works and the knowledge that the minister will at least consider our approach. 

 












41 comments:

  1. Thank you so much one and all for the time and effort put into all this. Any progress at all is great, and that you appear to have been listened too is an important step.
    We'll see what happens next.

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  2. Thanks to all of you for a job well done, your help and support means more than words can say! xx

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  3. Thank you.

    I know how difficult it is to any any commitment, or real conversation, from Ministers.

    On the issue of people being told to sign on during the appeal process and the clash with the new JSA commitment - is this a/the key short-term issue now?

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  4. Might as well have saved your breath.

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    1. Let her play the politician, keep herself in the spotlight at best a silly girl, as green as the hills , with not a brief in sight to advise..

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    2. Your attitude helps no one. Can you hear yourselves? I'm disgusted.

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    3. And let them think we're giving up? I don't think so.

      Peculiar choice of insult from you, voxpopuli2, given what Sue has to endure; anyone can see that's the opposite of what she is.

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    4. So speaks the "Voice of the People"

      Isnt't that what the Daily Mail calls itself?

      Mean spirited, suspicious, snippy. I see a link

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    5. As wonderful a person as Sue Marsh is I don't think scumbuckets like Mark Hoban care about or take any notice of what she says. People like Hoban would happily lay waste to the world if told to by their superiors and there was some benefit to be garnered for them personally from such an action.

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  5. Thank you for all the hard work you put into this meeting, I hope nobody is suffering too much afterwards. I hope that you are able to keep going with this, difficult as it is when sometimes it's like bashing your head against a brick wall.

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  6. I think you have done a good job. Hopefully if some of your ideas are accepted and work well, then they will come back to you for further ideas. This could be the start of a process of change. It can also open the door to presenting alternatives.

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  7. Thanks a million for this detailed report Sue, and thanks a trillion to the three of you for doing this.

    The fact you managed to get them to respond on so many issues suggests that Hoban et al are now willing to engage on improving the process of claiming ESA.

    It does seem like they have accepted the need to make the process of claiming ESA more efficient, 'cos making it a living nightmare of chaos and confusion has not had the tacitly desired aim of silencing sick and disabled people to get them off the benefit lists.

    I'd agree that testing them on the claim that everyone found initially and wrongly fit for work can claim JSA is a big short term priority. Could people submit examples of where they haven't been able to claim JSA after being denied ESA?

    Love the idea of pushing them to get ESA113 forms sent out after every claim, and of making guidance on forms clearer. Would be great to monitor any progress on this.

    Anyway, heartfelt thanks again and let us know whether we can do anything to help!

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  8. I personally doubt Hoban intends to do anything that will result in less people being found 'fit for work'. As far as he is concerned, getting people off sickness benefit is the point of the exercise, and I doubt he cares much how he does it.

    Still, many thanks for your efforts. All we can do is keep campaigning and keep the pressure up until the inhumanity of this sham assessment is exposed.

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  9. Thank you.

    Mark Hoban's responses were better than I dared hope and it sounds like he actually listened.

    Hopefully he has also realised that campaigning groups are not scary and it can actually be helpful to meet with them!

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  10. Bless all of you involved. Your determination is more than admirable. I just hope that Hoban's listening translates into actions. Very glad you had Michael Meacher with you!

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  11. Having had at least one meeting with ministers myself, I know that this result is exceptionally encouraging. Very well done. I'm sure it was more than obvious that you knew your brief extremely well - you 3 together make an awesome team!

    I would urge you to have sight of the minutes of the meeting as soon as they're produced, so you have something tangible to go back to as things proceed. Holding the minister to account for everything he said is really important. It will show you mean business and hopefully enable you to continue in an ongoing engagement, which has to be a great deal better than effectively letting them get on with it without challenge.

    A huge well done to all 3 of you - brilliant work, which I hope is the beginning rather than the end.

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  12. Thank you all for your work on this. And to those who criticise, I'd like to see them do better. In fact, I'd like to see them do anything that comes up to your standard.

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  13. Thank you so much, Sue, for your hard work and dedication, and congratulations on your constructive meeting with minister Mark Hoban.

    Samuel Miller
    (Montreal, Canada)

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  14. my mp said overall my approach was the best in which a benefits adviser from the DWP comes round your house with a fully qualified GP from the GMC so as to see first hand what your sick and disability needs are and this to include all security checks so that any benefits that are paid go to whom they should be paid in the right home of the claimant at the right address

    The plus point of my approach was that it gives a relaxed feeling and any carer can be present so that the doctor knows of what care is being provided and which group having looked at the claimants health history to place that person in IE support group / WRAG ETC

    As i say if you wont things simple they are but the government don’t like things simple it seams so more lives are lost

    my way will always be the best as it’s the only logic that makes sense except the likes of IDS etc who has his own agenda in which costs lives

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    1. I'm sorry Nick, but I can't agree with that approach in any way, shape or form. That's an invasion of privacy, a persons home is not the business of any one in government. Disability and illness are medically provable, we're not in the dark ages. Your proposal is just setting up more bureaucracy, more of people being treated with suspicion. Most people don't want people coming in their home to inspect them to see if they're worthy.

      Like I said on another post yesterday, medical evidence does not lie, once someone has presented the evidence it should be quite clear that they're not lying, and they do indeed need the benefit they've claimed. Lurching to more authoritarianism isn't the answer. And that's exactly what your proposal is. no one has a right to invade someone's private life, you cannot allow that to be put on trial. These are medical conditions, end of story, everything after that is up to the individual.

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    2. my way James is far better then for a sick and disabled to venture out often miles to visit a ATOS centre for a tick exercise and then having to wait months for a decision and then very often then going on to an appeal there again taking many months

      my way is by far the best as the GMC doctor would have all your notes to hand and be able to understand the reasons of why you cant work and then be able to place you in the right group WRAG or SUPPORT and within an hour it's all over and painless

      threatening a sick or disabled person to attend an ATOS centre or lose benefits is a killer in some cases and is full of uncertainty

      of course it would be nice to keep things as they were with just your doctors sick note but those days are over

      it's either my way in future or a trip to the ATOS centre end of story as that is the only options for choice

      and all I'm saying my way is the better choice of the to

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  15. Well done, Sue and Sam (wasn't there a third person going? them, too) for both pressing for, taking part in, and representing us at, the meeting with Mark Hoban MP, Michael Meacher MP, together with The Chief Medical Officer and other Civil Servants. I'm glad that you were able to raise so many matters with them and to get some apparent agreement from Mr. Hoban – which he will have to be held to, firmly! I'm very glad to hear that Mr. Meacher pressed Mr. Hoban on a follow-up meeting; and hope that that will be adhered to, as well. And I hope that 'willing to listen to constructive and fully-worked out proposals' doesn't transmute into '...constructive and fully-costed...' by the time you get the minutes of the meeting. I agree with Jane (comments, above) that you'll need to press for the minutes to be sent as soon as possible.

    When you said, "seemed to agree", a vision popped into my head of Joanna Lumley dragging (drat, can't remember his name – the person she'd had the meeting with about settlement and pension rights for Gurkha ex-servicemen) out to an immediate press-conference after a meeting, saying, "You agreed, didn't you?...", fixing him with a gimlet, headmistress-y stare, and him having no option but to nod 'yes', helplessly. I rather hope that, if he did nod, that you and Sam got the headmistress-y gimlet stare in first :)

    Hope you're all not too knocked out after yesterday – and three-cheers to all involved in the planning of the agenda,

    xJ

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  16. Thank you all so much for the tremendous effort and energy you put into this. I wish you many extra Spoons to recover !

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  17. Thank you for your incredibly hard work, all of you. I really hope the Hoban and others really do take notice and act appropriately.

    Kate

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  18. well done sue I'm just glad i wasn't there as I'm sure i would have told him that he'd better watch out as the UN will be keeping tabs on him in future and all of who have died will come back to haunt him at some point

    the dead aren't being swept under the carpet that he can be assured of and he's needs to address your point very quickly if further deaths are to be prevented

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  19. There has been an alternative to the "work capability assessment" since 1916. Psychometric testing.
    It was used to assess wounded soldiers.
    It was used by government up until 1986 when Maggie Thatcher privatised it and it disappeared from use.
    Psychometric testing tests using both practical and mental tests the following.
    What, if any, work a person is capable of.
    IF they are capable of work, what work,and that is VERY specific.
    What, if any, training and/or education would be needed for them to do that work.
    What, if any workplace modification would be needed.
    I knew as soon as Professor Harrington a world expert on psychometric testing did not mention it as a more accurate alternative to the WCA he had been nobbled.
    He has also never had the courtesy to answer my communications with him about it.

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  20. Excellent work, thank you so much. I'm never optimistic about this issue, but it's good to know he actually had to listen to sense for once.

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  21. Well done Sue and all. Grabbing every opportunity to communicate is the right way to go about campaigning for change.

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  22. earlier there were around 57 comments and now 26.
    care to explain?

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  23. Well, if a comment is deleted on the site, it either says "This comment was removed by the moderator" (me) or "this comment was removed by the author"

    I can only assume you must have read a different post or misread the number

    Either way, I can't imagine many reasons I should have to explain myself on my own blog

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  24. Ha ha, you didn't ask if he wanted salt with his answer Sue! By the way, the 'Result of WCA consultations' post has 57 comments, think Uncle Honj must have been reading that, easy mistake to make i guess, lol.

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  25. I personally am not sure about this, we're less than two years away from an election and I don't trust the condems not to try to curry favour by hinting at a few concessions which they won't deliver, also, to use such meetings as PR to claim that they are successfully negotiating with disabled people. I'm not sure efforts wouldn't be better directed at winning assurances from Labour

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    1. You're right to worry.

      The history of all these welfare changes is that both political parties do exactly that. They invite representation from disabled groups and charities, and then use that to justify the changes to the public, claiming the support and input of such groups, while quietly ignoring any recommendations.

      Some charities/groups have withdrawn from the process for this reason.

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  26. Unity? What fucking unity? There is none. You have assumed you speak for all disabled people by claiming there is unity and that is a lie, not carers, carers weren't allowed near Hoban, only those that did nothing to reflect the real anger that is in the disabled community.

    Marsh I am stating here and now that there are at least as many people that don't want you representing them as the pathetic sycophants that follow you like dumb sheep.

    The meeting was a one-sided sham, it has no authority nor validity as people that oppose you and the Spartacus group were not represented. Carers being left out completely yet again?!!!!

    Unless people who disagree with you and Spartacus are involved you can go take a running jump, that was the polite version.

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    1. admin
      sue only had 45 minutes with mark so how was she able to get that view across ?

      she was unable to discuss all the many hundreds that have died so far in going through the welfare reform process

      this in itself would have taken months of talks to get through at least and will take years to get to form a legal process started by which time mark and IDS will have long retired

      sue did her best and spoke the best she could under the extreme circumstances she found herself in

      We all feel strongly about the carers but that will be for sue at a later date unless you yourself take it upon yourself to take this up with mark by yourself or by the carers Charity

      The bottom line is that the government don't care about the sick or disabled or any carers and how many deaths there have been and that has always been plain for everyone to see

      As i say sue has done her best to represent everyone and for the rest of her life will continue to so in a way that she feels best able to do so

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    2. You can choose to have a dialogue or you can choose to have a demonstration. Both are equally valid in the current circumstances.

      What you can't do is have a public squinny because someone does one or other.

      In this case, Sue Marsh and her colleagues chose dialogue and within that has come out some interesting points from the minister as to how their expectations of what the system should operate as works. This allows future challenges to be made where the rhetoric doesn't meet the reality.

      This was a different Mark Hoban to the smirking game-player in Parliament. One shouldn't forget that Parliament is as much a game as anything. Sadly.

      As a result, a space has opened up which can be explored and pushed further. This makes the meeting successful and valid. Authority is incurred as a result of the sides acknowledging each other.

      The arrogance that you display "Admin" is breathtaking to assume because you disagree with what occurred then it is invalid. That's far worse of an attitude than Mark Hoban's in my opinion.

      Apart from ranting on the internet, what exactly are you doing to help improve the lot of carers that you claim are being ignored? Or is that just your situation that is being ignored? In which case you need to ask for help perhaps?

      Your last point is somewhat paradoxical. Spartacus represented Spartacus in the meeting. A group of like-minded people. There's nothing to stop you developing a carers group, cultivate MPs and holding your own meetings with those in power. What you can't do is ask Spartacus to not be Spartacus.

      My impression of this post is that you would rather continue to play the victim.

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  27. Congratulations Sue, you are leading the way in Welfare activism and giving us all reasons to be hopeful in bleak times.

    I don't trust tory politicians like Hoban like many other commentators, but it is worth remembering what you have that he and his ilk don't: time, passion, knowledge and principles. He needs you to make it *too hard* for him to do the wrong thing, and easy enough to do the right thing. I think that is the essence of political activism.

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  28. I support the intentions behind this meeting, but I fear this may have been a trap.

    We know this government are sneaky and manipulative and we know they don't care. Hoban is a particularly snide and arrogant example. We also know how evasive they are from just how long it's taken to get 45 minutes with this character.

    I'm sure he was charming and friendly. I'm sure he appeared to listen, but I suspect that you may have unwittingly provided him with more ammunition to support the full range of their changes. That's not your fault - that's what these tory scumbags are like.

    For example, before he was shuffled Grayling made it clear he wanted GP's out of the equation completely. The tories don't want them writing notes at all and that ATOS should handle all parts of the process, not just the WCA.

    "Mr Hoban appeared to particularly agree on gathering medical evidence earlier in ALL claims."

    Consequetnly I think that is why Mr Hoban appeared to agree. I think you've unwittingly given them exactly what they want and it may well be, in the future, the best policy is solid and total resistance. If Hoban and company don't udnerstand that we hate all of this (and them) by now, a 45 minute meeting won't change anything.

    It's a sad fact of life and I do not wish to traduce the efforts of those that have participated in this, neither to do i want to upset anyone. I simply think that, given the nature of the tories and how vicious they are these days, they will twist what was said and see this meeting as evidence the disabled community are coming around.

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  29. One question I would like on the form is, Is their condition progressive? If the answer is yes and they are then found unfit to work, they should then be permanently remived from the cycle of testing.

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