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Government’s independent reviewer did not know of coroner’s report blaming suicide on the WCA

10 November 2015

Ministers appear to have failed to hand a 2010 coroner’s report about the work capability assessment (WCA) that warned it put at risk the lives of people with mental health conditions – to the expert they commissioned to independently review the test

 An investigation by Disability News Service (DNS) (highlighted by ITN News at 10 last night) suggests that Work and Pensions Secretary Iain Duncan Smith and Employment Minister Chris Grayling neglected to pass on a legal letter written by a coroner in the wake of the suicide of a disabled man, Stephen Carre, in 2010.

The letter – written under Rule 43 of the Coroner’s Rules – said Stephen Carre’s death had been triggered by being found “fit for work”, and it called for a review of the policy not to seek further medical evidence from a GP or psychiatrist if a claimant has a mental health condition.

A coroner could only write a Rule 43 letter if they believed that the evidence they heard in an inquest “gives rise to a concern that circumstances creating a risk of other deaths will occur or will continue to exist in the future”.

Stephen Carre, who lived alone, had been found “fit for work” after an assessment by a doctor working for Atos Healthcare, with the final decision that he was not eligible for ESA  – again, with no effort made to consult his doctor, psychiatrist or community psychiatric nurse – made by a DWP Decision Maker.

Although he began the next stage of the appeal process, he took his own life sometime in the next few days. His body was found on 18 January 2010.

Professor Malcolm Harrington, who was appointed by the DWP to review the “fairness and effectiveness” of the WCA for the government in June 2010 believes he was not shown the coroner’s report:

“I cannot recall the report. Nobody brought it to my attention that I can remember. If I had known about that coroner’s report, I would have said that this was something else we need to look at. I am a doctor, I know about coroner’s reports. Coroner’s reports are something that you don’t ignore.”

The need to secure further medical evidence was a consistent concern during the three reviews Professor Harrington carried out.

He made it clear in his third – a recommendation that has still not been implemented by the government, three years later – that decision-makers should “actively” consider seeking further medical evidence.

Professor Harrington says that If he had been shown the coroner’s letter, it would almost certainly have led to him making recommendations far earlier about the need to seek further medical evidence.

It is unclear if the DWP’s own minimum mental health safeguards were followed in Stephen Carre’s case.

The DWP’s Safeguards that need to be in place before a mental health service user is found fit for work and has their benefit award terminated state:

“Where the claimant has a known background of mental illness there are minimum requirements that Jobcentre Plus should be adopting to ensure that we are not found to be neglectful in our duty of care towards these claimants. The minimum requirements are:

  • Where the claimant has been attending a Psychiatric Unit, a liaison officer should be appointed to maintain good communications between Jobcentre Plus and the Patients Affairs Officer.
  • Where it is known that the claimant has a social worker designated to them we should liaise closely with Social Services Department.
  • All cases, where there is a known history of mental illness, should be referred to a manager before a decision is made to withdraw benefit. The definition of a manager is Band C or above. “

For more information on the DWP’s safeguarding guidance see the CPAG Welfare Rights Bulletin article Safeguarding guidance: a tool for practitioners

For further information see the DNS news stories

WCA death scandal: Ministers ‘failed to pass 2010 suicide report to Harrington’

WCA death scandal: ‘DWP and Atos killed my son’

Government hides information on death of Michael O’Sullivan

See also the ITN News at 10 item Government welfare advisor did not know about 2010 suicide 'triggered by work assessment'