PIP: The Disability Benefit Shake-Up Spotlight

Welfare reform has arrived here.

It's time to say goodbye to Disability Living Allowance,

and hello to PIP, the new Personal Independence Payment.

Good afternoon. You're through to the independent helpline.

More than 100,000 people are being reassessed

as they move across to the new benefit. Many are losing out.

We're seeing clients who had DLA for life being

reduced down to nothing.

The title is Personal Independence Payment,

and by taking away my car,

they were taking away my ability to have a little bit of independence.

But those behind the changes say the new benefit is working.

It is light years better than the old benefit.

We are getting more money to the right people.

And that is a good thing.

Capita is the private company managing the switchover.

But how transparent are their assessments?

And what if some are wrong?

I thought, no, this must be some kind of mistake.

There were a lot of inaccuracies.

Tonight, Spotlight can reveal growing concerns that,

on occasion, Capita have been changing or, as they call it,

auditing their assessments, before submitting them

to those deciding whether claimants should get the benefits or not.

What this says is that either their words were twisted

or some of the things in the assessment were fabricated.

Thousands of people are now challenging their decisions,

but who is challenging Capita?

Certainly, Capita should be called before the committee

for scrutiny in terms of the assessments that they provide.

This is Martin Murtagh.

He's 66 and lives in sheltered housing in north Belfast.

His family have been devastated by dementia.

Two of his sisters have already died due to the illness.

A third is in a nursing home.

It was so sad, and I usually break down when I talk about it.

I don't know how I haven't broken down. I can still see them.

I can still see them, as if they're sitting there.

I don't want to forget them.

In Martin's home, labels have been put up to help him to remember

to do things,

because now Martin has been diagnosed with dementia as well.

Martin's sons take it in turn to look after him, but after seeing

the rapid decline of their three aunts,

they are worried about what lies ahead.

Me and my three brothers, we all try and come down,

try and... We take turns staying or cooking or helping my father out.

I mean, it's all you can do, really, isn't it?

Be there for your family in their time of need.

I know it's going to get worse, but there's nothing I can do about it.

Under the old system, Martin was on lifetime DLA.

He has now been reassessed under the new system, PIP.

Personal Independence Payment is much harder to get than DLA,

because it places less importance on your diagnosis.

Instead, what counts is how well you can function on a day-to-day basis.

Martin comes along to this dementia support group once a week.

I'm Lil, and I have dementia.

I'm Martin, I have dementia.

Through submitting a freedom of information request,

Spotlight has discovered that more than 125,000 people

across Northern Ireland will have to be reassessed

to see if they are still eligible for benefits.

Campaigners think those with dementia shouldn't have to go

through the process of being reassessed,

but almost all of them will.

There's nobody around this table here trying to fool the system.

We have dementia. Dementia, at some stage, is going to kill us.

Most of this group are due to have their benefits reassessed,

but because they look physically healthy,

some are now frightened to leave the house.

Some of our members are now feeling that they're too scared to

go out over the door

because somebody might shop them in

for just going out and living their lives,

and it's an extra stress and it's an extra worry

to burden our members with.

I'll just move this round for you.

Martin is starting to go through the reassessment process.

His family has found the paperwork very difficult.

Some of the questions on it about the toilet,

about the shower, about the dressing, the cooking,

well, they must know if you've got dementia,

or any sort of illness that you're diagnosed with,

that you can't do these things.

As part of the process, an assessor came to his home.

He asked me, "Could you touch your toes?"

He said, "What about the toilet?"

Martin answered it - he takes me to the toilet. He showers me.

They do the bath and the cooking.

You being able to touch your nose or put your hands on your head or

whatever, touch your toes,

I mean, how is that relevant to having dementia?

Martin relied on the money from his DLA for essentials.

The money helps.

I'm able to get a taxi, go to the shops and be able to get...

I change a lot.

With me wearing pads, I soil a lot, and I need a lot of bedclothes.

I need a lot of clothes. I throw the stuff out.

With that money, I'm able to get the things.

I'm able to get the help I need.

How are you doing, Peter?

Hi, nice to see you again. How are you keeping?

Simon Matchett used to live life to the full,

but that changed when he felt something was wrong.

It started just with tingling, like, pins and needles,

and then it made its way up my arm.

My doctor wasn't too sure what it was.

Simon was diagnosed with multiple sclerosis. He was 32.

It was a shock to the system.

The lesions that you have on your brain and spinal cord,

they move around, so they can attack any nervous system in the body,

so you don't know when or where, or how bad the attack can be.

He had been holding down a full-time management job in Edinburgh,

but as the condition began to deteriorate,

he moved back home to a bungalow in Bangor, to be near his family.

Simon was getting higher rate DLA

and was able to get a Motability car to help him get around.

He was worried about PIP as he had heard stories from those with MS

in England who had lost their entire award.

I was extremely stressed, and that is not a good sort of state

to be in with MS, with it being a condition that affects your nerves.

As we know, PIP isn't paid just because someone has an illness.

What matters is how it affects their ability to do specific things.

DLA was an assessment of your total circumstances,

the difficulties that you have,

and there was a good deal more leeway in saying,

I've got difficulty with this, I've got difficulty with that.

PIP is different because it has 12 activities,

you are scored on what you can do with regard to those activities.

Do you have difficulty eating? Can you manage the toilet?

Can you dress?

So, you have a number of limited activities,

they look at your capacity to do these.

Supporters of the new PIP system say the cost of DLA was spiralling.

More than 200,000 people in Northern Ireland claimed it,

costing taxpayers more than £1 billion a year.

It was the Conservative government that introduced PIP.

Justin Tomlinson is a former Minister for Disabled People

and had responsibility for PIP.

To be absolutely clear, the stakeholders

and the charities do recognise that PIP is a better benefit than DLA.

Through the introduction of Personal Independence Payments, we are

getting more people accessing the higher rate of benefits.

It is a much, much better benefit.

It was never about cutting the money.

It was about recognising there is a much wider

spectrum of challenges that people face through their own

individual long-term health conditions or disabilities.

PIP was introduced in Northern Ireland in 2016 and, so far,

over 55,000 have applied for it.

Getting PIP is quite a complicated process.

Firstly, you'll receive a letter telling you that you're going

to be reassessed.

You'll be posted a copy of this form, which is called PIP 2.

It's 40 pages long

and asks you about how your disability affects your life.

Then most people will have a face-to-face assessment,

either at a centre like this or at their home, where the

PIP assessor will interview them.

If you're not happy with your decision, you can

ask for what is known as a mandatory reconsideration.

This is where you write a letter to the Department for Communities

asking them to look again at your case,

and you can provide further medical evidence.

Finally, if you still aren't happy, you can bring your case here for

appeal, where you'll face a panel of legal and disability experts.

Jyl Frey-Pullan suffers from muscular dystrophy,

an acute form of it.

She's the only person with this particular type in Northern Ireland.

She and her husband David settled here after

he began working as a test pilot for Shorts in the late '90s.

They volunteer at a Newtownards food bank,

itself on the frontline of dealing with the fallout of PIP.

We've seen an increase in people coming along to the food bank

specifically because they've maybe been on high rate

and it's been reduced to the low rate, so then they're trying

to manage on that, or it's literally been cut altogether.

So people are really having to come to the food bank

because their DLA has stopped?

Yes, definitely.

Jyl has also had her disability reassessed for PIP.

My legs are almost useless.

This type of muscular dystrophy...

..impacts on just about

every body system.

I'm just a carer for her,

so I can't really

go anywhere alone...

..without the thought, is she all right?

I have come back from being out and found her on the floor.

Jyl had been on higher rate DLA.

She qualified for a Motability car,

which was able to hold her electric wheelchair.

Capita, who won the £65 million contract to deliver

PIP in Northern Ireland, sent an assessor out to see Jyl.

She assumed she would transfer straight over to PIP

because of her condition.

My reaction was, she'll come in, she'll check me out,

and she'll see that I obviously can't do a lot of things for myself,

and I really didn't think there would be any difficulties at all.

But then a letter from the Department for Communities

brought a nasty surprise.

I was pretty optimistic that it would be OK,

but I prayed over it anyway,

and I opened it up and I could not believe what it said.

I was absolutely in shock.

And I thought, no, this must be some kind of mistake.

They're not talking about me.

And...

..realised, yes, they were talking about me,

and things that were written in the letter,

there were a lot of inaccuracies.

The assessor decided Jyl was able to walk a greater distance

than she says she can.

She was given eight points, which means she did not get enough to keep

her Motability car, which she'll have to return before Christmas.

The report also said she managed to get up off a chair unaided,

but the couple say that didn't happen.

There was nobody more surprised than us

when the first rejection letter came back,

saying, "We have awarded you the lower rate of PIP,

"but the higher rate is denied

"because we don't think you have any mobility issues."

At a mandatory reconsideration,

Jyl's request for a car was again turned down.

Like many others in the same situation,

she is now waiting for a date for her appeal.

Spotlight has obtained figures which show that more

than 12,000 people here have asked for a mandatory reconsideration.

But you shouldn't hold out much hope

if you think your decision will be overturned.

Spotlight has obtained a document which shows that

only around 20% of decisions

at mandatory reconsideration stage here are changed.

During a mandatory reconsideration,

the department is supposed to look at the case again,

but Owen McCloskey from the Law Centre says Capita are being

consulted during this process,

and there is potential for a serious conflict of interest.

They are asked by the decision-maker to consider

new evidence, which may suggest, medically, they are entitled,

and that's in conflict with their original report.

If they determine that the subsequent further evidence

shows that the client does have entitlement,

then that would effectively be saying their original report

wasn't reliable or didn't come to the correct conclusion.

We asked the Department for Communities to

appear on the programme, but they declined.

In a statement, they told us that

when a mandatory reconsideration is requested,

it's considered by a different decision-maker within

the department, but that they may ask Capita to assess

the impact of any new evidence on the company's original assessment.

But the main concern for claimants is that what

they say during their assessments is not always being

represented in the final report sent to the department.

A serious issue that we feel that we've identified is

the auditing of reports,

and potentially changes being made to the report

without clients being made aware of it.

It's only if claimants appeal against the decision that they

get a chance to see what Capita has told the department about them.

Simon is one of those who's not happy with what's been

written about him.

There were things, as I said, like that, that isn't accurate,

that didn't happen or, you know, I didn't actually say that.

And a lot of the times it could come down to, you know,

he said, she said, sort of thing.

They made a decision about how far you could walk based on...what?

Based on, basically, the corridor in the assessment centre,

which... I stopped several times, and I did not make a straight

walk down that corridor and a straight walk back up it.

So, at no point did they see me

convincingly walking 30 to 40 metres.

David is also unhappy.

He says what actually happened is not reflected in Jyl's assessment.

Jyl can't get up from a seated position.

They say they saw her do it.

Now, that's just blatant lying. That's almost perjury.

They say she refused to stand on one leg.

She was asked to and said, "I'm afraid I can't."

It just...

Oh, it's making me angry.

Even though Jyl is waiting for a date for her appeal hearing,

she hasn't been shown changes that may or may not have been made

to her original assessment by Capita.

It's a problem the Law Centre says applies to all cases.

We're looking for copies of each version of the report,

so before and after it has been edited,

and it may have been edited multiple times.

We're also looking for access to the actual audit document,

so where the auditor has assessed the report, they've identified

quality issues and they've made recommendations for change.

It's important that we see that actual document.

The president of the appeals tribunal has sent this letter

to Spotlight.

In it, he says that tribunal members have expressed

concern about the auditing practices.

He says he has been in regular contact with

the department about the issue.

And he added that if not all information is made

available at a tribunal, people can ask for the decision

to be set aside and reheard.

But after Spotlight put these points to the

Department for Communities, they told us that arrangements are now

in place to facilitate earlier versions of assessments being

made available, an arrangement not in place in the rest of the UK.

But what of Capita?

We asked them to take part in the programme, but they declined.

We sent them a series of questions about the people

featured in this programme and about their auditing process.

They said we didn't provide them with enough personal information

to allow them to comment on the individual cases.

They said they had a robust auditing process in place to ensure

a high quality of assessments, and said their staff

are healthcare professionals who are trained and empathetic.

They added, if anyone had a concern about the process,

they can contact Capita directly.

Another fundamental question in PIP is,

when is medical evidence considered, and who should provide it?

Like all claimants,

Simon was asked to give details of his health professionals

on his assessment form, and assumed Capita would contact these people.

It asks you for so much information.

All the information about the medical professionals who help you,

neurologist, doctor, MS nurse, occupational therapist,

to which I later found out they don't actually contact them.

Capita told us their official guidance says it's not always

necessary to ask for further medical evidence.

This is something that the BMA in Northern Ireland has noted.

There does seem to be instances where there is no initial

medical evidence sought,

and we would only hear whenever the patient goes for appeal.

That is the first time that medical evidence is asked for.

In the midst of this confusion, some claimants have themselves

been going to their GPs to ask for letters confirming their disability.

Doctors say this is extra work,

and some feel they have to pass the cost on to the patient.

Dr Stout charges just over £30.

Is it morally right that doctors could charge for this?

I think that is something that is very destructive to

a doctor-patient relationship.

We're ultimately here to treat patients and to try and keep them

as well as possible, and to be put in that sort of environment,

with that sort of transactional thing,

is very uncomfortable for everybody involved.

Raymond Crowe is one of the few people in Northern Ireland to

have completed his appeal.

Following an accident, Raymond suffered facial injuries

which left him with a speech impediment.

He was also left blind in one eye, deaf in one ear,

and had to have a number of his fingers amputated.

He also walks with the aid of a stick.

Raymond had lifetime DLA, and qualified for a Motability car

and a care component.

After being attacked and spat on on buses, he says the car

was his own safe space and give him the confidence to leave the house.

But that car gave you a little bit of confidence?

He also had to go through a face-to-face assessment.

Despite this, in Raymond's assessment,

it was noted that he could be understood

and that he spoke clearly.

It was also noted that he had a functional grip.

Like Jyl and Simon, Raymond did not score enough points to keep

the higher rate that he was previously on,

under DLA, so has had to give back his car.

More and more people are taking their case to appeal.

There, they can present additional medical evidence.

Tribunal reps say they have seen a huge increase in demand

for their services.

Since the start of September, it has been flat out,

sometimes doing two or three appeals per day.

The group say many of the clients they represent have

succeeded in having their assessment decision overturned at appeal.

No-one we speak to is happy with the assessments.

Usually what they say is that either their words were twisted or that

some of the things in the assessment were just fabricated, you know?

The Government don't agree with this interpretation,

and say that the reason appeals are successful is simply

because people provide more information.

Quite often, the claimant will think,

ah, I didn't raise that, or I didn't have that,

and they have an opportunity to go away and submit additional evidence,

therefore the decision that was taken before was

right on the information provided,

but once additional information was provided, a different outcome comes.

Shea Ross is representing Raymond at his appeal.

Raymond has very physical disabilities, you know?

Someone, who, if an assessor were to look at,

it's quite obvious there are things he can't do for himself.

Raymond's best friend Jimmy says he was taken aback

when he saw what was written in the report

and found out that Raymond had been given zero points.

Totally shocked, because when Raymond is out and about,

Raymond has always someone with him

because of his communication difficulties,

his grip difficulties,

he has got no grip on one of his hands. No grip at all.

Raymond's case was baffling,

to think that he had ever to go to a tribunal.

Raymond is still deeply affected by the assessment,

and feels the whole process has completely belittled his disability.

What would you say to them now?

What would you say to the assessors and people now?

HE SOBS

Hey...

Come on.

At appeal, the original decision was overturned,

and Raymond was awarded standard rate care.

But this still wasn't enough to get his car back.

Civil servant Paul Gray was commissioned by the Government

to examine how the new PIP system was working in the rest of the UK.

I've recommended that, actually, as a default,

one should move to assessments actually being recorded so that

if there is any dispute on either side, there is actually

a tape that can be listened to.

Any of our advisers can help you through that process...

The Stormont Executive knew PIP would be politically toxic

and wanted to try and limit the damage.

They pumped extra money into services like this benefits helpline

when PIP was introduced.

It's handling thousands of calls a month.

People on DLA who are being reassessed onto PIP

and are worried about that and worried about the process

and how to fill out the forms

and worried about the medical assessment,

they would ring this helpline

and we can explain the process and help them through the process.

There's also been money provided to recruit advisers to help

with the forms.

Because they are new forms, it's a new benefit,

people are seeking advice on that, so we have extra staff

through the Welfare Reform Project in each bureau to cope with that.

Aside from this help,

money has also been provided to support people financially

through the appeal process if they've lost their benefits,

something that is not available in the rest of the UK.

If you lose your DLA and don't transfer to PIP,

you will get the same amount of DLA paid up until your appeal process.

It's to support people and save them

falling off a cliff face if they do lose benefits.

Simon was one of those who was helped with the payments

while he appealed his decision but, in the meantime,

he had to return his Motability car.

I was devastated, and my father came up to the dealer's

and dropped me home.

I just felt that, when I got dropped home, that was me.

I was into isolation status, as such, you know?

The title is Personal Independence Payment, and by taking away my car,

they were taking away my ability to have a little bit of independence.

You know, that I can do things for myself

and not have to be dependent on others.

After Simon returned the car, his mental health began to suffer

and he was referred to a counsellor.

Thoughts had bounced into my mind.

It had put me to the point...

Even when I was diagnosed with multiple sclerosis,

I didn't have those kind of thoughts. I ended up just...

I didn't... I couldn't see a path, as such.

I didn't know what way life was going to turn out.

Capita reviewed Simon's case and stuck to their original decision.

The case was then reviewed internally

by the Department for Communities.

They awarded Simon the two extra points

he needed to be able to get another car.

He says he finally felt vindicated,

but feels he should never have lost it in the first place.

Anybody that I spoke to,

whether they be in the MS Society or family, friends,

any... Well, my own GP,

his own words were "utterly ridiculous"

that it was taken off me.

Martin, too, felt the whole process was stressful and unnecessary.

It put me into a terrible depression

and I actually felt suicidal with it, so I did.

I actually have the key for his medicine cabinet

so he can't get into his tablets.

It's how worried... It was that extreme at one point.

I could see the stress and anxiety it caused my father,

and the diagnosis itself, there is no cure, so I mean, why was it

even necessary for that fella to come out to assess my father?

I just thought it was a waste of time.

Martin was eventually awarded PIP,

but as there are no more lifetime awards, he has been told

he will have to be reassessed when he is 76, in ten years.

When carrying out the reviews for the Government, Paul Gray says

he found that the public had little faith in this new system.

What my conclusion in the second review was that public

trust and confidence was a long way short of what you need for people

to feel confident that the system is operating fairly and consistently,

and the sort of things that I was seeing and observing

were the high level of disputes around initial decisions,

and the very high upholding rates,

particularly for those cases that went to appeal.

Supporters of PIP insist they have designed a better benefit,

which is helping those most in need.

Is it hard for you hearing these horror stories of people who have

just had such negative experiences going through the system?

-We don't want anybody to have a negative experience...

-People do.

Oh, absolutely, but the reality is that there were horror stories

under DLA, and there were far more.

The PIP process is recognised to be much more thorough,

much more able to identify individual challenges.

It means we're spending £3 billion a year more,

so more money is going to some of the most vulnerable

people in society, but it's not a completed project.

With PIP still in its early stages in Northern Ireland, Paul Gray

thinks the project should be reviewed

before it gets much further.

Since my reviews didn't cover Northern Ireland, yes,

I think it would be a very good idea for somebody to take a look at that.

Spotlight has been told by the Information Commissioner that

they've received a number of complaints about Capita

and the department. We've obtained figures which show

that of those in Northern Ireland who have applied to

transfer from DLA to PIP, over 35% have had their benefits

disallowed on the basis of their initial assessment.

So far, just over 1,000 people have completed the full appeals process,

of whom well over one in three have been successful.

As PIP continues to roll out,

Universal Credit is the next big change on the horizon.

Over the next six months,

thousands will be affected by changes to their benefits,

and it may be that the problems with PIP prove to be just

the tip of the iceberg.