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England and Wales High Court (Administrative Court) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> MM & Anor, R (on the application of) v Secretary of State for Work and Pensions [2012] EWHC 2106 (Admin) (26 July 2012) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2012/2106.html Cite as: [2012] EWHC 2106 (Admin) |
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QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT
Strand, London, WC2A 2LL |
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B e f o r e :
____________________
THE QUEEN on the application of (1) MM (2) DM |
Claimants |
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- and - |
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THE SECRETARY OF STATE FOR WORK AND PENSIONS |
Defendant |
____________________
Mr Martin Chamberlain (instructed by Legal Department for the Department of Work and Pensions) for the Defendant
Hearing dates: 29 June 2012
____________________
Crown Copyright ©
Mr Justice Edwards-Stuart:
Introduction
The procedure for claiming ESA
The legal framework
"6 Disability
(1) A person (P) has a disability if—
(a) P has a physical or mental impairment, and
(b) the impairment has a substantial and long-term adverse effect on P's ability to carry out normal day-to-day activities.
(2) A reference to a disabled person is a reference to a person who has a disability.
. . .
20 Duty to make adjustments
(1) Where this Act imposes a duty to make reasonable adjustments on a person, this section, sections 21 and 22 and the applicable Schedule apply; and for those purposes, a person on whom the duty is imposed is referred to as A.
(2) The duty comprises the following three requirements.
(3) The first requirement is a requirement, where a provision, criterion or practice of A's puts a disabled person at a substantial disadvantage in relation to a relevant matter in comparison with persons who are not disabled, to take such steps as it is reasonable to have to take to avoid the disadvantage.
. . .
21 Failure to comply with duty
(1) A failure to comply with the first, second or third requirement is a failure to comply with a duty to make reasonable adjustments.
(2) A discriminates against a disabled person if A fails to comply with that duty in relation to that person.
(3) A provision of an applicable Schedule which imposes a duty to comply with the first, second or third requirement applies only for the purpose of establishing whether A has contravened this Act by virtue of subsection (2); a failure to comply is, accordingly, not actionable by virtue of another provision of this Act or otherwise.
. . .
29 Provision of services, etc.
. . .
(7) A duty to make reasonable adjustments applies to—
(a) a service-provider (and see also section 55(7));
(b) a person who exercises a public function that is not the provision of a service to the public or a section of the public.
. . .
31 Interpretation and exceptions
(1) This section applies for the purposes of this Part.
. . .
(3) A reference to the provision of a service includes a reference to the provision of a service in the exercise of a public function.
(4) A public function is a function that is a function of a public nature for the purposes of the Human Rights Act 1998.
. . .
(9) Schedule 2 (reasonable adjustments) has effect."
Preliminary
1 This Schedule applies where a duty to make reasonable adjustments is imposed on A by this Part.
The duty
2 (1) A must comply with the first, second and third requirements.
(2) For the purposes of this paragraph, the reference in section 20(3), (4) or (5) to a disabled person is to disabled persons generally."
"Information required for determining capability for work
(1) Subject to paragraphs (2) and (3), the information or evidence required to determine whether a claimant has limited capability for work is—
(a) evidence of limited capability for work in accordance with the Medical Evidence Regulations (which prescribe the form of doctor's statement or other evidence required in each case);
(b) any information relating to a claimant's capability to perform the activities referred to in Schedule 2 as may be requested in the form of a questionnaire; and
(c) any such additional information as may be requested.
(2) Where the Secretary of State is satisfied that there is sufficient information to determine whether a claimant has limited capability for work without the information specified in paragraph (1)(b), that information will not be required for the purposes of making the determination."
"113 Proceedings
(1) Proceedings relating to a contravention of this Act must be brought in accordance with this Part.
. . .
(3) Subsection (1) does not prevent-
(a) a claim for judicial review;
. . .
The essential issue
The development of the assessment process
"The review further recommends that Decision Makers are able to seek appropriate chosen healthcare professional advice to provide a view on the accuracy of the report if required.
26. The Decision Maker is able to use additional medical evidence to help to assess a customer's eligibility for ESA, but in practice this doesn't appear to be taking place. Decision Makers should be better trained in interpreting medical evidence and in giving appropriate weight to the evidence provided.
27. In summary, the Decision Maker has a pivotal role in evidence gathering. They should ask the claimant to name a chosen HCP and seek a report from them (for some claimants, the Decision Maker may have to undertake that task). When the Decision Maker has received the Atos report, including a personalised, free text summary (see chapter 5), they will offer to send it to the claimant's chosen HCP. When a report has been received, the Decision Maker reviews all the evidence and commissioned reports, including the ESA 50 questionnaire with free text paragraph (see Chapter 4). Following liaison with the claimant and, if necessary, Atos and the claimant's HCP adviser, the Decision Maker makes a decision."
[Original emphasis]
"Response: Accept
Rationale: Decision Makers should seek appropriate advice and/or additional evidence in coming to their determination if they require. Different approaches, e.g., with Atos healthcare professionals providing advice and support in interpreting evidence on site through case consultations or "surgeries" and or workshops/training events, are currently being trialled."
The submissions of the parties
(1) He submitted that a duty to make reasonable adjustments is actionable only insofar as it constitutes discrimination against an individual claimant contrary to s 21(2) of the Act: see s. 21(3). It is not open to these claimants to seek relief on behalf of those suffering from mental health problems generally.(2) But, in any event, there is no evidence that the current assessment system places persons with mental health problems at a substantial disadvantage when compared with persons who do not have mental health problems.
(3) The current assessment system already caters for the needs of people with mental health problems.
(4) The Government has accepted all the recommendations made by Professor Harrington in his first report and Professor Harrington has himself confirmed in his second report that all those recommendations had been, or were being, implemented.
The issues of fact and the extent to which the recommendations of Professor Harrington have been implemented (the first limb)
"If you have any medical reports from your doctor, consultant or health care professional, or any other information you wish us to see, please send them with this questionnaire."
On the final page of the form, the following words appear:
"Tick this box if you are including any medical reports."
"If the mental health flag has been set when the Q referral was made, the MSRS system will automatically identify any mental health cases and the cases will be referred to a Health Care Professional (HCP) and the WCA referral action will continue within Medical Services."
It is to be noted that this paragraph immediately follows the rubric "ESA 50 not returned - Mental Health Flag Set". Therefore it is not dealing with the situation that arises upon receipt of a claim. There are then further provisions in the document giving guidance on how to proceed in cases where the mental health flag has been set. For the purposes of this judgment, it is not necessary to look at them. The point that Mr Chamberlain was inviting me to take from this document was that it provides an example of one of the ways in which the system has been adjusted to cater for those with mental health problems.
"Where, in the scrutinising practitioner's judgment, there is a clear possibility that an examination may be avoided they should make reasonable attempts to seek further evidence. FME should not be requested simply to confirm that an examination is required or to obtain further information to assist the examining HCP."
And
"Where there is evidence of a previous suicide attempt, suicidal ideation or self harm expressed in the ESA50/50A, the HCP must request FME."
"Each case must be considered on its individual merits. However, in deciding the appropriate course of action, you may wish to consider the following points:
. . .
? Where a claimant is likely to be so distressed by being called for an examination or have such a high level of disability that an examination will only be considered when all evidence gathering has failed, the case should be reviewed further. In particular consider those claimants with major mental health conditions such as psychotic illnesses and claimants who, for example, are oxygen dependent, or quadriplegic etc."
"4. I am pleased to say that all the year one recommendations have been, or are being, implemented. The Department for Work and Pensions (DWP) moved swiftly to make the recommendations Departmental policy and DWP Operations and Atos Healthcare have enacted these policy changes."
Mr Chamberlain submitted that there was nothing in Professor Harrington's first report that said that further medical evidence should be asked for at the outset in all cases of those with mental health problems. As I have already indicated, this is a point which remains unclear and which I consider is not appropriate for determination on a permission application.
"The claim form should be amended to make clear that medical evidence may be supplied with the claim, the purpose for which such evidence may be used, and why it may be beneficial."
The threshold issue: is judicial review the appropriate remedy?
"Which of two available remedies, or perhaps more accurately, avenues of redress, is to be preferred will depend ultimately upon which it is more convenient, expeditious and effective. Where ministers have default powers, application to them will generally be the better remedy, particularly where, as so often, the central complaint is in reality about the substantive merits of the decision . . . Where, on the other hand, as here, what is required is the authoritative resolution of a legal issue, issue no 1, then, in common with Dillon LJ, I would regard judicial review as the more convenient alternative remedy."
(1) The First Claimant was diagnosed with multiple sclerosis in his mid thirties. He was then a Research Manager for the World Future Council, an international NGO. This has impacted on his mental health. He has been diagnosed as suffering from "severe anxiety/depression", with suicidal ideation, and prescribed mirtazapine, an antidepressant. Much to his surprise the result of his assessment in early 2011 was that he was awarded no points. He then obtained further medical evidence, together with evidence from his girlfriend, and was then able to persuade the First-tier Tribunal that he was incapable of work by reason of his mental health problems. Ms Lieven submits that this was, to all intents and purposes, a finding that his mental health issues had a substantial effect on his ability to carry out day to day activities (to an extent making him incapable of work). She submits that there is nothing to suggest that he has subsequently improved, and will therefore not face further problems as a result of his mental health problems in any review of his entitlement to ESA. In his witness statement he said:"If expert evidence had been sought by the DWP in my case at an early stage, a great amount of distress and physical and mental setbacks could have been avoided. I understand that it is likely that I will have to go through this process again when my case is reviewed. If new procedures are not introduced so that medical evidence is both sought and considered by the DWP at the beginning of a case like mine, I fear further damage will be done to my health."(2) The Second Claimant says that she has been unable to work since 1992 and was diagnosed with schizoaffective disorder in 1997 or 1998, and has been accepted as incapable of work for the purposes of claiming IB since the mid 1990s. She is under the care of her local Community Mental Health Team who have expressed the view that "the nature of her illness means that she can have great difficulty in social and stressful situations". She says that her last experience of the IB assessment process, in 1995, was traumatic. She is concerned at the prospect of being called for an assessment when she is due for migration to ESA.
Transfer to the Upper Tribunal