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Behind every “fit for work” decision lies fear, humiliation and loss. Inside the DWP’s assessment regime that punishes illness and calls it reform.
Introduction
Walk into a DWP assessment centre and you can feel it — the silence, the dread, the weight of what’s at stake. Every person there knows that a stranger behind a screen can decide whether they eat, heat their home, or lose everything.
These assessments are supposed to help the sick and disabled. Instead, they’ve become instruments of humiliation and fear — designed not to understand, but to deny.
The Industry of Assessment
In Britain today, sickness and disability are business opportunities.
The government contracts out “health assessments” to private companies — Atos, Capita and Maximus — paying them hundreds of millions of pounds to determine who is “fit for work.”
Each assessment lasts less than an hour. The result can decide your future for years. Medical evidence from doctors is often ignored. Assessors are under pressure to meet targets — though the DWP insists otherwise — and those targets favour rejection.
A Work and Pensions Committee inquiry found that 83 % of claimants felt their assessor didn’t understand their condition. 69 % said the process made their health worse.
“The assessor didn’t even look at me,” says E, 41, who lives with severe arthritis. “She kept typing. When I cried because I couldn’t move my hands, she told me to calm down.”
This is not healthcare. It’s performance management dressed up as compassion.
Fit for Work — or Fit for Profit?
The Work Capability Assessment (WCA) and Personal Independence Payment (PIP) tests were sold as ways to “help people back into work.” But when you look at the numbers, they’ve helped no one but shareholders.
Disability News Service has documented case after case of wrongful decisions later overturned on appeal — around 70 % are successful. That’s tens of thousands of people forced through months of hardship for no reason.
The cost of appeals runs into millions, all paid by taxpayers. Meanwhile, contractors keep their bonuses.
And the human cost? It’s uncountable.
“I waited nine months for my appeal,” says J, 58, who has chronic heart failure. “I lived off food parcels. When I finally won, they back-paid me. But nothing pays back the panic attacks or the nights I thought about ending it.”
How the Fear Works
Fear is the system’s lubricant.
Every claimant knows someone who’s lost everything after an assessment. Every brown envelope could be the one that says your support is ending.
That fear keeps people compliant. It stops them from complaining. It breaks them down quietly.
Even the terminology — “mandatory reconsideration,” “capability test,” “fit for work” — sounds neutral, bureaucratic. But behind each phrase is pain.
A 2019 study by the University of Liverpool linked the WCA process to suicide rate increases among claimants. The DWP denied responsibility.
“I was told to prove I was ill,” says N, 33, who lives with ME/CFS. “How do you prove exhaustion? I dragged myself to the centre, collapsed afterwards, and they wrote that I seemed ‘well-presented.’”
When people start dying because of administrative procedures, something has gone very wrong.
Paperwork Over People
Doctors, psychiatrists and social workers have repeatedly criticised how the DWP dismisses professional medical evidence. Assessors use “descriptors” — tick-box criteria that reduce complex illnesses to yes-or-no answers.
If you can raise your hand, you might be “fit.”
If you can smile, you might be “coping.”
If you arrived alone, you’re clearly “independent.”
The process encourages people to understate pain, because they’re ashamed of begging for recognition.
“I tried to look strong,” admits C, 47. “They said that meant I was fine.”
In no other part of medicine would this logic survive five minutes. But in DWP world, it’s gospel.
Mental Health on Trial
For claimants with mental-health conditions, assessments are especially traumatic.
The Royal College of Psychiatrists has warned that the DWP’s approach actively worsens depression and anxiety. People who disclose suicidal thoughts are often met with scripted responses.
“I told them I’d tried to kill myself last month,” says R, 26. “The assessor asked if I was planning to do it again ‘anytime soon.’ Then she ticked a box and moved on.”
The cruelty is casual. It’s procedural.
And when tragedy follows, it’s written off as an isolated incident.
Deaths the Department Can’t Hide
Despite repeated attempts to block disclosure, Freedom of Information requests and coroner’s reports reveal a grim pattern.
Between 2011 and 2023, internal DWP reviews recorded hundreds of claimant deaths linked to benefit decisions. Some were ruled suicides after “fit for work” assessments.
A BBC investigation found that the department routinely ignored its own “safeguarding” warnings. Officials were aware of risks but failed to act.
Every few years a minister stands at the despatch box, offering “thoughts and condolences.” Then the machine starts up again.
It’s hard not to see this as state negligence.
The Private-Sector Shield
Atos, Capita and Maximus insist they follow DWP rules. The DWP insists they follow government guidelines. The result is a perfect circle of unaccountability.
When claimants complain, they’re bounced between company hotlines and government desks until they give up. Even when an assessor is found to have lied — and many have — disciplinary action is rare.
This shield of bureaucracy means no one ever takes responsibility.
Meanwhile, Capita’s profits soared by millions last year.
Assessment Centres: Factories of Shame
The buildings themselves tell a story: bare walls, fluorescent lights, locked toilets. Some aren’t accessible at all — a bitter irony for disability assessments.
“The centre had stairs,” says P, 64, who uses a wheelchair. “They told me to come back another day.”
Inside, people sit in silence clutching folders of evidence. No one meets each other’s eyes. It’s like waiting for judgment, not justice.
When you treat citizens like criminals, you get fear, not fairness.
Appeals: Winning the Battle After Losing Everything
Roughly seven in ten appeals succeed, according to the Ministry of Justice. But by the time that happens, claimants may have lost their homes, health, or hope.
The DWP rarely apologises, even when tribunals rule it was wrong. Back payments arrive quietly, without acknowledgment of the months of misery.
Appeals don’t fix the harm — they just prove it existed.
A System That Creates Illness
Assessments are meant to measure capability, yet they actively damage people’s health.
A BMJ Open study found clear evidence that the reassessment process led to increased antidepressant prescribing and mental-health service use.
In other words, the policy designed to help sick people get better is making them sicker.
“I went in with anxiety,” says D, 39. “I came out with PTSD.”
No civilised country should be able to read that sentence and carry on as normal.
The Government Line
Each time these scandals hit the headlines, the Department for Work and Pensions issues the same statement:
“We take the welfare of claimants very seriously. Our assessors are fully trained, and we continuously improve the process.”
But words are cheap. Lives aren’t.
If improvement were real, we wouldn’t still be burying people whose only crime was being ill in Britain.
Reform Is Not Enough
The DWP doesn’t need tweaking; it needs rebuilding.
Real reform means:
- Independent assessments carried out by NHS professionals, not private firms.
- Mandatory use of medical evidence from the claimant’s GP or specialist.
- End to reassessments for degenerative or terminal conditions.
- A legal duty of care on the DWP for claimant wellbeing.
- Public transparency on deaths linked to benefit decisions.
Until that happens, the culture of fear will thrive.
A Personal Note
I write these stories because I’ve seen what this system does. The exhaustion. The shame. The quiet terror of another brown envelope.
The people who message me aren’t asking for luxury. They’re asking to survive.
When a state forces disabled people to relive their trauma for cash, it stops being a democracy and becomes an endurance test.
Britain can be better — but not while cruelty is government policy.
Conclusion: End the Fear
The DWP wants us scared and silent. But fear only works when we whisper.
We can speak, write, march, record. We can remember the names they’d rather we forget.
Because behind every statistic is someone’s mother, brother, friend — someone who deserved care, not contempt.
And one day, when accountability finally arrives, it won’t be the claimants who should be ashamed.
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Sources & Further Reading
- BBC – DWP benefit death investigations
- Disability News Service
- The Guardian – Assessment contract failures
- Royal College of Psychiatrists Statement on Assessments
- BMJ Open – Mental Health Impact of Reassessments
- Work and Pensions Committee Reports
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