Paul Litchfield CBE FRCP FFOM is a British physician who was Chief Medical Officer for BT Group plc from 2001 to 2018. He reviewed the Work Capability Assessment run by Atos for the Department for Work and Pensions in 2013 and 2014 and he is an advisor to the UK government on the relationship between mental ill-health, absence from work and the take up of out-of-work sickness benefits.
Litchfield studied clinical sciences at St Andrew's University in Scotland before moving to Manchester University for his undergraduate clinical training. He graduated with a degree in medicine in 1977. [1]
Litchfield joined the Royal Navy shortly after graduation. He served at sea and ashore for three years as a junior officer and then began training in his chosen field of occupational medicine based at the Institute of Naval Medicine in Gosport. [2] In 1982, he studied for a higher degree in occupational health at the London School of Hygiene & Tropical Medicine [ citation needed ]. When he was fully trained, he worked in a dockyard environment as the Medical Officer of Health. In 1994, Litchfield retired from the navy at the age of 40 in the rank of Surgeon Commander. [2]
On leaving the Forces, Litchfield worked for two years in a senior medical position in the Civil Service before moving to the private medical company BMI Healthcare, where he worked as Clinical Development Director until 2000.[ citation needed ]
In 2001, he was made Chief Medical Officer at BT. Litchfield is one of the architects of BT's Work Fit programme, which uses "multiple communication channels" to promote beneficial lifestyle changes, such as encouraging healthy eating and exercise to tackle the problem of obesity in sedentary office workers. [3]
For just under four months in 2006, BT ran a mental health promotion campaign called 'Positive Mentality' in which employees were given information on how to "stave off" mental illness by eating different types of food, exercising and learning to relax. Litchfield has claimed that the early years of his tenure at BT coincided with a 30% reduction in mental health sickness absence and an 80% reduction in the firm's rate of medical retirement on the grounds of chronic mental illness. [4]
Litchfield chaired the Faculty's ethical committee between 2007 and 2013. [5] He co-edited Ethics Guidance for Occupational Health Practice in 2012. [6]
In 2006, Litchfield was a member of the DWP's Mental Health Technical Working Group, which was set up to design a new mental health assessment for Incapacity Benefit claimants that would "identify accurately those who in spite of their condition are fit to continue in work". [7] This work shaped the criteria used to gauge mental function in the Work Capability Assessment (WCA) that was introduced in 2008.
In 2009, he co-wrote a report on mental health and the workplace for the DWP. It focussed on the beneficial aspects of work for some people with a mental health condition and it highlighted the large and growing proportion of people on out-of-work benefits whose primary diagnosis was some form of mental illness. [8]
In July 2010, he attended a seminar with the Minister for Welfare Reform and the Minister for Disabled People to discuss the department's strategy on mental health and welfare reform. [9]
In 2013, DWP ministers chose Litchfield [10] to review the performance of the WCA. [11] [12] The assessment was controversial [13] [14] because it was generating large numbers of fit-for-work findings that were subsequently disregarded by DWP decision-makers or overturned by independent tribunals. In the first year of Litchfield's tenure, all healthcare professionals previously approved to carry out the WCA – more than a thousand in total – had to be retrained yet the success rate at appeal rose to 52%. [15] In the second year, Atos, the outsourcing company responsible for the core assessment, disclosed to the Financial Times that it would be ending its contract with the DWP prematurely, citing the company's opinion that the WCA was "not working" as one of its reasons for leaving. [16]
In May 2014, Litchfield appeared before Parliament's Work and Pensions Select Committee to explain the problems with the WCA. [17] By the summer, more than 700,000 people were waiting an average of 9 months for their WCA, because of bottlenecks in the system caused by long assessments (lasting well over an hour) and a shortage of healthcare professionals willing to carry them out. [18] [19]
In 2015, the Conservative Secretary of State for Work and Pensions criticised the WCA, which was introduced when Gordon Brown was Prime Minister. He called the test "unbelievably harsh", said it contained "perverse incentives" for claimants and lamented the fact that doctors were offered only a "binary choice" when asked for their opinion on fitness for work. [20] Litchfield's professional opinion, as expressed to Parliament, was that the test was "by no means perfect" but nevertheless adequate.
Litchfield is Chair of the What Works Centre for Wellbeing – an independent organisation that promotes evidence-based policy to improve wellbeing. [21] [22]
He is a member of 'Fit for Work UK'. [23]
He was awarded the OBE in 2007. [24] In 2018 he was created a CBE for services to workplace wellbeing. [25]
The Department for Work and Pensions (DWP) is a United Kingdom government department of His Majesty's Government responsible for welfare, pensions and child maintenance policy. As the UK's biggest public service department it administers the State Pension and a range of working age, disability and ill health benefits to around 20 million claimants and customers. It is the second largest governmental department in terms of employees, and the largest in terms of expenditure (£187bn).
Jobseeker's Allowance (JSA) is an unemployment benefit paid by the Government of the United Kingdom to people who are unemployed and actively seeking work. It is part of the social security benefits system and is intended to cover living expenses while the claimant is out of work.
Atos is a European multinational information technology (IT) service and consulting company with headquarters in Bezons, France, and offices worldwide. It specialises in hi-tech transactional services, unified communications, cloud, big data and cybersecurity services. Atos operates worldwide under the brands Atos, Atos|Syntel, Atos Consulting, Atos Healthcare, Atos Worldgrid, Groupe Bull, Canopy, Maven Wave, and Unify.
Mark James Harper is a British politician who has served as Secretary of State for Transport since 2022. A member of the Conservative Party, he has been Member of Parliament (MP) for Forest of Dean in Gloucestershire since 2005.
Dame Carol Mary Black is a British physician, academic, specialising in rheumatology. She was President of the Royal College of Physicians from 2002 to 2006, advised the British Government on the relationship between work and health from 2006 to 2016, and was Principal of Newnham College, Cambridge from 2012 to 2019. She is an expert on the disease scleroderma.
Sir Cary Lynn Cooper, is an American-born British psychologist and 50th Anniversary Professor of Organizational Psychology and Health at the Manchester Business School, University of Manchester.
Employment and Support Allowance (ESA) is a United Kingdom welfare payment for adults younger than the State Pension age who are having difficulty finding work because of their long-term medical condition or a disability. It is a basic income-replacement benefit paid in lieu of wages. It is currently being phased out and replaced with Universal Credit for claimants on low incomes, although the contribution-based element remains available.
Incapacity Benefit was a British social security benefit that was paid to people facing extra barriers to work because of their long-term illness or their disability. It replaced Invalidity Benefit in 1995. The government began to phase out Incapacity Benefit in 2008 by making it unavailable to new claimants, and later moved almost all the remaining long-term recipients onto Employment and Support Allowance.
The Office for Nuclear Regulation (ONR) is the regulator for the nuclear industry in the United Kingdom. It is an independent statutory corporation whose costs are met by charging fees to the nuclear industry. The ONR reports to the Department for Work and Pensions, although it also worked closely with the now-defunct Department of Energy and Climate Change.
Vocational rehabilitation, also abbreviated VR or voc rehab, is a process which enables persons with functional, psychological, developmental, cognitive, and emotional disabilities, impairments or health disabilities to overcome barriers to accessing, maintaining, or returning to employment or other useful occupations.
Occupational health nursing is a specialty nursing practice that provides for and delivers health and safety programs and services to workers, worker populations, and community groups. The practice focuses on promotion, maintenance and restoration of health, prevention of illness and injury, and protection from work‐related and environmental hazards. Occupational health nurses (OHNs) aim to combine knowledge of health and business to balance safe and healthful work environments and a "healthy" bottom line.
Occupational safety and health (OSH) or occupational health and safety (OHS), also known simply as occupational health or occupational safety, is a multidisciplinary field concerned with the safety, health, and welfare of people at work. These terms also refer to the goals of this field, so their use in the sense of this article was originally an abbreviation of occupational safety and health program/department etc. OSH is related to the fields of occupational medicine and occupational hygiene.
Personal Independence Payment is a welfare benefit in the United Kingdom that is intended to help working age adults with the extra costs of living with a health condition or a disability.
The Work Capability Assessment (WCA) is used by the British Government's Department for Work and Pensions (DWP) to decide whether and to what extent welfare benefit claimants are capable of doing work or work-related activities. The outcome of the assessment also determines whether claimants are entitled to "new style" Employment and Support Allowance (ESA) and potentially additional elements of Universal Credit (UC).
Disabled People Against Cuts (DPAC) is an organisation based in the United Kingdom for disabled people and allies to campaign against the impact of government spending cuts on the lives of disabled people. Formed on 3 October 2010 DPAC promotes full human rights and equality for all disabled people, and operates from the Social Model of Disability.
Disability in the United Kingdom covers a wide range of conditions and experiences, deeply impacting the lives of millions of people. Defined by the Equality Act 2010 as a physical or mental impairment with a substantial and long-term adverse effect on a person's ability to carry out normal day-to-day activities, it encompasses various aspects of life, including demographics, legislation, healthcare, employment, and culture. Despite numerous advancements in policy and social attitudes, individuals with disabilities often encounter unique challenges and disparities.
The Faculty of Occupational Medicine (FOM) is the professional and educational body for occupational medicine in the United Kingdom. It seeks to ensure the highest standards in the practice of occupational medicine, overseeing the continuing professional development and revalidation of its members.
Neil Greenberg is an academic psychiatrist, who is a specialist in the understanding and management of psychological trauma, occupational mental ill-health and post traumatic stress disorder. Greenberg works with King's College London and served as the President of the UK Psychological Trauma Society from 2014 to 2017. He also runs the psychological health consultancy March on Stress. During the 2020 COVID pandemic, Greenberg was part of the NHS England and Improvement Wellbeing Team and contributed to the national response to protect the mental health of NHS workers.
Criticism of the Work Capability Assessment, used by the Department for Work and Pensions in the United Kingdom, to assess and reassess claimants of Employment and Support Allowance or enhanced rate Universal Credit, has been wide-ranging, from the procedure itself, to the financial cost of using both Atos and Maximus to assess claimants. Other criticisms discuss the level of deaths, suicides and high overturn rates at tribunals that the WCA has caused.
The Parliamentary Under-Secretary of State for Pensions is a junior position in the Department for Work and Pensions in the British government.