What’s What Councillor Watts? An open letter from Mental Health Resistance Network to Richard Watts

What's What Councillor Watts? An open letter from Mental Health Resistance Network to Richard Watts

Employment coaches have been placed in six GPs’ surgeries in Islington. ‘Jobs on prescription’ is part of toxic and dangerous government plans to merge health and employment services – putting the Jobcentre in the NHS. Boycott Workfare, Mental Health Resistance Network, and Disabled People Against Cuts will be protesting the scheme from 3pm on 4th March, outside City Road Medical Centre. For more details on the protest and our reasons for opposing the scheme, see the Facebook eventthis co-written article on the DPAC website and this letter from a GP about work cures and the duty to #DoNoHarm.

This guest post is an open letter from Mental Health Resistance Network to the leader of Islington council, Richard Watts.

Dear Councillor Watts

As you are aware by now, the Mental Health Resistance Network are involved in the organisation of a demonstration  due to take place outside the City Road Surgery in Islington on March 4th. The protest is intended to voice our disquiet at the introduction of  Job Coaches into six Islington surgeries, in a pilot project which has been enthustiastically promoted by yourself and Dr. Josephine Sauvage, a GP at City Road surgery, and Joint Vice Chair (clinical) of Islington CCG.

We first learnt about this pilot in an article in Pulse Magazine, and immediately suspected that that the DWP were likely to be central to this scheme. Our suspicions were confirmed when we found a document, authored by Kay Peat, the CCG Employment Lead for Islington CCG. The document makes it clear that Ms. Peat’s job is directly  funded by the DWP, and that the Working Better’ pilot which you and Dr. Sauvage were promoting is also directly funded by the DWP. Furthermore, Ms. Peat’s document confirms that Remploy, a company mainly owned and controlled by Maximus, have been engaged to provide the Job Coaches that Dr. Sauvage says she will be ‘prescribing’ to her patients.

Maximus, as I am sure you are aware, have taken over from ATOS, in conducting Work Capability Assessments for those claiming Employment Support Allowance. What you may not know is that we at the MHRN instigated a judicial review of the WCA which found that the procedure “disadvantages people with mental health problems, learning disabilities and autism”.

Almost two years later, the DWP has taken no significant action to bring that disadvantage to an end. In the interim, people with mental health issues in the ESA WRAG have also been subjected to an enormous number of sanctions. Researchers from Herriot Watts University have shown that the WCA continues to place those with Mental Health difficulties at “a substantial disadvantage. A document by your Assistant Chief Executive (Strategy and Partnerships) also confirms our suspicion that the Islington pilot is specifically aimed at people with Mental Health issues seeking medical treatment: “Mental ill-health is the major reason for people claiming ESA, so it is suggested that the focus is on this group”.

People with Mental Health issues already have a lower life expectancy of 15 to 20 years, and we are against any merging of health of job seeking services which would make it more difficult for them to access health care. We constantly talk to people who say that they need their Mental Health symptoms to be dealt with before they feel ready or able to start looking for work. Frankly, when you are suicidal or being abducted by aliens work is the last thing on your mind.

We were thus interested to read your recent statement that our “fears about the scheme were “misplaced” because it was “entirely voluntary and not linked, in any way, to any welfare-to-work conditionality or sanctions regime”. This was coupled with a claim by one of your council spokespersons that ” he had been told by Remploy that it was “a completely separate company and brand” to Maximus, and that “Maximus have absolutely no involvement in the Working Better project and none of the coaches are from Maximus”.

It didn’t take long for us to establish that on their own website Remploy state that “MAXIMUS brings commercial knowledge and expertise to the joint venture and will work with Remploy to build on its existing success”. Elsewhere on their site Remploy lists amongst its board members its chair,  Akbar Piloti, who  is the President and General Manager of MAXIMUS Human Services, overseeing worldwide Child Support Services, Child Care, Child Welfare, Workforce Services, and Tax Credit and Employer Services. Along with Mike Batty:

“With more than 20 years’ experience in financial operations, Mike became the Director of Finance for MAXIMUS UK in January 2015. Mike is responsible for leading the financial organisation across all four business streams in the UK”

And  Leslie Wolfe:

“Leslie is General Manager MAXIMUS UK and is responsible for all aspects of its business lines in the United Kingdom.  Prior to moving to the UK,  Leslie held key roles for MAXIMUS in Canada and the USA.”

So, as the Remploy website proudly notes on its front page, it works in partnership with Maximus. The statement by your spokesperson does not bear up to scrutiny, and neither, it would appear does your own claim that the DWP funded-, and Remploy/Maximus-run scheme is “not linked, in any way, to any welfare-to-work conditionality or sanctions regime”. As we have already noted, Mental Health claimants are placed at a substantial  disadvantage in the WCA process, administered by Maximus and the DWP, and those who score 15 points and are then placed in the WRAG group are at serious risk of being sanctioned by the very same DWP which is funding the pilot in your Labour Borough.

You have asked us to suspend our action and to meet with you to discuss the scheme in more detail. We are unlikely to do so. As Ms. Peat notes, “The pilot started in September 2015 and is due to finish in September 2016. No formal evaluation of the pilot is planned however it is being used as a pre-trial for the Supported Employment Trial”. This means that it is then likely to be rolled out in other areas, and we are intent on doing our utmost to persuade GPs not to get involved in the scheme.

Our concerns are numerous. We do not trust Maximus, nor do we trust the DWP, and we are concerned that people who are in need of treatment will be deterred from seeking help if they have cause to believe that doing so may result in them being ‘prescribed’ employment coaching instead of the treatment that they desperately need. Your Assistant Chief Executive also confirms our fears that Remploy/Maximus would gain direct access to our medical notes (at paragraph 4.3):

“enabling the employment coach to add updates directly onto the patient’s medical record (with work planned to assess whether this is happening in practice); and encouraging the coach to present the service to a practice meeting as the first step towards the integration of clinical treatment and employment support”

We are aware that to date the DWP welfare reforms (many of which were initiated when your party was in power) have led to many MH claimants having their benefits slashed, being sanctioned and a significant number of deaths. Very few long term MH claimants have actually moved into jobs, and  we long ago gave up on being swayed by the  rhetoric of welfare reform and austerity, we focus instead on what we see actually happening to ourselves and others.

We know that GPs such as Dr. Sauvage bear witness to the difficulties people facing MH difficulties face in securing actual appropriate treatment for the issues they struggle with, as patients are being discharged from secondary care back to primary care at an alarming rate, MH budgets are being slashed and at best most  patients can expect superfical interventions such as time limited referals for CBT or to the ‘Hubs’ being trialled in other Labour Boroughs such as Lambeth (where the Hub is based in the Streatham Job Centre) and Southwark (where the Hub is based in the so-called Employment Academy). We marched against the introduction of CBT inside Streatham Job Centre, and now we learn that as part of your Islington scheme, there are also plans for CBT to be provided in the DWP Job/Sanctions Centre. No doubt as a councillor you have come across people who experience thses difficulties in your own surgery.

Another of your claims is that “We know that employment is one of the best ways to tackle poverty”. Again this does not bear up well to scrutiny, with a marked increase in in-work poverty and the growing likelihood of Universal Credit  claimants facing sanctions if they cannot secure longer hours or higher wages. We have also seen a rapid increase in the use of zero hour contracts.

Until you are ready to start having real discussions about the real issues we are stuck with having to organise demonstrations in order to bring attention to the complicity of elected Labour officials such as yourself with the  “welfare-to-work conditionality or sanctions regime” that you so clearly are engaging in and promoting.

Let us know when you are ready to do more than verbally distance yourself from the very same ‘welfare-to-work conditionality or sanctions regime’ you have elected to partner with and promote.

In the meantime, we will see you across the barricades.

The Mental Health Resistance NetworkIslington GP protest facebook banner image


Campaigners from Disabled People Against Cuts, Mental Health Resistance Network and Boycott Workfare will meet outside City Road Medical Centre (190-196 City Road , London, EC1V 2QH) on Friday 4th March from 3pm.

See the Facebook Event Page for further details. If you can’ t get there on the day there will be an online protest – further details will be posted on this page nearer the time. Please also support the thunderclap for the protest.  


Comments (4)

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Cllr. Richard Watts


I have just been sent the link to this blog post and wanted to take this opportunity to clarify our position and again extend an invitation to meet with you to discuss your concerns over our ‘working better’ programme.

I want to start by again reiterating that ‘working better’ is an entirely voluntary scheme. This is a service that is available for patients to join voluntarily if they feel it would be beneficial, it is absolutely not forced on them. Once a patient starts seeing an employment coach there is no obligation that they have to continue and finish. They also do not have to be claiming any benefits to be part of the scheme and once again, it is in no way linked to benefits or sanctions.

I would also like to be very clear that none of the personal patient information from the scheme is, or ever will be shared with JCP or the DWP.

We initially piloted ‘working better’ as a result of the recommendations from the Council’s Employment Commission after listening extensively to disability groups locally.

During its research the Commission heard that disabled people or those who have a long-term health condition or are recovering from illness may need more support and some practical adjustments to enter the workplace.

It also heard how there are some groups, including disabled people that continue to face discrimination in their job search – many of whom just want to be given a chance to show what they can do.

The commission heard from Disability Action in Islington, who called for: making “current employment, apprenticeships and volunteering support services accessible and inclusive to disabled people”

The commission’s final report, called for establishing employment support services where people with extra needs already went – such as GP surgeries.

The scheme is not about work being a ‘cure’ or ‘fix’ for people’s impairments and health conditions. It’s about doing more to break down barriers and help make employment support services more accessible and inclusive to the disabled people who want to benefit from them.

While I do understand your concern over workfare and the sanctions regime – both of which I share, I do believe your opposition to ‘working better’ is misguided.

Islington council has a long and proud history of being on the side of our disabled and vulnerable residents. In 2013 we were the first council in the country to declare a vote of no confidence in ATOS because of their work capability assessments locally. We were the council who led the charge to save the Local Welfare Provision fund, which provides a vital safety net for some our most vulnerable residents. We have also just ring-fenced vital financial support for vulnerable disabled residents who were previously supported by the Independent Living Fund.

I would very much welcome the opportunity to meet with you and discuss this further.

You can contact me on

I look forward to hearing from you.

Cllr. Richard Watts

Tina Bate

Dear Cllr Watts
You are merely reiterating claims which have already been debunked and are completely invalidating the concerns of disabled people with regard to the need to keep health and welfare separate. While this may not be a concern to some disabled people's groups, or to individuals, to others it is crucial to their wellbeing and that is especially true for those of us who have been emotionally and psychologically damaged by linking the two spheres.
Particular vulnerability is experienced by those of us with mental health problems, and a lot of people who have been through the dehumanising processes as run by companies like Maximus are experiencing severe mental health issues, often for the first time.

If you cannot begin to understand disabled people's position on this issue, I believe you to be either politically naiive or willfully ignorant of the massive scale of operations involved here. This is not just a local issue, it is a national (if not international) one and one on which many disabled people would be very happy to educate you given the opportunity.

In any meeting that you do succeed in arranging, I would hope that your intention would be to listen, but it appears that you only wish to push forward your own agenda at the expense of a large number of very frightened and angry people.

Mental Health Resistance Network

Dear Cllr. Watts

As service users and survivors of the psychiatric system, we are accustomed to people in suits ignoring our real concerns, talking down to us and believing that they are acting in our best interest even when we are telling them differently. Sadly, your comment does little to persuade us that you are going to offer us a different trajectory.

It seems you are determined to ignore the problematic issues that your pilot scheme has created, and that you are somehow incapable of comprehending how horrendous it would be for someone to find a DWP funded Employment Coach from the Maximus 'family' in the surgery where they seek treatment for a condition that has been exacerbated by a perverse decision in the ESA or PIP sham assessment processes, or a benefits sanction which has removed their very means of survival and independence. Unfortunately such events are now everyday occurrences in your borough, and the areas to which your pilot is intended to spread. It seems we all have to somehow get used to these injustices because all the safeguards appear to have failed. Rather than providing effective opposition to these outrages, you and your pilot seem set on adding to the misery.

We told you that we would meet with you when you are ready to have an adult discussion with us. You are clearly nowhere near ready to do that. I suspect that rather than genuinely reaching out to us, your comment is merely public posturing in the hope that some people will be persuaded by your whitewash.

As we noted in the Open Letter, your Assistant Chief Executive confirmed that this scheme is specifically aimed at claimants with Mental Health issues. You attempt to play this down by telling us that claimants do not even need to be on benefits to participate in the scheme. This is clearly you dodging the issue, as your signature appears on a document which states:

"The Council has agreed an ambitious target to reduce the number of people claiming ESA by 2,660 by March 2019"

Page 17:

In an Islington Employment Commission document, the aim of targeting those on benefits is also made explicit:

"This will mean triaging and focusing the majority of our time, support and resources on those claiming Employment Support Allowance (ESA), Income Support and people who have been claiming Job Seekers’ Allowance or not claiming any benefits and who have not worked for a long time."

We simply do not believe that there are many people who are long term unemployed and not claiming benefits, although we are painfully aware that Tory welfare reforms have led to the disappearance of a large number of claimants.

We are not convinced or reassured by your claim that "none of the personal patient

information from the scheme is, or ever will be shared with JCP or the DWP" bearing in

mind that your own council has made it clear that Remploy/Maximus Job Coaches will "add updates directly onto the patient’s medical record". How do we know they will not pass on information? Unsurprisingly, we have no interest in being part of any scheme that gives corporations direct access to our personal medical records, and we find it shocking that your council and the CCG have adopted so cavalier an approach to patient privacy.

You single out Disability Action in Islington, and quote them as calling for making “current employment, apprenticeships and volunteering support services accessible and inclusive to disabled people”. Nothing in that quote suggests that this means they support the idea of
GPs being prompted by a computer screen to nudge their patients towards employment coaching by Remploy/Maximus staff in the surgery. In any case the word 'current' can hardly be used to describe a pilot which would not have been current at the time. Perhaps you should approach all the DPOs in the borough and ask them specifically if they are happy with a scheme that runs the risk of replacing health care and treatment with 'prescribed' job seeking aimed specifically at getting 2,660 people of ESA? In fact, we may well do that ourselves........

When the pilot was announced, you said that the aim of the scheme was to 'promote the idea of employment for people with health conditions ( Later, your Assistant Chief Executive stated: "Considerable attention has been paid to using this service as an opportunity to embed employment into the ‘wiring’ of the healthcare system" Promoting the idea of work appears to be a far stronger motive than making services more ‘accessible and inclusive’. It shows that the pilot is part of a policy agenda which sees the only relevant indicator of someone’s health and worth being whether they’re working or not.

We have come across another document which seems to be undated - and appears to be an attempt to defend the pilot from our criticisms -

That document, like your reply claims:

"The pilot is entirely voluntary. People can opt out at any point. Once begun there is
absolutely no obligation to continue."

You fail to tell us what steps have been taken to ensure that patients understand that the scheme is 'entirely voluntary' and that they do not have to take part in it. Many patients would feel compelled to do what their doctor suggested, for fear of being seen as a 'difficult patient' if they declined. Most patients would be unaware that the doctor was being prompted by
their computer via an Islington scheme to promote the pilot, and if made aware of that fact and the fact that they could say no without fear of being flagged as difficult patients , we suspect you would find take up to be very low , especially if they were also made aware that joining the scheme would give staff of the Remploy/Maximus group direct access to their patient records.

Here is a bit of history for you:

In July 2014, the Tories were already publicly discussing stripping claimants "of their state allowances if they refuse to undergo treatment for anxiety and depression". They announced plans for a trial which involved hiring "specialist private organisations outside the NHS and
welfare system to take control of providing a combination of psychological and employment support to claimants"

In May 2015 your party failed to win the general election and the Tories gained overall control of parliament.

Four months later your Borough, in partnership with the DWP, started a pilot which placed Remploy/Maximus staff in GP surgeries. Your trial did not even include provision to ensure that psychological support would be provided to those claimants who became part of the scheme.

So, even if it is true that participation in your scheme is voluntary at this time, and even if that is being made clear to patients, you are in no position to reassure us that when the pilot is rolled out further, without any formal evaluation having taken place, that conditionality will not be introduced at that stage.

You chose to ignore our points about in work poverty, and the fact that current working conditions in many jobs would be detrimental to many claimants with Mental Health issues. They still stand, and until they are addressed, your reassurances that Islington "has a long and proud history of being on the side of our disabled and vulnerable residents" in no way proves that this scheme is good for us, or that it will not undermine the GP/patient relationship, or that it will not lead to sanctions/workfare and conditionality for disabled people.

Your Labour council should be resisting the Tory attacks on claimants with Mental Health issues, and not mirroring their policies or assisting their implementation.

We will definitely be demonstrating against the pilot on March 4th and we will continue to fight it thereafter.

The Mental Health Resistance Network

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