Are you fit to work?

How do you know if you're fit to go to work?

You would think, wouldn't you, that being able to get ready and out, get yourself to your place of work, work your shift and get home again would be just ever so slightly relevant, wouldn't you?

Most people's work shifts are at least 4 hours long, so given everything else, you need to have at least six hours' stamina in the tank, and much more if you do anything physical.

Everyone's situation will be variable and unique to them, and if they're very sick, they're likely to have a whole load of professionals around them who will know them and their capabilities well.

As a result of the changes brought in by the last Labour Government (and ever so slightly, but not enough, improved by the Coalition thanks to the influence of the Liberal Democrats), everyone on sickness and disability benefits is being put through an assessment process, sub-contracted out to a company called ATOS. I have never heard anyone have a good word to say about ATOS. Not once. A reputation like that takes some building.

I don't have an objection in principle to an assessment process, but I'd like it to be one that doesn't cause people unnecessary stress. I don't believe that we're anywhere near there yet. Bear in mind that seeing in stark black and white the extent of your health conditions and how they limit you is pretty painful in itself. Most of the time people try to push through the barriers of mental and physical disability and get on with as much as they possibly can. Having to fill in a form that seems full of traps and pitfalls and bears little relevance to the world of work just compounds the problems.

And this, dear readers, is the Bad Boy in question, the form most people have to complete. This is the form that someone behind a desk at ATOS uses to decide whether you are ill or not. I expect most of you looking at it will be reasonably fit and healthy. Imagine being confronted with this, with a time limit by which you have to complete it or you lose your benefit, when you're undergoing Cancer treatment, or dealing with Parkinsons, or coming to terms with the fact that you have MS, or depressed or stressed or anxious.

So what are the questions. Well, you have to say how your illness affects you on a day to day basis. If you're not used to organising your thoughts on paper, a big box to complete is quite scary.

Then you're asked about various physical and mental capabilities.

When I was ill for a long time with Glandular Fever, there was no way, at its worst, I could have got from my bed to the bathroom, let alone to work for a whole day. Yet if I completed this form, I'd feel like a fraud because I could have done virtually everything within it. On some days, I could walk 50 metres, although I would have struggled with 200. I could pick up a pound coin, turn the pages of a book, walk up my stairs most of the time if I'd been able to get down them. When I had the energy I could communicate with people, and most of the time I didn't upset them.

I could set my alarm clock (although my husband still can't work the Sky Plus, and he's reasonably healthy so I'm not sure what that proves), I could put the washing machine on no bother, although it could take me half a day to get the energy together to sort the clothes into loads.

So, any decision maker would see that I could do everything and would most likely tick the box that said "get your backside down the job centre, you scrounger". And I think there is that culture, that mentality, within the DWP. Everyone I know who has ever claimed benefits say that they are made to feel like a criminal when they do so. It's hardly surprising that so few have confidence in an assessment process that seems designed to have them marked as fit for work.

In reality, though, for a good while, I was as likely to be physically able to get to work as I was to fly to the moon and back before Elevenses. Even after I went back to work, there were days when I drove myself beyond my limits and, literally, collapsed in a heap. For months, I literally didn't have any life at all outside work and slump. If being ill and being isolated and stuck at home had been bad, that was worse.

But enough of me. Imagine someone with Angina who suffers intermittent heart attacks, who can't go to sleep  without being put on a special machine in case they stop breathing, who's confined to a wheelchair as a result of 20 years of ME, who has severe depression and anxiety, who's been in this situation for several decades, who requires 24 hour care. Can you just imagine how stressed out they must feel at the thought of filing in these forms? They'll have seen the news about the inefficiency of the system, how so many sick people are marked as fit for work. They'll be petrified about losing their benefits. And if they aren't, their family certainly will. I'm not making this scenario up, by the way. It's a real one happening to a friend of mine right now. She's given me permission to give the outline details on here. A properly functioning assessment process would clearly put her husband in the support group. A compassionate benefits system would give her far more support as a carer too but we won't go there at the moment.

There has to be a more respectful, dignified way of assessing people. The system introduced by Labour was appalling, relying in the first instance on the opinion of an ATOS employee. The Coalition's willingness to implement the recommendations of Professor Malcolm Harrington as he makes them is a step in the right direction, but they aren't there yet. An assessment process that takes no account of the realities of travelling to and completing a day's work with a fluctuating condition is in my view fundamentally flawed.

I know that Steve Webb and Jenny Willott have done lots of work on this and are pushing in the right direction, but we are not there yet. The assessment system is still making too many wrong decisions and people simply do not have confidence in it. The family I mentioned above are going through real torment at the thought that they might lose their benefits. I strongly suspect that they won't, but it surely can't be fair to put them through such anxiety in the meantime. A form that asked more relevant, realistic questions combined with a more helpful and positive culture within the Department of Work and Pensions and ATOS would help. When we see people like Sue Marsh, who's in and out of hospital the whole time, whose immune system is basically borked, for want of a better word, and who's in constant pain, having her ESA taken off her, you can do nothing else but question the fairness of the assessment system.

Sue writes on her "Diary of a Benefit Scrounger" blog about her daily struggle to keep going. This week she's faced the prospect of another admission to hospital. Read her account here.

Nick Clegg has done more than any other Government Minister I can remember to speak out about mental illness and provide real money to help people access the therapies they need to get better. This is so much better than people just being parked on benefits for years and left. What he's done will give people their lives back. That's such a valuable thing for him to have done. I have no doubt that we have stopped the Tories doing some even more horrendous stuff on welfare reform, but I can't accept or support either the one year time limit on contributory ESA or an assessment process that seems to have little relevance to the realities of work.