The response we received from the Royal College of Occupational Therapists to this letter from an alliance of 112 disabled people, professionals, and groups, was not adequate. It is not OK for a professional body to be sponsored by – and advertising for – a company which makes money by taking it from disabled people. There is no way to work within the current assessment system without harming disabled people.
We should keep campaigning until the RCOT change, not least because this is a frightening precedent for other professional bodies in a climate where it is already difficult for many disabled people to get supporting letters from their healthcare professionals for benefits applications. To that end, below is a picture of RCOT’s response and a template reply detailing why it was not adequate. Please consider sending either this letter or your own version of it to the RCOT. Email it to Andrew Sharratt, head of media relations, at email@example.com and cc in firstname.lastname@example.org. You might have to click on the images to make them easily legible.
Dear Royal College of Occupational Therapists (RCOT),
I am writing regarding your recent response to concerns raised by Occupational Therapists and mental health service users and Personal Independent Payment (PIP) claimants about the acceptance of sponsorship from Capita and publication of their adverts in OT News.
A recent open letter signed by 112 members and service users resulted in a non-committal response from yourselves stating any “sponsorships are carefully considered… to ensure they do not conflict with our professional or ethical standards” and that you do not endorse the views of who or what you align yourselves with.
Firstly I would like to point out whether it was your intention or not to support and endorse Capita’s work and values is neither here nor there: One organisation being sponsored by another implies agreement and support for each others’ ways of working. A simple example would be that of a marathon runner with ‘Mind’ printed on their vest – the assumption from bystanders is that the athlete is running for Mind. Regarding Capita, it is the way RCOT’s actions are perceived rather than your intentions which matter. General members of the public will see RCOT being sponsored by Capita and assume a partnership. This link is damaging to the profession due to the reputation, priorities and values of Capita, all of which are starkly at odds with those of Occupational Therapy.
Occupational Therapy as a profession is relatively unknown, part of the professional body’s role should be raising the profile of Occupational Therapy whilst also representing the views of its members and working on behalf of the people your members serve – the service users. Indeed you call upon your members to work in a client centred way – “You [RCOT members] seek to act in the best interests of service users to ensure their optimum health, wellbeing and safety” (RCOT 2017, p9) I would hope a professional body would lead by example, also working in a client centred way. This is not only a requirement for Occupational Therapy but also a more general Health Care Professions Council (HCPC) standards for all health care workers. A standard I feel which is called into question by your current relationship with Capita.
Capita is one of several companies tasked by the DWP with carrying out assessments regarding eligibility for PIP – PIP having been introduced to replace Disability Living Allowance (DLA) and save money from the welfare budget. It is true, as you state in your response letter, they are part of the landscape. But that is not to say they should be accepted. When something is introduced into the landscape which runs counter to a profession’s standards and ethics, which limits ability to act in a client centred way, which threatens the health, wellbeing and safety of service users, the onus is on the professional body and its members to work to challenge the threat in order to uphold said professional standards and ethics by working for a better system and a fairer, more ethical landscape for service users. This is how, with Capita, RCOT stays true to its standards and ethics, – by challenging Capita. Not by advertising their company and accepting their sponsorship, which implies a level of welcoming them in to the landscape.
By acting as you have and accepting Capita into the landscape, you are, intentionally or not, promoting Capita – this is what advertising and sponsorship is – promoting. Promoting a company aiming to save the government money cannot be considered to be in the best interests of service users. Accepting into the landscape a company whose sole purpose is to meet government austerity targets by removing benefits from service users clearly contravenes professional standards and ethics – “… professional practice is concerned with developing, maximising and/or maintaining service users’ ability to engage in a range of occupations.” (RCOT 2017, p2) How can the professional body advocate working to maintain, let alone maximise or develop a service user’s ability to engage in occupation whilst promoting a company whose aim it is to remove the very benefit that facilitates this engagement? It is my position that you cannot.
Stated on your website is that you “… encourage our members to play an active role as ambassadors for the profession” – the Occupational Therapists among us would expect our professional body to also serve as an ambassador for the profession and argue that by aﬃliating the profession with Capita runs counter to this aim.
I would like to put it to you that it is not ethical to accept money from a company whose treatment of benefit claimants is so diabolical – 65% of appeals were found in favour of the claimant. PIP assessments have also been linked to an increase in suicidal ideation such is the stress of the assessment process and potentially triggering and traumatic questions during the assessment itself. The evidence for which can be found here – http://www.independent.co.uk/news/uk/politics/fit-to-work-wca-tests- mental-health-dwp-work-capability-assessment-benefits-esa-pip- a7623686.html This is totally at odds with the essence of Occupational Therapy being person centred, using occupations to enhance health and wellbeing and supporting people to do what they want/need to get done either by adapting task or environment to fit the person. Again, how can this be seen as not breaching professional standards and ethics?
It’s irksome that RCOT felt it acceptable to align the profession alongside a business that not only treats people so awfully, but whose priority is profits before people, this clearly fund counter to client centred practice and working in the best interests of service users.
A recent undercover investigation by Dispatches found assessors being told “… [do] as many assessments a day as you can possibly manage” with assessors admitting “completely dismissing” what they were told during assessment having completed the report before meeting the claimant. Again I refer to the College’s professional standards and ethics: “… must not engage in, or support, any behaviour that causes any unnecessary mental or physical distress.” (RCOT 2015, p16) Clearly by accepting Capita unchallenged into the landscape to some extent facilitates the abysmal treatment of service users and fails to “…preserve their individuality, self- respect, dignity, privacy, autonomy and integrity.” (RCOT 2015, p16)
How you, as a professional body, can do this without consulting your members is incomprehensible. How any member of RCOT can think it’s okay to make the decision to appear to endorse and align the profession with the values of Capita without breaching professional standards and ethics is both beyond me and actually quite concerning.
I therefore maintain that it is not only concerning but also unacceptable that RCOT arrived at the decision that to advertise and accept sponsorship from Capita did not breach the professions ethics and standards. This letter demonstrates how RCOT’s current relationship with Capita does indeed run counter to Occupational Therapy’s professional standards and ethics.
I therefore ask you again to consider your position in regards to Capita and strongly believe in order to uphold the profession’s reputation and adhere to standards and ethics as set by the college, that you divorce yourself of your current involvement and aﬃliation with Capita. I also request you oﬀer an explanation and justification of how you initially arrived at the decision that accepting Capita sponsorship and publishing their adverts was not felt to contravene occupational therapy’s professional standards and ethics.
Royal College of Occupational Therapy (RCOT) 2015 Code of Ethics and Professional Conduct. RCOT: London
Royal College of Occupational Therapy (RCOT) 2017 Professional Standards for Occupational Therapy Practice. RCOT: London