Scandal of council’s use of ‘irrational’ medical assessments

Our Town Hall reporter, KEN LEE, discovers how the council has been spending tens of thousands of pounds on discredited remote medical assessments to avoid providing housing for the homeless

Croydon’s Labour-run council has spent £53,165 in the past four years paying for medical assessments to decide whether homeless people and asylum-seekers are fit to live on the streets – without a doctor ever meeting the individuals being assessed.

NowMedical provides medical assessments of people that exclusively use paper records, with no face-to-face contact between the company’s doctors and those being assessed.

Croydon has been using NowMedical since 2015 to assess the housing needs of a total of 1,519 people, and has continued to use a system which has been described by a senior judge as “irrational”.

NowMedical has received a total of £2.2million in fees from the Home Office and local authorities around the country. Boroughs which have used the service include Croydon, Lambeth, Sutton, Southwark, Bromley and Bexley, according to research from the Bureau of Investigative Journalism shared with Inside Croydon.

But several NowMedical assessments have been overturned when challenged through the courts. In one instance in 2016, a judge rejected the Home Office’s decision to issue a removal notice on a woman left housebound by a stroke. NowMedical’s report deemed her disabilities “not insurmountable” and pronounced her fit to fly, recommending that she receive assistance on the flight.

Data obtained by the Bureau shows that Croydon spent more money on assessments from NowMedical than most of our neighbouring boroughs. In 2018-2019, the latest financial year for which figures are available, Croydon paid NowMedical £17,455 for 499 assessments.

Critic: Lord Leveson

Of London boroughs, only Southwark outspent Croydon in the last financial year, paying £50,910 for 2,175 assessments.

Criticism of NowMedical’s methods is not new.

In 2006, the widely respected judge Lord Justice Leveson said that the view of Ealing council had been “tainted” by their reliance on the work of NowMedical. Using a remote medical assessment, Ealing decided that a woman who was suffering post-traumatic stress disorder after being raped, tortured and imprisoned in Iran could be placed in the lowest housing priority band, categorising her as having “no recognised housing need”.

Leveson over-ruled the council’s decision, describing NowMedical’s assessment as “irrational” and “a conclusion that cannot be justified”.

More recently, in 2017 a suicidal homeless woman won her appeal after being refused housing support from Lambeth. The council relied on the assessment of NowMedical who declared the woman to not be “significantly more vulnerable than any other person”.

Yet the woman’s own GP had stated that she would “not cope with being homeless”.

The judge in that case, Judge Parfitt, was scathing in her condemnation of the council’s “fundamentally flawed” approach, commenting that “it might have helped” if someone from NowMedical had “taken the time to see the appellant or indeed considered her medical records”.

Human rights lawyers who have dealt with the kind of assessments produced by NowMedical for councils such as Croydon have described them as “pretty cursory… They are short, amounting to a page or two, they don’t go into massive detail”.

Nicholas Nicol, a barrister who has succeeded in challenging council decisions based on the work done by NowMedical, said, “In my opinion, they are delivering in the broadest terms, the advice that their customers want to hear.”

Figures from the homelessness charity Shelter for 2018 showed that 5,762 people were homeless in Croydon. Yet in Croydon’s review of 2018-2019, the council praised its own action on homelessness, stating, “the number of decisions the council had to make in response to households applying as homeless in 2017/18 was 1,336, the fewest in 11 years, a strong indication of the impact Croydon’s ‘Gateway & Welfare’ approach is having.”

The Labour councillor who usually likes to take credit for Croydon’s “Gateway and Welfare” services, and is the cabinet member responsible for housing is Alison “Lying Cow” Butler.

There is mounting and widespread criticism of an approach that includes using NowMedical’s cursory assessments to deny people access to housing.

Alison Butler: the Labour council’s cabinet member for housing

Yesterday, The Independent reported Dr Frank Arnold, of the Medact Migrant Solidarity Group, as saying, “We need a wider review into the misuse of medical evidence by the state for commercial and essentially political purposes. I’m talking about Home Office, councils, disability rights, and other disputed entitlements.

“To put it at its lowest, these cases raise questions which should be investigated by the appropriate clinical regulators – the General Medical Council for the doctors involved and the Care Quality Commission for NowMedical, the organisation employing them.”

And Nicol was scathing in his criticism of local councillors for allowing their Town Halls to continue using NowMedical’s services. “Council officers have had years to correct NowMedical’s practices,” Nicol said.

“As soon as councils start applying some pressure, I would hope that NowMedical would respond to their customers and change their practices. There’s currently no incentive for NowMedical to change their practices, and the people who employ them seem to be happy with the service they’re providing.”

Inside Croydon contacted Jo “We’re Not Stupid” Negrini, the council chief executive, to ask how Croydon can justify using the “irrational” services of NowMedical to assess housing need without actually examining the individuals concerned.

The CEO, who receives an annual salary of £220,000, failed to take the opportunity to justify the council’s conduct.

About insidecroydon

News, views and analysis about the people of Croydon, their lives and political times in the diverse and most-populated borough in London. Based in Croydon and edited by Steven Downes. To contact us, please email
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1 Response to Scandal of council’s use of ‘irrational’ medical assessments

  1. David Wickens says:

    This is the Council that for many years has discouraged the public from giving money etc to street people because they claim that none of them are homeless.

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