a first-hand account published by the British Medical Journal. He suggested that the DWP's alleged actions might have been at least partly driven by pressure to "reduce government debt". The DWP's senior doctors made no reply but the clinical director of Atos did respond. In relation to the claim that some Atos assessors had been led to interpret the test's criteria too harshly, she did not deny that the "bogus rules of thumb" had been used in training talks but she said that assessors were expected to follow the written guidance contained in the 255-page instruction manual issued to all assessors: The foreword to the WCA Handbook states: Lack of appropriateness for Incapacity Benefit reassessment The reassessment programme was dogged by problems: handling of the contract was criticised by the National Audit Office and by the Public Accounts Committee, which described the DWP's project management style as "complacent"; the overhaul of the WCA by medically-qualified civil servants produced what seemed to be a more stringent version of the test, but outside experts warned it was flawed; thousands of appeals were launched each month, swamping the tribunals service and leading to long delays; in 2013, accusations of bias, questions about quality and a contractual dispute caused the process to stall; and the DWP's attempts to restart the reassessment programme in 2015 were hampered by a shortage of healthcare professionals willing and able to carry out the test. During the reassessment programme, more than 50,000 vulnerable people successfully appealed to independent tribunals after wrongly being declared fit for work. The number of people choosing to appeal fell dramatically in 2013, although the summer of that year saw a cluster of well-documented deaths of people who had recently had their benefits cut after being declared fit for work. At inquests, coroners have raised concerns about information-gathering prior to face-to-face assessments, and there is epidemiological evidence to indicate that the 'roll out' of the WCA has been associated with hundreds of deaths. An independent review undertaken by occupational heath expert Professor Malcolm Harrington, a small team from the DWP, along with an Independent Scrutiny Group that included the National Clinical Adviser to the Care Quality Commission and the chief executive of the mental health charity MIND, gave a negative report of the WCA's usability, with The Guardian summarising Professor Harrington's opinion as being that the test was "impersonal", it "lacked empathy" and it was