There are new regulations for Employment Support Allowance about to come into force on the 28th of January. These regulations were proposed only six weeks before they will come into force, leaving very little time for the impact to be considered.
Worse, these regulations make drastic changes to the assumptions made during the assessment that will result in even more people being refused sickness benefits or told to take part in work-related activity.
The two big changes are:
An assessor can consider what mobility aids, equipment, medical treatments or medicines might help the claimant return to work, and then, without consulting them as to whether the change is suitable, they can judge them fit for work or for work related activity based on them making that change. This completely ignores things like side-effects of medication, suitability of adaptions and mobility aids, or even if such help is available to the individual. This could already happen to some extent, such as with wheelchairs, but will now apply to a far wider range of changes. This also raises the huge problem of medical treatment without consent, since refusing to take a drug that could help a person return to work, even for very good reasons, could lead to benefits being withdrawn.
The second huge change is to how the the assessment considers the relationship between mental and physical health conditions. Where previously any disability or restriction could be applied to any activity, whether it was caused by mental problems or physical problems. These new regulations will strictly separate the two such that one set of questions considers purely physical restrictions, and another set purely mental restrictions. You may be completely unable to perform a task due to mental illness, but be considered able to physically and therefore able to full stop. This equally applies to side effects of medicines. For medicines that treat mental health conditions, only the impact of side effects ON mental health will be considered. Crippling physical side effects caused by treatment for mental health will be completely ignored when deciding that a person can work.
These changes will pull the rug from under the feet (or wheels) of hundreds of thousands more people who are struggling to live, never mind to earn a wage. Make no mistake; whatever the intention of these changes, this is a cut in support.
Please write to your MP urgently to oppose these new regulations. You can find and contact your email through Write to Them. My own communication with my MP will be available on this blog later today.
Please share this and other blogs about this subject on Twitter with the hashtag #esaSOS as well as on Facebook and anywhere else you think suitable. A tweet of your own will have far more impact than a retweet.
Please also add your signature to the War On Welfare petition to call for a cumulative impact assessment of this government’s welfare reforms.
We undertook concerted, intensive fieldwork in very deprived neighbourhoods of Glasgow and Middlesbrough but we were unable to locate any families with three generations who had never worked.
If we cannot find a ‘culture of worklessness’ here, amongst these extreme cases of very long-term unemployed families, we are unlikely to find it anywhere.
Even worse, the adverts lead to a statement at the Conservative web site which tries to present benefit rises with inflation as unfair by pointing out that wages have not risen as much. Two questions are asked:
Should benefits increase more than wages?
Do you think it’s fair that people can claim more in benefits that the average family earns through going to work?
There is a text box to enter your own comments but it is limited to 300 characters which makes it very difficult to say much at all. Here is what I wrote:
I object; your questions are loaded. Benefits must rise in line with with the cost of living but wages must rise dramatically to stop exploiting workers. Austerity is an ideological choice and is destroying our country. Stop pitting poor against poorer in the hope that we won’t notice your crimes.
In my opinion this campaign is a disgusting attack on the poorest people in our society and it is aimed at pitting poor people against poorer people by vilifying unemployed people and presenting a false dichotomy that we can only help one group. It tries to incite resentment among people who are not paid enough against people who receive even less. This campaign is furthering that favourite Tory lie of deserving and undeserving poor. It is utterly disgusting.
Yesterday the government released the final regulations for Personal Independence Payments. I haven’t absorbed enough detail to do a full blog post on this yet but these are some useful links related to it.
Owen Jones confronted Iain Duncan Smith with the names of two people who have died as a result of the work capability assessment. He did not react well. I urge you to watch this video of the last part of Question Time, particularly the last minute if you want to see what IDS is really like.
“Hang on a second, we’ve heard a lot from you. Let me tell you something. I didn’t hear you screaming about two and a half million people who are parked, nobody saw them for over ten years, not working, with no hope, no aspiration, we are changing their lives, I am proud of doing that, getting them off benefit is what we are going to do.”
Iain Duncan Smith is proud of getting people off benefits. Never mind that there is no work for them to go to even if they can, and that the way lives are being changed is by sending people further into poverty and homelessness. Not only that, but he thinks that being “parked on benefits” and left alone is a bad thing. Well those of us on permanent sickness and disability benefits do have hopes and aspirations. We hope to not have too much pain today and we aspire to getting the care that we need so that we can undertake something entertaining that isn’t lying in bed waiting to die. We probably don’t aspire to being a rich Tory, which is probably similar to being dead in the head of Iain Duncan Smith. As for nobody seeing sick people, now they are being reassessed so frequently that they are committing suicide. Winning an appeal at tribunal often leads to an immediate call to another assessment.
The WCA continues to be portrayed in an extremely negative light, often fuelled by adverse media coverage, representative groups and political points scoring. Whilst the Review continues to hear examples of individuals who have been poorly treated by the WCA process, DWP can be reasonably pleased with what they have achieved. Some recognition of the considerable work to date would give a more balanced picture and DWP needs to be more proactive in communicating this. [Emphasis mine.]
I don’t know what world Harrington inhabits but that “adverse media coverage” was brought about by relentless campaigning from those who are directly affected in horrendous ways – “representative groups” and the only “political points scoring” we’ve made has been nearly universally against all three main parties. We have had a very hard time getting people within those parties to see the problem at all. Calling for the DWP to get better PR is not the solution.
Right in the foreward I was struck by his comments about tribunal judges.
Recommendations on the training of professionals in DWP Operations, Atos Healthcare and the Tribunals have produced some limited progress. In particular, it is regrettable that the First-tier Tribunal has effectively distanced itself from the rest of the WCA. Feedback from the Judges to the Decision Makers has, at last, started in a rudimentary way. However, much, much more is needed if we are to see a real dialogue between the Judges and the Decision Makers. This must happen on cases where there is a difference of opinion on what category is appropriate for that case based on the same set of evidence. For the First-tier Tribunal to suggest that the WCA Independent Review has no remit to consider the appeal stage of the process is illogical and untenable in my view. [Emphasis mine.]
Harrington is calling for feedback from tribunal judges to the Atos assessors and the DWP decision makers over why they reached different decisions to those made by the DWP. However the comments that Robert Devereux DWP private secretary made before the Public Accounts Committee on the 19th appear to be directly quoting the paragraph above out of context and instead criticised the tribunal judges for reaching a different decision. His thought appears to be that if looking at the same evidence then the decision should also be the same, without considering that the original decision makers might have been wrong. What Devereux and Harrington both seem to have missed is that Atos and the DWP have often failed to look at the evidence at all and the face-to-face assessment is not likely to find anything that strays from the Lima computer system’s checklist. There have been many cases where Atos and DWP staff have refused to look at evidence from healthcare professionals or refused to wait for evidence, and many more cases where evidence has been lost in the system somewhere between health care professional and decision maker.
One of Harrington’s conclusions stood out to me:
The Work Capability Assessment (WCA) remains a valid concept for assessing benefit claimants’ eligibility for Employment and Support Allowance (ESA). Whilst the WCA continues to garner considerable – and sometimes, but not always, justifiable – criticism the Independent Reviewer has not seen or heard any compelling arguments or evidence that the whole system should be scrapped. Instead it needs to be made fairer and more effective by improving both the process and the technical descriptors used to assess eligibility.
I know a lot of people would disagree with that, but I think this is a lost battle and the public will continue to support assessments in this way. I took a little more hope from his recognition that we do need change.
A number of the major charities in this year’s call for evidence say that although they have seen some change for the better, it is disappointingly incomplete in coverage and depth. I agree with them. Changing such a large and complex process and such a controversial assessment takes time – it is happening.
So far as the descriptors are concerned, progress has been positive but slow. We are close to a new and much improved set of provisions for cancer treatment. For the mental, intellectual and cognitive conditions descriptors and for the fluctuating condition descriptors, work is underway for a formal review of new proposals from a number of charities to compare them with the existing descriptors. This work will continue into 2013 and I have been asked to chair the expert independent steering group overseeing the quality and validity of the evidence-based review. It is important to wait for the results of this before rushing to conclusions about how to change the descriptors.
We know from earlier this year that the DWP have been testing new descriptors and I hope that there will be progress on these so that serious conditions affecting ability to function which are currently missed will be noted in future. Also note in the paragraph above that Harrington is to continue working with the DWP on this aspect.
I am concerned that cancer treatment has been singled out as needing special attention once again. Cancer is very bad and unpleasant and everyone knows someone who has had it, that’s why it is politically dangerous to send patients on chemotherapy to work. However many other conditions are equally serious and yet not so media-friendly and are therefore treated differently. The Work Capability Assessment is supposed to be about assessing the impact of the condition on ability to function, not what treatment is being received.
Harrington made a number of recommendations to the DWP. I am pleased that the first is for decision makers to consider the need for further documentary evidence. Whether they will do this or not is another question but as I said before the gathering of evidence is a big problem.
It is essential that all relevant medical and allied evidence about the claimant is available to the DWP Decision Maker at the earliest possible stage in the assessment process. If this can be achieved then Tribunals will be based on Judges and Medical Members considering the same body of evidence as the Decision Maker did.
Less pleasing is his second recommendation:
DWP Operations need to find an appropriate balance between better quality decisions that are carefully considered and ‘right first time’ and the achievement of appropriate benchmarks at a local level.
Now I could be wrong here, but that looks very much like a target.
The third recommendation is that the DWP should try to get more feedback from tribunals as to why decisions are overturned. This seems reasonable as it could affect change in the decisions made to start with. The fourth recommendation is that the DWP must highlight improvements, and be open about problems. As I said before, better PR for the DWP is not the answer. I’m open to hearing about improvements made but not if they are used to distract from problems that remain unsolved.
What I didn’t write about yesterday is the definition that the government are using for troubled family, and that definition is very bad indeed. The Conservative Party have turned to research by the Economic and Social Research Council (ESRC) to decide who might be “troubled”. The government have decided that a troubled family is one that meets five out of seven criteria:
No one in the family who is working
Parents who have no qualifications
The mother has a mental health problem
One parent has a long-standing illness or disability
Unable to afford basics, including food and clothes.
In fact these criteria boil down to one thing: poverty. And the ESRC have come right out and stated that the government have basically made up their own minds about what it all means. They said “In the term ‘troubled families’ it deliberately conflates families experiencing multiple disadvantage and families that cause trouble.” The definition that the government are using does not mention child truancy, criminal records, ASBOs, police call outs, drug abuse, or any of the other things that they claim to be addressing.
It is quite likely that none of these conditions are under the control of the family themselves, and yet under government plans they can be penalised for it. Even worse than that, though, is the presence of illness, disability and mental health on that list. These are definitely not under the control of the people involved, but it is clear from what Eric Pickles told The Independent that the government do blame these people. Pickles said that these families must end an “it’s not my fault” culture of excuses and must stop avoiding taking responsibility for their own lives. He said that there would be “less understanding” and a tougher approach.
This is blaming the victim, plain and simple. It fits right in with the Bio-Psychosocial model of disability that the government have adopted after decades of being advised by insurance company UNUM. The model basically says that disability is all in the mind of the disabled person and they only need to adopt a better attitude to overcome barriers to work and other activities. This is the model that has seen so many people judged fit for work in their Work Capability Assessment by Atos, and now we see it being used to clamp down on poor people who the Tories find distasteful. Instead of helping them, which costs money, they are punishing them because they don’t fit their Victorian ideal of “deserving poor”.
That’s what you get printed on vouchers for emergency food supplies from Co-op and Tesco given out by a charity where I live. And now, it seems, it could apply to all benefits paid to “120,000 problem families” if Iain Duncan Smith has his way. According to The Telegraph:
Iain Duncan Smith has asked his officials to see if so-called ‘problem’ families should receive their welfare payments on smart cards, rather than in cash.
The cards would only be able to pay for “priority” items such as food, housing, clothing, education and health care.
The Work and Pensions secretary wants to stop parents who are alcoholics or who are on drugs from using welfare payments to fuel their addictions.
The team of civil servants in his department have been asked to come up with proposals by the end of this month.
Under government criteria, a troubled family is one that meets five out of seven criteria: having a low income, no one in the family who is working, poor housing, parents who have no qualifications, where the mother has a mental health problem, one parent has a long-standing illness or disability, and where the family is unable to afford basics, including food and clothes.
There are many problems with this definition but it can be summarised thusly:
“So basically anyone without the good manners to be born healthy, rich and privileged.” – @IamMrJ
Leaving aside for a moment the morality of dictating what people can buy, the first problem I can see with this scheme is that it will favour big businesses and supermarkets and leave small local shops and markets by the wayside. There will be costs involved in accepting these payment cards which small shops will be unlikely to be able to afford, as well, I’m sure, as checks to make sure that shops honour the restrictions . Street markets are usually cash only which would bar people from getting cheap local fresh fruit and vegetables too.
The second problem is related; because of barriers to accepting the smart cards or to restrictions on what can be purchased people will be barred from shopping around for cheaper food and some will be prevented from purchasing specialist items that are required for their health but are not prescribed or considered by government to be necessary.
The third problem, and possibly the biggest problem I see is that sick or disabled people often have no choice in where they shop. The limited ability to travel or to carry things can mean that the nearest shop is the only one they can use. If small shops are not able to accept these cards then there may be no other source of food open to these people.
Many sick or disabled people order their shopping over the internet; in fact this is often a requirement since care plans have written internet shopping in so as to cut costs of providing carers for shopping trips. This will probably be less of a problem since supermarkets will accept cards but the question remains as to whether or not they will accept them over the internet.
If the idea of this scheme is as reported, to stop feeding addiction, then it will be pointless anyway. Addiction is powerful and removing funds doesn’t mean that people won’t be addicted any more. If someone is dependant on nicotine or alcohol then providing benefits on a restricted smart card will not prevent them from obtaining these things if they have to. It will lead to a black market – to bartering of valuable items for cigarettes and alcohol, or to selling of benefit funds for much less than the real value resulting in less money for the benefit recipient. It could well lead to theft to feed the addiction. It will certainly drive some into prostitution. Drug dependency drives people to desperate measures and they won’t always be rational.
Pleasure and Entertainment
Finally we must ask why society deems it acceptable to tell those who are least fortunate that they must not have any pleasures or enjoyment. It seems that those who must rely on benefits are resented and even envied for what they have. Some is illogical; for example Motability cars are not a luxury, they are required for people who cannot walk to get to medical appointments or to go shopping and the cars are leased not given. Internet connections may be the only way that some people can shop, communicate, pay bills, claim benefits or get support and yet some people still think that an internet connection is a luxury that those on benefits should not have. People who have TVs and perhaps TV subscriptions are resented, but for those who are forced to stay in the home by illness or have no funds to go out it may be the only thing to occupy their time. Should these people be forced to sit and stare at the wall for the rest of their lives? We seem to have broken the concept of national insurance. When a person who has worked and paid their dues becomes unemployed or unable to work and receives benefits they are resented for claiming benefits that they have been paying for while working. Must they too give up all pleasure in their lives? We can be certain that restrictions along these lines will exacerbate or even cause mental health problems.
The government hasn’t addressed the reasons for smoking and drinking either, and it’s not just about addiction. Smoking is an appetite suppressant When food is expensive and income is so low parents often buy food for their children while smoking to mitigate their own hunger pangs. Alcohol is a pain killer and a sedative; like it or not for some people despite all of our medical advances alcohol may be the only way that they can have a few pain-free hours or relax enough to go to sleep.
Before we start I would like to point out that I am not a historian and I am not a sociologist and as such I have done my best to present the information here as I understand it. With that out of the way, I’ll start with an overview of how disabled people were treated in Germany during WWII.
The Aktion T4 programme ran in Germany from 1939 to 1945. In the 1920s Alfred Hoche and Karl Binding, part of an extreme eugenics movement, advocated killing those who were judged to have “life unworthy of life.” In the 1930s there were huge cuts to state institutions causing overcrowding and Nazi propaganda emphasised the cost of caring for mentally ill and disabled people. In 1939 parents of disabled child Gerhard Kretschmar wrote to Hitler to ask him to permit their child to be killed. Hitler agreed and immediately set up a committee whose job was to organise more such murders – Aktion T4. When the war started parents were told that their mentally ill and physically disabled children were being sent to special treatments centres. In fact they were murdered without the knowledge of the parents. The programme was soon extended to adults, starting in Poland then in Germany. Throughout the programme Hitler knew that there would be huge opposition to such killing and so he never put his orders in writing. The one exception was a secret letter written to authorise the formation of the Aktion T4 programme, mainly because his justice minister would not cooperate without one. The programme operated in secrecy until it was too late for most people. Under the programme at least 200,000 disabled people were murdered over six years, either through lethal medication, starvation or gas chambers.
Now we jump forward to Britain today. The events I describe in the paragraph above are unthinkable. No government minister, no tabloid newspaper, no man in the street would advocate such things, right?
That’s not quite true though. Most of the pieces are in place. We have propaganda pushing the idea that sick and disabled people are scroungers, workshy, lazy. This propaganda is coming from government ministers, their special advisers, and tabloids like the Daily Express, The Sun, the Daily Mail. Even broadsheets like the Times and the Telegraph have contributed. Such propaganda has even been raised by MPs in the Work and Pensions Select Committee and ministers told to stop. The propaganda is working too, with hate crimes against disabled people up in vast numbers.
We have many people fighting to legalise assisted suicide, inadvertently promoting the idea that life for some people is not worth living. Sure, we’re only asking for voluntary euthanasia, but what other factors might be in play? Pressure to stop being a burden, financial problems, cuts to care all contribute to a desire for death. If euthanasia becomes legal what is to stop people from being pushed to kill themselves? It may be overt or it may be through suggestion and through making their lives hell. (This is more my fear of how it could go wrong than any judgement on my part for or against euthanasia.)
We have cuts to local authority care budgets, starting in Worcestershire, that mean anyone whose care costs more than sending them to an institution will lose some care. The politicians argue that it’s a choice because people can choose to move to a care home or to cut some of their care provision. But what to cut? Eating? Washing? Dressing? Using a toilet? We have already seen people lose in court after fighting to not have to wear a nappy. Adults are expected to soil themselves rather than get help to use a toilet. We have also seen the loss of the independent living fund. The net result is loss of care or institutionalising people. Most care homes are run by private companies and neglect does not seem uncommon. I think more abuse and neglect is likely especially when companies are cutting costs because they have underquoted better homes.
We have sick and disabled people being judged as fit to work and told to claim job seeker’s allowance and look for work, and we have even more seriously sick and disabled people being placed in the Work Related Activity Group. Both groups are subject to The Work Programme where they are expected to undertake unpaid work experience for large companies, and government plans are to make such work placements of unlimited duration. Work makes you free.
Under these plans anyone who is seen to not be cooperating with The Work Programme and other work related activities will see their benefit income slashed. Those on Job Seeker’s Allowance can have their entire allowance removed entirely for weeks, even six months. Those on Employment Support Allowance (e.g. too sick to work) will see three quarters of their allowance removed. Of course anyone who has been judged as fit to work or has been placed in the WRAG is expected to be capable of going on work placements even if their assessment was wrong and they are waiting a year for an appeal, and even if people are seriously harmed by trying to work. The result is that those who don’t destroy themselves trying to find jobs that don’t exist or going to endless work placements will instead not be able to afford food, clothes, fuel bills, rent and more. Many will be able to use food banks but some will not be physically able to get to them and food banks rely on charity from other people who are struggling too.
Is it such a large step for disabled people to be dying? No. It’s already happening. Reports in April claimed that 1,100 people had already died after being placed in the work related activity group. That’s more than thirty people a week. This is what Chris Grayling calls “Tough love.”
Some government ministers make policy decisions without thinking about the consequences of what will happen in practice. Others are fully aware of what will happen and just don’t care. Either way, they are often covered by claiming that their policy in itself does not harm people, even though the flaws with implementation allow people to fall through the net and come to harm. Government ignore evidence. They dismiss statistics, they blame the previous government, they claim that processes are being sorted out now, they claim that any harm is the fault of the sick or disabled or unemployed individual. The Government are hiding behind Atos and A4e who are “just carrying out orders” but they way they carry out those orders makes things even worse. Government ministers have the same attitude as many other people in power – they can say “make it happen” and the minions do the dirty work.
In 1930s Germany the government themselves ordered the rounding up and the killing of disabled people. In modern-day Britain the government can claim that it is not their fault, even that it should not happen, but private companies and the chasm of bureaucracy between various government departments are what kill people. Starvation, homelessness and neglect are what will kill people. The implementation is different and the scale is different but the attitude and the outcome are the same.
Since making my income public one thing that has been bothering me is that while my wife and I now receive enough money to live on and DLA to provide for the extra costs of my care and mobility, a vast number of my friends do not. And I feel sort of guilty about that. I know that I shouldn’t, I am getting the proper benefits for my circumstances, but I feel horrible that other people – many with greater need than me – don’t get the help that they are supposed to get.
I went through a Work Capability Assessment with Atos and I was placed in the support group. I know that I am sick enough to merit ESA and DLA but it was always in doubt whether Atos would recognise that. I can’t help wondering what would have happened if my journey to the assessment centre hadn’t been so awful. (You can read about that travesty on a previous blog post.) If I hadn’t arrived shaken, stressed and exhausted perhaps my assessment would have gone quite differently – Atos have been criticised for ignoring variable health problems and could easily have judged me differently if I had appeared well that day.
Perhaps it is chance that I ended up in the Support Group for ESA rather than the Work Related Activity Group or even found fit for work. But then my DLA was awarded on the basis of the Work Capability Assessment too, even though that isn’t supposed to happen until PIP is introduced. So is that two benefits received by pure chance? Being awarded ESA helped me to get DLA and getting DLA has increased the amount that I get from ESA, and both of those ensure that I get housing benefit too. At some point I may get carers allowance although that might lower the amount that I get from ESA.
The point is, I now have enough to live on without being in poverty and always struggling to pay the bills. Many other people are not so lucky. What I really want is for access to these benefits to be available to all the other people that need it. I have so many friends who haven’t got the benefits that they so desperately need. Friends who can’t walk, or can’t get out of bed, or can’t cook for themselves. Friends who have been through the assessments by Atos and refused on absurd grounds. Friends who are in hospital near death and don’t get benefits. I was really terrified that I wasn’t going to get my ESA, and the form filling for benefits and the assessment process itself made me more stressed which led to me being more physically ill too.
Even when people have managed to get all the benefits to which they are entitled it isn’t always enough. I need relatively few adjustments to live. A wheelchair, a shower seat. Some people need hoists and lifting equipment and wet rooms and stairlifts and bigger rooms to fit it all in… and the list goes on. Of course some of that can be paid for in other ways such as from council funds or (until now) the Independent Living Fund but many people end up sorting out their own adaptions. I talked to my GP about getting an NHS wheelchair yesterday and she suggested that it would be quicker and easier to buy one for myself. (Not that I can’t try to get an NHS one.) That happens a lot with costlier items too.
Clearly the benefits system isn’t great at the moment. It’s obvious that it needs reform to solve these problems. But – and this is an important but – the Welfare Reform Bill doesn’t solve these problems. It makes them far worse. It abolishes multiple sources of funding, it cuts the DLA / PIP budget by 20% and it restricts who can get help and who will receive PIP. Government ministers have told us that those most in need will get more help. What they are less keen to tell everyone is that the extra help for those most in need is being snatched away from those who are only quite in need. If you need help but not loads of help, that’s tough. Because the government says you’re not going to get any help at all.