“From 25th November 2013 Ingeus will be delivering a new Department for Work & Pensions (DWP) Health Professional led contract for customers claiming Employment and Support Allowance (ESA) with an 18-24 month prognosis post Work Capability Assessment (WCA). The 2 year pilot programme will ensure clients have access to suitably trained Health Professionals to support the management of their health and wellbeing. We are looking to recruit Occupational Therapists to deliver the ESA pilot across the Central Region.”
It gets worse though. Perhaps unsurprisingly, the words “Bio-psychosocial model” make an appearance.
“Delivering bio-psychosocial initial health assessments to identify clients health related concerns and barriers to returning to work, usually taking place via face to face 1:1 appointments but may also require telephone based interventions as well as on occasions a home/community visit.”
The Bio-Psychosocial model of disability is what 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. It places blame for being ill on the patient and insists that they can just think their way better, as though thinking can eradicate viruses or fix broken genes or regrow broken or missing body parts.
I think access to an extra doctor, nurse, OT or some one else could really be a great help to a lot of sick and disabled people but not through this scheme. Any extra healthcare needs to be consensual and voluntary, this is not. The money spent on this scheme would be far more useful given to the NHS. And as for this scheme using the bio-psychosocial model, you might as well just tell sick and disabled people to “snap out of it”.
The Benefits and Work website claims that people will lose their Disability Living Allowance permanently if someone accuses them of fraud. There is some truth behind this claim but the headline is a wild speculation from the information that they actually have.
The facts behind the story are this:
People who currently receive DLA will all be “invited” to apply for Personal Independence Payments over the next few years. A large number of people who receive DLA are not expected to qualify for the same level of support from PIP and so this move is rightly feared by many. People can apply for PIP before their DLA runs out if they wish – these are “self selectors” in DWP speak. Anyone whose care or mobility needs change will have to apply for PIP rather than alter their DLA claim. As long as nothing changes, most people can remain on DLA until 2015 or the end of their award.
The scary part of this story comes from a quote that Benefits and Work found on Rightsnet.
“At our local JC+/customer/representative forum meeting last week a DWP partner support manager brought the following change of wording to the attention of the meeting (second bullet point on page one of link)
In his wordsanyone who was ‘bubbled’ (shopped) would be taken as if they were a ‘self selector’ in the DLA/PIP reassessments.
Nothing appears to have been changed in the PIP trans regs to allow this but it is worrying when the PIP/DWP ‘thinking’ changes the words ‘those claimants where we receive information…’ from the actual legislation.”
The source claims that anyone who is reported to the DWP for fraud will be treated as if they have reported a change and therefore have to apply for PIP.
This is a fairly tenuous link, but a worrying one all the same. The overwhelming majority of reports to the benefit fraud hotline are either malicious or wrong and the fraud rate for DLA is incredibly low. If all that is required to trigger the move to PIP is a false report then a lot of people are going to be badly affected. However, we do not know whether this second-hand claim is true, or whether the practice will be widespread or just confined to one or two areas, and we do not know if a person will have to be found guilty of benefit fraud or just reported – the wording could mean either. Given the history of the DWP’s approach to sanctions I wouldn’t say it is out of the question for this to happen against the rules, but we will have to wait and see about that.
I find the way that Benefits and Work have reported this to be irresponsible and misleading. In their email they stated that “The DWP have ruled that…” when there is no such ruling, only a second-hand report. They also missed out the third sentence from their quote, which stated that nothing has changed in the PIP regulations.
I do not think anyone should worry about being moved because of a malicious fraud report, at least until we have more evidence.
“Although the primary focus of the panel’s work has been to review the provision of what is often referred to as specialist disability employment training as delivered by Residential Training providers, the panel has been mindful of other DWP programmes such as Work Choice and Work Programme and note the disappointing statistics published recently.”
The document is a review of residential training for disabled people. It makes plenty of reference to “markets”, to “cost/benefit analysis” and to how the programme is great because it is “intensive”. It doesn’t make any mention of the potential health impact of an intensive course on a sick or disabled person, or the practicalities of being away from home with familiarity, provisions for medicines and care, or the impact of upheaval and stress of being forced to go away. In my opinion the most scary statement is this one:
“In the vast majority of cases, the type and severity of a person’s impairment/health condition has little bearing on their ability to secure and sustain employment”
It seems that plans are already in place to send a lot more people on such residential training.
“If the provision continues following this review it will be subjected to an open competition to tender for contracts for provision post August 31st 2014.”
There are plans for non-disabled people too.
The panel considers that the provision can be improved in the following ways:
1) Increase numbers that use the residential element including reaching out to nondisabled people who are long term unemployed and would specifically benefit from the provision e.g. they would benefit from a holistic and intense approach. It could be more cost effective to increase numbers of RT trainees, as the unit cost of provision would then be driven down.
This isn’t what I thought it was on first impressions, however I still have serious reservations about it. As is pointed out in the comments below:
“This is talking about residential colleges that currently exist that are primarily for adults with severe learning difficulties and/or multiple complex needs. When people in that group reach 19 it often their fervent wish to go to one of these residential places and they often don’t get the chance.”
So, I can see that this can be a positive thing in some circumstances and I was wrong to call it a work camp. However, the attitude of the review bothers me a lot. To claim that impairments and health conditions don’t keep people out of work is just plain wrong. Overcoming barriers in society can only get someone so far; sometimes an impairment just will not let a person work. The suggestion to roll this scheme out to long-term unemployed people shows there is a view that this “holistic intensive approach” is to be used elsewhere, and my fear is that it will be applied to people who are significantly sick or disabled but unlucky enough to be in the work related activity group for ESA. Combined with the DWP’s penchant for sanctions this could be a very bad thing. Also not addressed is how sick and disabled people will function away from their support structures at home.
The Department of Work and Pensions have today announced that they will hold a “further consultation on the mobility component of Personal Independence Payment (PIP)”.
This follows the outcry after the threshold to be eligible for the most help with moving around was tightened from fifty metres to twenty metres with no indication during the consultation that this would be the case. Myself and two others had initiated a Judicial Review against the DWP to declare the consultation invalid and force a rethink. The Judicial Review would have taken place at the end of July.
The DWP would very much like you to believe that it is holding this new consultation because it is a kind and listening department and their announcement does not mention the court proceedings at all.
“However, the department has received significant feedback from disabled people and their organisations that they want a further opportunity to comment on the finalised assessment criteria rules around the mobility component. That is why it is now giving notice of a further consultation to be launched late June.”
However the emails sent out to my solicitor and to members of the stakeholder consultation forum had a subject line of “Re: Judicial Review” so make of that what you will.
While this new consultation is very good news it is not an admission that the twenty metre eligibility is wrong or an indication that the DWP will change their minds. We will have six weeks to make sure that the DWP has no choice but to admit that the twenty metre limit will cause serious harm to a great deal of people, withdrawing support from people that desperately need it. I will publish details of how to contribute to the consultation once they are available.
A lot of credit is due to Jane Young and We Are Spartacus for getting legal action organised to bring about this new consultation.
I will be discussing with my solicitor and other people involved what step to take next.
Lease one from Motability using the mobility component of DLA
Get a charity to buy one
It should be obvious that buying one is not really an option for most people living on sickness and disability benefits. Many people who need a high end power wheelchair do lease one from the Motability scheme however that option is not available to those who already use their DLA to lease a car through the scheme, or who do not receive DLA at all. In some circumstances a charity might be willing to foot some or all of the bill for a power wheelchair. Specialist charities for certain diseases or impairments might do this although in practice most do not have this option either. In my case there is a charity that helps people in the area that I live in who might be able to pay for part of the cost of a power wheelchair for me but since charity funds must be carefully looked after they require me to need a wheelchair but be unable to get one from the NHS before they will help. That leads me to the main option, to ask for a wheelchair from the NHS.
Soon after my power wheelchair broke an occupational therapist referred me to Worcestershire Wheelchair Services and I was told that I would get an assessment but that I would have to wait a long time. In the meantime I bought a manual wheelchair using my credit card. I have a bankruptcy in my past because of my illness so that credit is at an interest rate of 34% APR.
I knew when I was referred for a wheelchair assessment that I would not qualify for a power wheelchair because I only need a wheelchair when out of the house but that was OK because once I had an assessment I could turn to my local charity. As I understood then from other doctors and therapists I should qualify for a manual wheelchair, although probably one with small wheels that required an attendant to push it because self-propelling a wheelchair soon hurts my arms as much as walking hurts my legs. (This is why I purchased a self-propel chair, since I would like to be able to turn myself around even if I mostly have someone pushing.)
Then, today, I received this letter from Wheelchair Services. (Click to enlarge.)
The letter informed me that I would not receive any wheelchair from the NHS because in Worcestershire they are
“Currently only able to supply wheelchairs to people who meet higher level needs i.e. to those clients who have a permanent mobility problem, who are unable to walk and who require a wheelchair within their own home.”
So, because I can walk or stagger around at home, I will not receive any kind of wheelchair to help outside where I cannot walk more than a few metres or stand up for more than a few seconds – not even a manual wheelchair. They won’t even visit to assess me. There are also many people who need a power wheelchair but are unable to get one from the NHS because they, like me can walk to some extent around their own home. In a lot of these cases they would use a wheelchair inside if only they could fit one in their home, but because they cannot they too are denied any help from wheelchair services. I know of several people who are currently trying to raise funds through donations to purchase their own power wheelchair because of this.
I’m not too worried about this in my own case because I have the manual wheelchair that I bought, and I have my wife to push it much of the time, and I still hope to get help from a local charity. I am far more worried about all the other people who haven’t been so fortunate and have no chance to buy a wheelchair, no charity help, no car and no one to offer lifts. I struggle to understand the justification for the NHS in Worcestershire not giving a wheelchair to people who need one but only when outside. If applied nationally, this policy would trap tens or hundreds of thousands of people in their own homes, unable to go out to medical appointments, to buy food or to visit family and friends. I don’t know how long this policy has been in place in Worcestershire but I hope that it is the only area doing this.
Worcestershire Wheelchair Service informed me that their qualifying criteria have been this way for a number of years due to low funding. Worcestershire is not looking like a good place for a chronically sick or disabled person to live right now; Worcestershire council are planning to remove funding for care at home for a large number of people and send them to live in care homes instead. This is a huge backwards step, a removal of freedom for a lot of people and reverts to the old method of locking those with disabilities away from society. This policy on wheelchairs will ensure that more people are trapped at home and so require care from the local authority, which in turn may put them into a care home.
Are we as a country really so short of money that this is the route we want to take?