Welfare sanctions are killing people with chronic illnesses such as type 1 diabetes

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David Clapson

The sister of David Clapson, a 59-year-old ex-soldier who died in 2013 after he was sanctioned by the Department for Work and Pensions (DWP), issued a judicial review and human rights claim in the High Court last year, challenging the refusal by the Senior Coroner for Hertfordshire to hold an inquest into her brother’s death.

Clapson, who had type 1 insulin dependent diabetes, was found dead in his home on 20 July 2013. His benefits had been stopped by Department for Work and Pensions staff who knew that he suffered from diabetes.

At the time of his death, Clapson had been unable to pay for his metered electricity as he had been rendered destitute by the sanction. His life saving insulin could not be refrigerated due to having no electricity, and he had no food available to feed himself. Clapson starved and this was aggravated by a severe drop in blood sugar. He died because he could not feed himself or refrigerate his insulin without access to lifeline State benefits. His death happened after being sanctioned for a month because he missed a single Job Centre meeting.

The coroner said that he hadn’t eaten for at least three days prior to his death. 

In 2014 Clapson’s sister, Gill Thompson started a petition with Change.org which gained over 200,000 signatures and helped to secure a Parliamentary Select Committee Inquiry in March 2015, which came up with 26 recommendations.  

However, the government rejected the Select Committee recommendation that the number of peer reviews into deaths of persons subject to a sanction be made public.   
 
The government also rejected Thompson’s calls for an Independent Review into David’s death and the deaths of others in similar circumstances and refused to create an independent body to conduct more reviews into the deaths of those in receipt of ‘working-age’ benefits. The Government response can be found here.  

The Coroner has declined to open an inquest. Further pre-action correspondence was sent, supported by reports by Diabetes UK and a leading Diabetes Consultant. Both reports confirmed that insulin-dependent diabetes is a chronic illness and that food and insulin refrigeration are of crucial importance in order to manage the condition.

Both reports expressed concern at the current Department for Work and Pensions (DWP) misleading guidance on diabetes, which states that “JSA claimants are likely to have well controlled diabetes”.

The Coroner maintained his refusal to open an inquest and, without mention of the medical reports provided, concluded that Clapson’s death was ‘not unnatural.’ The effect of the Coroner’s refusal is that no official investigation will be conducted into how it was that a vulnerable diabetic, known to the DWP and dependent on State benefits to live, came to die in his home from starvation, alone and without the means to feed himself or refrigerate his insulin in 21st century Britain.

Gill Thompson said: “The thing that continues to haunt me is that the DWP knew David was an insulin dependent diabetic yet they stated: ‘…we followed procedures and no errors were made….’
 
“Diabetes is a serious condition, which in cases such as David’s requires both food and insulin to stay healthy. I feel that the sanction resulting in my brother being left destitute and having no money to chill his insulin or to buy food, ultimately, led to his untimely death.

Going to Court is an option of last resort but I feel compelled to use every effort to ensure that the impact of the DWP imposed benefit sanction on David’s death is properly and independently investigated. I believe the DWP continue to impose sanctions on diabetic benefit claimants and not only for my brother’s sake, but also for others at risk, I hope the High Court grants me permission to challenge the Coroner’s decision. 

“All I want is for no one else to die like that, we are meant to be a civilised country.”

The government have been presented with many cases of extreme hardship, suffering and deaths because of sanctions, but they simply deny there is any “causal link” between the negative impacts, distress and deaths and their policies, despite the ever-growing and distressing evidence to the contrary. There is no evidence that there isn’t a “causal link” either. To establish such a link requires an inquiry and further investigation of an established correlation between the government’s policies and adverse impacts. If the government are so confident that their claim is right, then surely an inquiry would provide a welcomed verification of this. However, the government continues to refuse to do so.

Sanctions led to health deterioration, diabetic ulcers and leg amputation

David Boyce has diabetes. He was sanctioned for five months by the DWP, which meant he had no money whatsoever to meet his basic needs. As a result, he had to sell his belongings, but couldn’t afford to eat properly and subsequently in 2016, he had to have his leg amputated, as his medical condition spiralled out of control. A healthy diet is essential as part of the management and treatment for diabetes. 

David Boyce had to have his leg amputated when his diabetes spiralled out of control because he couldn’t afford to eat after having his benefits sanctioned

David Boyce

Boyce said that by July, 2016 complications from diabetes had already caused irreversible damage. His health deteriorated because he had no money to live on: he couldn’t control his insulin intake and was unable to follow his strict diabetic diet. 

Subsequently he suffered diabetic ulcers and was diagnosed with the flesh-eating infection, necrotizing fasciitis, and doctors were forced to amputate one of his legs.

Boyce was a photographer who used to own a business, but was forced to give up his work because of ill-health. There was a dispute with the DWP about his jobseeker’s agreement and he was sanctioned numerous times. David said that his benefits were frozen fourteen times because of “issues with paperwork.”

However, it’s clear that the sanctions happened because of a flawed decision-making process on the part of the DWP and he won an appeal which successfully overturned every sanction, with support from Salford’s Unemployed and Community Resource Centre. He was eventually awarded the money that had been wrongfully withheld from him

The government have claimed that benefit sanctions are an “incentive” to “help” people like David Boyce into work. However, David has been pushed even further away from the job market, because he’s now been left with a greater degree of disability: horrifically, the sanctions have cost him his leg.

Government denial of the impact of their punitive policies is costing people their lives 

He says he has now been kicked out of the flat he shared with Amy (Photo: Clifford Watson)

Amy Driver with her partner Clifford Watson

Amy Driver had type one diabetes and claimed Employment and Support Allowance. She was given a four-week sanction after she missed one appointment at the Job Centre due to a hospital appointment, according to her partner, Clifford Watson. Amy died because of complications of her condition caused by having no income to meet her basic needs. 

He said that the halt in their income meant Amy couldn’t afford to eat properly – which triggered hypoglycemica (a low blood sugar attack.) When the couple expressed their concerns and complained, Job Centre staff told Amy to go to a food bank. 

Clifford says Amy’s support was stopped multiple times over the last two years and in May 2017 she was sanctioned again despite showing documentation of the medical appointment she attended. He said: “We showed the evidence that she had a 94 per cent attendance rate and she was told she would get her money the next day but that didn’t happen.

“Next thing we’re told is that she had a four-week sanction and no one could explain why.” 

He added that money was tight surviving on his ESA alone and the sanction threw Amy into a depressive episode. 

Not having enough food to provide glucose for the body can cause dangerously low blood sugar levels (hypoglycemia) which can lead a state of ketoacidosis and if left untreated, to diabetic coma and death. Hypoglycemia is a serious condition and should be treated as a medical emergency. It requires prompt treatment, without which it may be fatal.

Amy was initially classed as being unwell enough to be placed in the Employment and Support Allowance (ESA) ‘support group’. People placed in this group after their assessment are considered too ill to work, paid indefinitely and don’t generally have to take part in work-related activities. However, Clifford says that in 2016 their local job centre lost her paperwork. 

“After her claim was messed up she was then having to attend classes aimed at getting her into work. She would go to the Job Centre and vomit. We kept trying to tell them that she really wasn’t well but no one would listen.” 

Clifford said that having diabetes had caused Amy’s eyesight and hearing to deteriorate and she had been discovered by himself and family members lying on the floor unconscious many times. “She would sleep and sleep – I had to make sure I was with her every four hours to make sure she had her insulin injections. She would just sleep through her alarms,” he said.

“Amy needed to follow a low sugar diet, and these foods for a specific diet aren’t cheap. I went without food to try to help her.

“It got her really down and she wouldn’t get out of bed or even watch TV. She hardly left the bedroom.

“One day I encouraged her to go visit her dad and she went to see him. When he saw her he told her she looked pale and suggested she have a lie down. Then he took a shower and after that found her body cold. 

“I was at home making her a roast dinner when her brother called me to say she’d passed away.”

Clifford, who had been Amy’s partner for eight years, said: “Amy’s diabetes made her extremely unwell. We had no food in the house at the time. She was told to go to a food bank – we called one and they said they didn’t have suitable food for diabetics.

“She was literally killed by the Government.” 

Amy was 27 years old.

Clifford said that last month he was evicted from the flat that the couple had shared in Hoxton, east London, by Hackney Council. 

“The council have taken my home away from me as it was in Amy’s name. I fought them to get a tenancy for the last 14 months but they kicked me out on the streets. I slept on park benches. 

“I’m staying with my parents now but there is no room for me there as they’re in a one-bedroom house. It’s a struggle finding landlords who will accept housing benefit and the council aren’t helping me.”

The Department for Work and Pensions and Hackney Council have been approached for comment, but have not yet responded.

More than a million benefits sanctions have been imposed on disabled people since 2010 – and last month the government quietly released a report of their own study that found there is “no evidence” that benefit sanctions work in the way that ministers have claimed. 

The DWP published the findings in the paper Universal Credit: in-work progression randomised controlled trial on the government’s website on 12 September, as MPs prepared for party conference season. There was no ministerial announcement about the results of the study.

The research, which was carried out over three years, found “no evidence” that sanctions for failing to apply for additional work, or undertake additional training “helped motivate participants to progress in work.” Rather than having the ‘beneficial effects’ the Conservatives insist they have,  sanctions “damaged the relationship between the work coach and the claimant,” the report said.

In a statement that can at best be described as utterly deplorable gaslighting, a spokesperson for the DWP said: “The ‘in work progression trials’ helped encourage claimants to increase their hours, seek out progression opportunities and take part in job-related training.”

The trials delivered positive results for many of the lowest paid people who claim Universal Credit and we are now considering the findings.” 

The Conservatives have a track record of denying empirical findings that don’t match their ideological expectations. They simply deny and dismiss any criticism of their prejudiced and discriminatory policies. Damian Green, the Work and Pensions Secretary at the time of the UN inquiry report, famously claimed that cuts to support for disabled people did “not necessarily mean worse outcomes.”

The government uses techniques of neutralisation:

Techniques of neutralisation are strategies used to switch off the conscience when someone plans or has done something to cause harm to others. They can also be used to switch off the conscience of others by perpetrators.

The idea of techniques of neutralisation was first proposed by David Matza and Gresham Sykes during their work on Edwin Sutherland’s Differential Association in the 1950s. Matza and Sykes were working on juvenile delinquency, they theorised that the same techniques could be found throughout society and published their ideas in Delinquency and Drift, 1964.

They identified the following psychological techniques by which, they believed, delinquents justified their illegitimate actions, and Alexander Alverez further identified these methods used at a socio-political level in Nazi Germany to “justify” the Holocaust:

1. Denial of responsibility. The perpetrator(s) will propose that they were victims of circumstance or were forced into situations beyond their control.

2. Denial of harm and injury. The perpetrator insists that their actions did not cause any harm or damage.

3. Denial of the victim. The perpetrator believes that the victim deserved whatever action the offender committed. Or they may claim that there isn’t a victim.

4. Condemnation of the condemners. The perpetrator maintain that those who condemn their offence are doing so purely out of spite, ‘scaremongering’ or they are shifting the blame from themselves unfairly. 

5. Appeal to higher loyalties. The perpetrator suggests that his or her offence was for the ‘greater good’, with long term consequences that would justify their actions, such as protection of a social group/nation, or benefits to the economy/ social group/nation.

6. Disengagement and Denial of Humanity is a category that Alverez
added to the techniques formulated by Sykes and Matza because of its special relevance to the Holocaust.

Nazi propaganda portrayed disabled people, Jews, and other non-Aryans as subhuman. A process of social division, scapegoating and dehumanisation was explicitly orchestrated by the government. This also very clearly parallels Gordon Allport’s work on explaining how prejudice arises, how it escalates, often advancing by almost inscrutable degrees, pushing at normative and moral boundaries until the unthinkable becomes tenable. This stage on the scale of social prejudice may ultimately result in murder and/or genocide.

Any one of these six techniques may serve to encourage violence by neutralising the norms against prejudice, aggression and violence to the extent that when they are all implemented together, as they apparently were under the Nazi regime, a society can seemingly forget its normative rules, moral values and laws in order to engage in wholesale prejudice, discrimination, exclusion of citizens, hatred and ultimately, in murder.

Ministers have accused citizens and the opposition of ‘scaremongering’, the Conservatives are denying responsibility for the consequences of their policies, denying harm, denying  distress; denying the victims and condemning the condemners.

Meanwhile, for many, the government’s approach to social security has become punitive, random, controlling, dangerous and an unremitting, Orwellian trial.

Sanctions are callous, dysfunctional and regressive, founded entirely on traditional Conservative prejudices about poor people and ideological assumptions. It is absolutely unacceptable that a government treats some people, including some of the UK’s most vulnerable citizens, in such horrifically cruel and dispensible way, in what was once a civilised first-world liberal democracy.

 

Related 

Welfare sanctions can’t possibly “incentivise” people to work. Here’s why

Disabled people are sanctioned more than other people, according to research

 

 


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16 thoughts on “Welfare sanctions are killing people with chronic illnesses such as type 1 diabetes

  1. Why Didn’t Gill Thompson help her brother whilst he was alive and needed it!! Given she knew how proud he is, you Don’t mess with type 1 diabetes!!! I would have hurt his feelings of pride to keep him alive, he had afterall been the main carer for their mother. Yes the DWP Did Wrong but she could have kept a closer eye on him.

    I have never had any family and that maybe colours my view a bit, but there Must have been some way of her helping him in some way! There must be some sort of personal responsibility here!

    Liked by 1 person

    1. I’m sure had Gill known she would have supported her brother. I don’t know whether she lived near him, whether she worked, or whether she has children. I don’t know if she had spoken to him during those three days he hadn’t eaten. I don’t know if she knew he had been sanctioned.

      I do know that when you have a chronic condition, it can very suddenly deteriorate and you may not even be aware of it yourself until it’s too late. I live with 2 sons who didn’t know I had developed pneumonia and sepsis and was dying. I also didn’t know. They both had flu, I also had flu. I have lupus, which is the reason I got so ill with the flu. It wasn’t until I tried to get a glass of water that they saw I was in a bad way. By the time the ambulance arrived I was in septic shock. They both cared for me while I was ill, they had the flu, I caught it days after they started with symptoms, and both had been very ill with it, but they made me food and brought drinks. I couldn’t eat, but they hadn’t been able to when they were going through the worst of it, either. I thought I felt so ill because it was a very bad strain of flu – which it was. I just slept most of the time, but the boys had at first, too. I would never blame them for not knowing I was so seriously ill, because I didn’t know I was either.

      You can only do something if you know how bad things are. 3 days isn’t a long time for people in families to not see each other, because people have their own lives going on too.

      People don’t expect a government department to fail someone as they did David and the other people I have written about. No one would expect people in the UK are facing hunger because our welfare system has become a system of punishment. David clearly didn’t tell his sister perhaps because he didn’t know himself how quickly he would deteriorate. I have hypoglycemia, though I don’t have diabetes. I have an autoimmune illness that affects my blood sugar. You don’t get a lot of time to act before you become incapable of dealing with it or for recognising what is happening to you. You become sweaty, drowsy, shaky and weak. Your thoughts become irrational and disjointed. You pass out. Sometimes very quickly.

      I don’t think Gill is to blame. I think the DWP who refuse to act on information they have are. I think the government who continue to deny any responsibility for the system they have created from public funds are. David worked – he was a vereran. He was abandoned by the government. His sister clearly cares very much for him. I don’t think it’s fair to imply this was in any way her fault.

      Liked by 3 people

  2. until the population wakes up to the fact that this government is culling its stock through benefit denial then nothing will get done aktion t4 rolling along without much of a ado

    Liked by 3 people

  3. It’s all up side down its not a competition who can sansion who when they want and tell people who are unfit to go to work that they are fit for work just by reading the ftf report it’s not on

    Liked by 1 person

  4. Great article, just a few points.

    High blood sugar (hyperglycaemia) not low blood sugar (hypoglycaemia) can lead to Ketoacidosis.

    Type 1 diabetes is twice as dangerous as some people realise, because both high and low blood sugar is very dangerous.

    Not enough insulin, no insulin or dud insulin (eg by not being refrigerated properly) will cause high blood sugar. This Is very dangerous, it can cause coma and death, but in the longer term, amputations, neuropathy and sight loss. That is not an exhaustive list of the complications. Not being able to run a fridge is therefore very dangerous. I had a dud vial of insulin once and my blood sugar rose to 26 within a dew hours. That’s about 5 times what is normal and close to danger level.

    Not enough food and emergency sugar can cause low blood sugar, ghis is even more dangerous. Blood sugars can move up and down very quickly, you can go from low to high in half an hour. Low blood sugar can causes faintness, faux drunkeness, coma and death. A diabetic must have food and sugar available at all times.

    I have been type 1 diabetic for 32 years and I think benefit sanctions is the worst possible thing to do to a type 1 diabetic, because they so materially interfere with the careful management of such a fickle and dangerous disease.

    Like

    1. Sorry but low blood sugar may also lead to a rise in ketones, which shows up in the urine too. If you have too much insulin or too little food, your body turns to fat and muscle for energy. ketonuria (ketones in the urine) is often accompanied by hypoglycemia. In sum, your body can produce ketones when blood sugars are too high or too low, and is especially prone to ketonuria when you are ill. Managing type one diabetes is a fine balancing act between eating properly and insulin doses.

      Ketones are produced when glucose is not available to the body’s cells as an energy source and/or when the body cannot use glucose as a fuel source because of fasting/hunger and when there is no insulin or not enough insulin. Even if you have your insulin dose, but haven’t eaten, that may also cause a rise in ketones.

      People with type one diabetes usually regularly test their urine for keytones. I have a form of autoimmune hypoglycemia, probably related to lupus as I don’t have diabetes, but I know all about ketones and hypos. I never have high blood sugar. I often have raised ketones, low blood sugar and hypo symptoms, though.

      If you are starving, it will cause hypoglycemia, and in the case of David, Clapson, he hadn’t eaten any food for three days. He also couldn’t use his insulin, because he could not keep it refridgerated. So it was a combination of both harmful factors.

      I agree that Type one diabetes is very serious, can be very difficult to manage and requires a routine of regular healthy eating and treatment to manage. Any thing that intereres with that balance is life threatening.

      I have to eat small meals often to manage my autoimmune condition. If I don’t eat, I end up unconscious. I don’t use insulin, however. I don’t have type one or type two diabetes. No-one really understands why I have hypos, I’m a bit underweight, and find it is marginally easier to manage when I put a little weight on. But I have lupus, which causes lots of autoimmune problems,this is probably just one of them. Two of my sons don’t have lupus, but do have hypo symptoms if they skip a meal or eat late. So there may be a genetic quirk at play too.

      Like

      1. Oh, thanks for putting me right on how low blood sugar can also cause ketoaciosis. When doctors warned me about how high blood sugar does this, I must have incorrectly assumed that’s the only cause. Sigh, another thing to watch out for!

        I’m not sure why, but my consultant has never suggested I test for ketones or prescribed a kit, maybe they only think there’s value in doing so for people who struggle to keep their sugar down.

        These hypos are very unpleasant, lucozade used to be very effective relief, but that was before the sugar tax. Now it’s Coca Cola and glucose tablets. You can probably understand why I get angry reading these cases, but in all cases of sanctions, there seems to be a collective wilful blindness on the part of people who support them to the fact that people can’t live on thin air.

        Liked by 1 person

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