This is Peter, I’ve known him for a few years, through our mutual campaigning on Facebook to raise awareness of issues that affect disabled people.
Peter also has multiple health conditions – ME/CFS, fibromyalgia, chronic pain, chronic depression, painful nerve entrapments, and arthritic wear in his neck. These conditions leave him exhausted and debilitated for much of the time. Even doing the most simple tasks can severely exhaust him. Not only is Peter’s mobility substantially restricted at all times, there are many days when he is not even able to leave his bed due to profound fatigue, a lack of energy and physical strength. He is unable to work, due to my impact of his health conditions.
For seven years, Peter received Disability Living Allowance (DLA) and then Personal Independence Payment (PIP). Under both awards, Peter also qualified for the enhanced mobility component. This meant that he could use this part of his lifefine benefit to lease a mobility car from the Motability scheme.
However, Peter was reassessed in January and despite the fact that Peter’s conditions are chronic, the assessor surprisingly decided that he now needs a lower level of support. This meant that Peter’s income was immediately cut by £50 per week.
Peter has appealed unsuccessfully through the Mandatory Reconsideration process, and is now going appeal the Department for Work and Pension’s decision at a tribunal court. However, the wait for appeals is currently long, and Peter has been told that his won’t likely happen until after Christmas 2018. In the mean time, Motability are taking back his car as they are no longer getting payments from the benefit agency.
The loss of income is becoming a struggle, but Peter tells me that the loss of his mobility car is absolutely devastating. He says: “A car gives someone like me freedom, it is autonomous mobility. I have no idea how I’m going to cope. Getting to and from bus stops is very hard. Buses end up causing me such pain and harm, that I cannot do anything once I’ve been on a journey. Taxis might be ok for one or two trips per week, but the cost soon becomes intolerable, and they restrict getting out of the house to just 2 or 3 times a week.
He added “I am appealing with the support of Disability Solutions West Midlands. They have an excellent record of overturning 90% of decisions on appeal, and on the evidence, they say my case is a good one. Therefore, once I finally get my appeal heard it is very likely I will have everything reinstated.”
Meanwhile, Peter is hoping to use crowd fund support to help him buy a car to help him over the difficulties and barriers he faces over the next six months or so. Without this support, Peter will be effectively housebound and unable to do everyday things, such as shopping, visiting the doctor and hospital, visiting friends, going for coffee or enjoying the outdoors. All of these things are vital his ongoing therapy, and basic inclusion in his community and wider society.
Personal Independence Payment is a non means tested benefit for people with a long-term health condition or impairment, whether physical, sensory, mental, cognitive, intellectual, or any combination of these. It is an essential financial support towards the extra costs that ill and disabled people face, to help them lead as full, active and independent lives as possible.
However, I’ve written at length about how the assessment process is unfit for purpose, and is creating distress and causing harm to disabled people. See for example: Government guidelines for PIP assessment: a political redefinition of the word ‘objective’, which discusses how, prior to the introduction of PIP, Esther McVey stated that of the initial 560,000 claimants to be reassessed by October 2015, 330,000 of these are targeted to either lose their benefit altogether or see their payments reduced.
Of course the ever-shrinking category of “those with the greatest need” simply reflects a government that has made a partisan political decision to cut disabled people’s essential income to fund a financial gift to the wealthiest citizens. There is no justification for this decision, nor is it “fair.”
That article also discusses government guidelines for PIP assessors or ‘health care professionals’. The PIP assessment is geared towards looking for “inconsistencies” in “functional limitations”. For example, if you say you can’t sit unaided for half an hour, but then say that you watch soaps on TV, it will be assumed you sit unaided for at least half an hour to watch TV, and that will be classed as a “discrepancy between the reported need and the actual needs of the claimant.”
The whole assessment is set up and designed to look for “inconsistencies.” In other words, the assessor is looking for any excuse to justify a decision that you are not among those in “greatest need” for a PIP award. The entire process happens within a framework of reducing welfare costs, after all. This makes a mockery of the government’s fondness for using the word “objective.”
As someone whowent through a PIP assessment last year, I know how harrowing and utterly unfair they can be. I was awarded basic rate. I was one point short of an enhanced level award. In a report concerning the decision, I was told that because I had a degree (I graduated in 1996, Master’s in 2007), because I worked as a social worker (until becoming too ill to work in 2010), and because I had a driving licence in 1993 (I can no longer drive because of flicker induced seizures), I had “no evident cognitive difficulties” caused by my conditions. It seemed inconceivable to the assessor that my illness, which arose after I graduated, has caused cognitive difficulties since 2010.
Assessors use any irrational and outrageous excuse they can to award the lowest amount possible.
I manage my health care and hospital appointments, shopping and so on because my son and other family members support me by taking me themselves. I’ve been unable to drive for a few years now.
However, Peter depends on his motability vehicle to get out to appointments, to shop and to meet friends. Without his car he will be trapped in the house, and the loss will cause him hardship and distress. That’s why I thought a crowdfund appeal would be appropriate.
The appeal is to raise £1,500 to help replace the loss of PIP payments and replace or keep Peter’s essential mobility car, so he can stay mobile and remain able to leave the house.
Jodey Whiting’s mother, Joy Dove, with Jodey’s daughter Emma Bell(Image: Ian McIntyre)
The Department for Work and Pensions (DWP) is facing a legal investigation after a mother of nine took her own life “because the DWP stopped her benefits”.
Jodey Whiting, who suffered severely disabling medical conditions, ended her own life in February 2017, shortly after the DWP stopped her disability support payments. The payments stopped because it was claimed by the DWP that Jodey failed to attend a work capability assessment (WCA).
However, her family claims that she never received the appointment letter and are blaming the Government for her suicide.
The 42-year-old grandmother was diagnosed with a brain cyst and curvature of the spine and could barely walk to her own front door, but an inquest has heard that despite her considerable disabilities, Jodey Whiting faced a distressing battle with the DWP for lifeline support.
Supported by volunteers from the Citizens Advice Bureau, Jodey appealed the DWP decision to end her claim, but was told that due to a backlog in appeals it could take up to sixteen months before her case was reviewed.
Her mother, Joy Dove, who assisted her daughter in claiming the lifeline support she was entitled to, has taken up the battle with the DWP following her daughter’s death. She told Gazette Live: “To have to wait another 16 months is devastating, but we can’t do anything about the fact there are so many cases that need investigating.
“I’m glad they’ve taken the case on. We will always fight for justice for my daughter.
“She has kids and grandchildren left without a mum, and I’ve been left without a daughter. I want to make sure this doesn’t happen to anyone else.”
The case will now be investigated by an Independent Case Examiner (ICE), who will look at the circumstances surrounding Jodey’s death and whether the DWP’s decision to stop her benefits affected her psychological state at the time of Jodey’s suicide.
The ICE will looks at five key parts of the case against the DWP:
The Citizen’s Advice Bureau sent a letter to the DWP regarding Jodey’s health issues on February 15, six days before her death, but it failed to act on it until March 23.
Despite being made aware of her death on February 23 using the ‘tell us once’ system, the DWP issued a claim to Jodey about her Employment Support Allowance claim on February 25.
The DWP failed to take appropriate action to upgrade their computer systems until March 1.
The DWP continued to call Jodey’s phone and leave her voicemail messages until May, despite knowing of her death.
The department failed to respond to Mrs Dove’s letter of April 13, 2017 until June 14, 2017.
Jodey had been sent a letter that instructed her to attend a work capability assessment on January 16 last year, but missed the mandatory meeting while being in hospital because of a brain cyst. She knew nothing about the appointment.
On February 6, the DWP ruled that Jodey had not ‘provided sufficient evidence’ for missing the appointment and stopped her disability benefits. Jodey raised concerns about the decision on February 10 and made a formal appeal on the 13th. She took her own life on February 21, before a different DWP decision maker had reviewed her case and decided on February 25 – just four days after her death – that she should have continued to receive disability benefits.
A message about the ruling was sent to Jodey’s mobile phone inbox after her death, despite the DWP being informed of her death.
Joy has also started a ‘Justice for Jodey’ petition, with the aim of persuading the DWP to look again at how it handles social security claims. You can sign it here: you.38degrees.org.uk/petitions/justice-for-jodey
She said that messages of support there have helped her as she struggles to overcome her grief: “We’ll never stop battling. The messages I get on the petition, and from people who have been in similar situations, are incredible.”
The DWP did not respond to requests for comment.
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Yesterday, the government published the latest Work and Pensions Select Committeereport on PIP and ESA Assessments. This is an utterly damning report, highlighting a lack of quality, consistency, transparency, objectivity and fairness from the government’s PIP and ESA incredibly expensive outsourced assessment regimes.
The report highlights failures by the private contractors, Atos and Maximus, to conduct accurate assessments, and substantial failures in the DWP’s decision-making – both the initial decisions about benefit awards and mandatory reviews were all too often found to be lacking in facts and accuracy.
The report document says: “We heard many reports of errors appearing in assessment reports. Such experiences serve to undermine confidence amongst claimants. So does the proportion of DWP decisions overturned at appeal. At worst, there is an unsubstantiated belief among some claimants and their advisers that assessors are encouraged to misrepresent assessments deliberately in a way that leads to claimants being denied benefits.
“All three contractors carry out assessments using non-specialist assessors” it adds “Without good use of expert evidence to supplement their analysis, the Department will struggle to convince sceptical claimants that the decision on their entitlement is an informed one…It is extraordinary that basic deficiencies in the accessibility of PIP and ESA assessments remain, five and ten years respectively after their introduction.”
The committee concludes: “Claimants of PIP and ESA should be able to rely on assessments for those benefits being efficient, fair and consistent. Failings in the processes – from application, to assessment, to decision-making and to challenge mechanisms – have contributed to a lack of trust in both benefits. This risks undermining their entire operation.”
The report continues: “The Government has also spent hundreds of millions of pounds more checking and defending the Department’s decisions.”
Recommending ultimately that the assessments might be better conducted by ‘in-house’ assessors, in the meantime the Work and Pensions Committee has called for new conditions to be put in place for transparency in the process.
1. For most claimants, PIP and ESA assessments go smoothly. But in a sizeable minority of cases, things go very wrong indeed. For at least 290,000 claimants of PIP and ESA—6% of all those assessed—the right decision on entitlement was not made first time. Those cases, set alongside other problems throughout the application and assessment process, fuel a lack of trust amongst claimants of both benefits. The consequences—human and financial—can be enormous.
Our recommendations aim to correct the worst of these problems and rebuild claimant trust. Properly implemented, they will bring real improvements for claimants going through the system now and in the near future. The question of whether a more fundamental overhaul of welfare support for disabled people is necessary remains open. We do not intend this to be the end of our work on PIP and ESA. (Paragraph 12)
2. Applying for PIP or ESA can be daunting. The Department has so far only made limited efforts to provide support and guidance in a variety of clear, accessible formats. It should not rely on already stretched third sector organisations to explain the Department’s own processes. A concerted effort from the Department to help with applications would be both reassuring to claimants, and of great practical benefit.
We recommend the Department co-design, with expert stakeholders, guidance in a range of accessible formats on filling in forms and preparing for assessment. This should include accessible information on the descriptors for each benefit, to be sent out or signposted alongside application forms. We also recommend the Department makes clear to claimants being reassessed that they should not assume information from their previous assessment will be re-used, and should be prepared to re-submit any supporting evidence already provided.(Paragraph 18)
3. Many PIP and ESA claimants have multiple health conditions that bring with them severe limitations. Focusing on what they are able to do is a common coping strategy—one that is often incompatible with filling in PIP and ESA application forms. It is impossible to draw a causal link from application to claimant health. The Department should demonstrate, however, that it is alert to the risk to mental health posed by parts of the application processes and seek to offset this. (Paragraph 20)
4. We recommend that the Department commission and publish independent research on the impact of application and assessment for PIP and ESA on claimant health. This should focus initially on improvements to the application forms, identifying how they can be made more claimant-friendly and less distressing for claimants to fill in. The Department should set out a timescale for carrying out this work in response to our Report.(Paragraph 21)
5. As a result of their health conditions, many PIP and ESA claimants require communications in a specific format. The Department’s resistance to meeting even some of the most basic of these needs makes applying for PIP and ESA unnecessarily challenging for some claimants. Its failure to provide a widely-used, accessible alternative to telephone calls, and Easy Read communications, is extraordinary.
We recommend that the Department enables claimants with hearing impairments to apply for PIP and ESA via email, ensuring this service is appropriately resourced to prevent delays to claims. In the longer term, it should look to offer this option to all claimants. It should also ensure key forms and communications—especially the PIP2, appointment and decision letters—are available in Easy Read format, allowing claimants to register this as a communication preference at the start of their claim.(Paragraph 25)
6. Home visits are an important option for claimants whose health conditions make attending an assessment centre difficult. Contractors interpret the Department’s guidance on home visits differently. They take varying approaches to granting them and require different standards of supporting evidence. This leads to inconsistencies between the benefits and between contractors. It can also place additional burdens on claimants and the NHS. (Paragraph 30)
7. We recommend the Department issue new guidance to PIP and ESA assessors on the procedure for determining whether claimants receive a home visit. This should specify that GP letters are not required where other forms of evidence and substantiation are available. This should include evidence from the claimant, as well as from carers, support workers and other health professionals. To ensure guidance is being followed, we recommend contractors be required to gather evidence and the Department audit requests made and granted for home visits, as well as reasons for refusal.(Paragraph 31)
8. Atos, Capita and Maximus all use a generalist assessor model. They pay no regard to the specialist expertise of individual assessors in assigning cases. They therefore assess claimants with the full gamut of conditions. The success of this model depends on a consistent supply of high quality, relevant expert evidence. There is ongoing confusion amongst claimants and those supporting them alike about what constitutes “good evidence” for functional purposes.
We recommend that the Department sets out in response to this Report its approach to improving understanding amongst health and social care professionals and claimants of what constitutes good evidence for PIP and ESA claims. This should include setting out how it will measure, monitor and report on the supply of evidence into PIP and ESA assessments.(Paragraph 39)
9. Successive evidence-based reviews conducted on behalf of the Department have identified a pervasive culture of mistrust around PIP and ESA processes. This culminates in fear of the face-to-face assessments. This has implications far beyond the minority of claimants who directly experience poor decision-making. It can add to claimant anxiety even among those for whom the process works fairly. While that culture prevails, assessors risk being viewed as, at best lacking in competence and at worst, actively deceitful. Addressing this is a vital step in restoring confidence in PIP and ESA.
The case for improving trust through implementing default audio recording of assessments has been strongly made. We recommend the Department implement this measure for both benefits without delay. In the longer term, the Department should look to provide video recording for all assessments.(Paragraph 44)
10. Some claimants may be unable or embarrassed to explain the full implications of their condition to their assessor. Companions can help them to articulate these and support claimants during a potentially stressful process. Their role in assessments is vital. The Department’s recognition of this in its guidance to contractors is welcome. We are concerned, however, that this guidance is not consistently followed.
There is no reference to companions in the Department’s auditing or contractor training programmes. That none of the contractors could even reliably tell us how many claimants are accompanied to assessment suggests this is not a priority. (Paragraph 49)
11. We recommend that the Department develop detailed guidance on the role of companions, including case studies demonstrating when and how to use their evidence. Contractors should also incorporate specific training on companions into their standard assessor training. After implementing default recording of assessments, a sample of assessments where claimants are accompanied should be audited on a regular basis to ensure guidance is being followed.(Paragraph 50)
12. DWP decisions on PIP and ESA claims are often opaque, even when decisions are correctly made. Ensuring claimants can see what is being written about them during assessment, and providing a copy of the assessor’s report by default would prove invaluable in helping claimants understand the reasoning behind the Department’s decisions. Both steps would increase transparency and ensure claimants are able to make informed decisions about whether to challenge a decision. In turn, many tribunals could be avoided, the workload of Decision Makers at Mandatory Reconsideration reduced, and overall costs lowered.
We recommend the Department proceed without delay in sending a copy of the assessor’s report by default to all claimants, alongside their initial decision. We also recommend it issues instructions to contractors on ensuringclaimants are able to see what is being written about them during assessment, and allowing their input if they feel this is incorrect or misleading. This should include, for example, emphasising to contractors that rooms should be configured by default to allow the claimant to sit next to the assessor or be able to see their computer screen.(Paragraph 55)
13. Claimants often go to considerable efforts to collect additional evidence for their claim, providing important information for generalist HCPs. Contractors and the Department should ensure that it is clear to claimants how and when this evidence is used. Without doing so, they will struggle to convince sceptical claimants that the decision on their entitlement to benefits is an informed one. Knowing how their evidence has been used will further empower claimants to understand the Department’s decisions, and to decide whether an MR is necessary. (Paragraph 60)
14. We recommend that the Department introduce a checklist system, requiring HCPs to confirm whether and how they have used each piece of supporting evidence supplied in compiling their report. Decisions not to use particular pieces of evidence should also be noted and justified. This information should be supplied to Decision Makers so they can clearly see whether and how supporting evidence has been used, making it easier to query reports with contractors. It should also be supplied to the claimant along with a copy of their report.(Paragraph 61)
15. Mandatory Reconsideration should function as a genuine check, not an administrative hurdle for claimants to clear. Improving the quality of assessments and reports will ensure fewer claimants have to go to MR, but disputes will always happen. The Department deserves credit for a renewed emphasis on MR quality. MR decision-making has not always been characterised by thoroughness, consistency and an emphasis on quality, however. Not all claimants who have, perhaps wrongly, been turned down at MR will have had the strength and resources to appeal. (Paragraph 66)
16. We recommend the Department review a representative sample of MRs conducted between 2013 and December 2017, when it dropped its aspiration to uphold 80% of MRs, to establish if adverse incorrect decisions were made and, if so, whether there were common factors associated with those decisions. It should set out its findings and any proposed next steps in response to this report.(Paragraph 67)
17. The Department argues that the high rate of decisions overturned at appeal is driven by the emergence of new evidence that was not available at initial or MR stage. It has displayed a lack of determination in exploring why it takes until that stage for evidence to come to light. In almost half of cases the “new evidence” presented was oral evidence from claimants. It is difficult to understand why this information was not, or could not have been elicited and reported by the assessor. The Department’s argument does not absolve it of responsibility.
Its feedback to and quality control over contractors is weak. Addressing these fundamental shortcomings would not only ensure a fairer system for claimants. It would also reduce the cost to the public purse of correcting poor decision-making further down the line. (Paragraph 72)
18. The Department must learn from overturned decisions at appeal in a much more systematic and consistent fashion. We recommend it uses recording of assessments to start auditing and quality assuring the whole assessment process.
When a decision is overturned, the Department should also ensure that the HCP who carried out the initial assessment is identified and that an individual review of how the assessment was carried out is conducted. Given what we know about reasons for overturn, this should focus on improving questioning techniques and ensuring claimants’ statements are given due weight.
We also recommend the Department lead regular feedback meetings with contractors and organisations that support claimants. These should keep the Department informed of emerging concerns and ensure that swift action is taken to rectify them.(Paragraph 73)
19. The Department’s quality standards for PIP and ESA set a low bar for what are considered acceptable reports. The definition of “acceptable” leaves ample room for reports to be riddled with obvious errors and omissions. Despite this, all three contractors have failed to meet key performance targets in any given period. It is difficult not to conclude that this regime contributes to a lack of confidence amongst claimants. (Paragraph 87)
20. The Department’s use of contractual levers to improve performance has not led to consistent improvements in assessment quality, especially in relation to PIP. Large sums of money have been paid to contractors despite quality targets having been universally missed. (Paragraph 88)
21. The PIP and ESA contracts are drawing to a close. In both cases, the decision to contract out assessments in the first instance was driven by a perceived need to introduce efficient, consistent and objective tests for benefit eligibility. It is hard to see how these objectives have been met. None of the providers has ever hit the quality performance targets required of them, and many claimants experience a great deal of anxiety over assessments.
The Department will need to consider whether the market is capable of delivering assessments at the required level and of rebuilding claimant trust. If it cannot—as already floundering market interest may suggest—the Department may well conclude assessments are better delivered in-house. (Paragraph 94).
While the above recommendations will help make some improvements, these alone are not sufficient to fix the fundamental lack of trust in the current assessment system. Many of us who have been through more than one assessment for PIP and ESA – that have too often been ordeals – face more of them in the future. It’s a relentless process and some of us have been forced to challenge Kafkaesque decisions more than once or twice.
The assessment is itself a challenge, after that many of us face mandatory review, and sometimes a formal complaint is also appropriate. With no more than 18% of mandatory reviews resulting in a reversal of unreasonable and often profoundly unfair decisions, we are then forced to go through an appeal. Often within 3 months of winning an appeal, we face a reassessment – I did.
Many of us also need to claim PIP. My experiences of the ESA assessments were so distressing and damaging to my health, exacerbating my illness, that I put off claiming PIP in 2011. In fact I only claimed from last year, and that was with a huge amount of support from my local councils’ occupational therapy and welfare support teams. Despite my illness being progressive, I will be reassessed in 2020.
Urgent reform of PIP and ESA is needed to ensure that disabled people are treated humanely, fairly and may maintain their dignity. It’s needed to ensure assessments are accurate, transparent and fair, and lead to disabled people getting the lifeline support that they need and are entitled to.
“Independent” assessments were introduced to reduce successful disability benefit claims, to save money. That was a clearly stated objective. However they have cost much more than they were intended to save.
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“An official survey shows that 76% of people in the [PIP] system responded to say that they were satisfied. That itself is not a happy position, but it shows that her representation of people’s average experience as wholly negative on the basis of a Twitter appeal does not reflect the results of a scientific survey.” Stephen Kerr, (Conservative and Unionist MP for Stirling), Personal Independence Payments debate,Hansard, Volume 635, Column 342WH, 31 January 2018
“The latest official research shows that 76% of PIP claimants and 83% of ESA claimants are satisfied with their overall experience.”Spokespersonfor the Department for Work and Pensions.
The Department for Work and Pensions Claimant Service and Experience Survey (CSES)is described as “an ongoing cross-sectional study with quarterly bursts of interviewing. The survey is designed to monitor customers’ satisfaction with the service offered by DWP and enable customer views to be fed into operational and policy development.”
The survey measures levels of satisfaction in a defined group of ‘customers’ who have had contact with the Department for Work and Pensions within a three-month period prior to the survey.
One problem with the aim of the survey is that satisfaction is an elusive concept – a subjective experience that is not easily definable, accessible or open to precise quantitative measurement.
Furthermore, statistics that are not fully or adequately discussed in the survey report – these were to be found tucked away in the Excel data tables which were referenced at the end of the report –and certainly not cited by Government ministers, are those particularly concerning problems and difficulties with the Department for Work and Pensions that arose for some claimants.
It’s worrying that 51 per cent of all respondents across all types of benefits who experienced difficulties or problems in their dealings with the Department for Work and Pensions did not see them resolved. A further 4 per cent saw only a partial resolution, and 3 per cent didn’t know if there had been any resolution.
In the job seeker’s allowance (JSA) category, some 53 per cent had unresolved problems with the Department and only 39 per cent had seen their problems resolved. In the Employment and Support Allowance (ESA) group, 50 per cent had unresolved problems with the Department, and in the Personal Independent Payment (PIP) group, 57 per cent of claimants had ongoing problems with the Department, while only 33 per cent have seen their problems resolved.
– means the sample size is less than 40.
A brief philosophical analysis
The survey powerfully reminded me of Jeremy Bentham’s Hedonistic Calculus, whichwas an algorithm designed to measure pleasure and pain, as Bentham believed the moral rightness or wrongness of an action to be a function of the amount of pleasure or pain that it produced.
Bentham discussed at length some of the ways that moral investigations are a ‘science’. There is an inherent contradiction in Bentham’s work between his positivism, which is founded on the principle of verification – this says that a sentence is strictly meaningful only if it expresses something that can be confirmed or disconfirmed by empirical observation (establishing facts, which are descriptive) – and his utilitarianism, which concerns normative ethics (values, which are prescriptive). Bentham conflates the fact-value distinction when it suits his purpose, as do the current Government.
The recent rise in ‘happiness’, ‘wellbeing’ and ‘satisfaction’ surveys are linked with Bentham’s utilitarian ideas and a Conservative endorsement of entrenched social practices as a consequence of this broadly functionalist approach. It’s not only a reflection of the government’s simplistic, reductionist view of citizens, it’s also a reflection of the reduced functioning and increasing rational incoherence of a neoliberal state.
As we have witnessed over recent years, utilitarian ideologues in power tend to impose his/her vision of the ‘greatest happiness for the greatest number,’ which may entail some negative consequences for minorities and socially marginalised groups. For example, the design of a disciplinarian, coercive and punitive welfare systemto make ‘the taxpayer’ or ‘hard-working families’ happy (both groups being perceived as the majority). The happiness of those people who don’t currently conform to a politically defined norm doesn’t seem matter to the Government. Of course people claiming welfare support pay tax, and more often than not, paid tax before needing support.
Nonetheless, those in circumstances of poverty are regarded as acceptable collateral damage in the war for the totalising neoliberal terms and conditions of the ‘greater good’ of society, sacrificed for the greatest happiness of others. As a consequence, we live in a country where tax avoidance is considered more acceptable behaviour than being late for a job centre appointment. Tax avoidance and offshore banking is considered more ‘sustainable’ than welfare support for disabled people.
This utilitarian problem, arising because of a belief that a state’s imposed paradigm of competitive socioeconomic organisation is the way to bring about the greatest happiness of the greatest number, also causes the greatest misery for some social groups. This is a problem that raises issues with profound implications for democracy, socioeconomic inclusion, citizenship and human rights.
My point is that the very nature and subject choice of the research is a reflection of a distinctive political ideology, which is problematic, especially when the survey is passed off as ‘objective’ and value-neutral’.
There are certain underpinning and recognisable assumptions drawn from the doctrine of utilitarianism, which became a positivist pseudoscience in the late nineteenth century. The idea that human behaviour should be mathematised in order to turn the study of humans into a science proper strips humans down to the simplest, most basic motivational structures, in an attempt to reduce human behaviours to a formula.
To be predictable in this way, behaviour must also be assumed to be determined.
Yet we have a raft of behavioural economists complaining of everyone elses’ ‘cognitive bias’, who have decided to go about helping the population to make decisions in their own and society’s best interests. These best interests are defined by behavioural economists. The theory that people make faulty decisions somehow exempts the theorists from their own theory, of course. However, if decisions and behaviours are determined, so are the theories about decisions and behaviours. Behavioural science itself isn’t value-neutral, being founded on a collection of ideas called libertarian paternalism, which is itself a political doctrine.
The Government have embraced these ideas, which are based on controversial assumptions. Even the best philosophers and neuroscience specialists have never resolved the debate around determinism and free will. There is no consensus on the matter.
The current government formulates many policies with ‘behavioural science’ theory and experimental methodology behind them, which speaks in a distinct language of individual and social group ‘incentives’, ‘optimising decision-making’ and all for the greater ‘good of society’ (where poor citizens tend to get the cheap policy package of thrifty incentives, which entail austerity measures and having their income reduced, whereas wealthy citizens get the deluxe package, with generous financial rewards and free gifts.)
There are problems with trying to objectively measure a subjectively experienced phenomena. There are major contradictions in the ideas that underpin the motive to do so. There is also a problem with using satisfaction surveys as a measure of the success or efficacy of government policies and practices.
A little about the company commissioned to undertake the survey
The research was commissioned by the Department for Work and Pensions and conducted by Kantar Public UK– who undertake marketing research, social surveys, and also specialise in consultancy, public opinion data, policy and also economy polling, with, it seems, multi-tasking fingers in several other lucrative pies.
Kantar Public “Works with clients in government, the public sector, global institutions, NGOs and commercial businesses to advise in the delivery of public policy, public services and public communications.”
“Kantar Public will deliver global best practice through local, expert teams; will synthesise innovations in marketing science, data analytics with the best of classic social research approaches; and will build on a long history of methodological innovation to deliver public value. It includes consulting, research and analytical capabilities.” (A touch of PR and technocracy).
Eric Salama, Kantar CEO, commented on thelaunch of this branch of KantarPublicin 2016: “We are proud of the work that we do in this sector, which is growing fast. Its increasing importance in stimulating behavioural change in many aspects of societies requires the kind of expert resource and investment that Kantar Public will provide.”
The world seems to be filling up with self-appointed, utilitarian choice architects. Who needs to live in a democracy when we have so many people who say they’re not only looking out for our ‘best interests’, but defining them, and also, helping us all to make “optimum choices” (whatever they may be). All of these flourishing technocratic businesses are of course operating without a shred of cognitive bias or self-consciousness of their own. Apparently, the whopping profit motive isn’t a bias at all. It’s only everyone else that is cognitively flawed.
Based on those assumptions, what could possibly go wrong right?
I digress.
The nitty-gritty
Ok, so having set the table, I’m going to nibble at the served dish. Kantar’s survey – commissioned by the Government – cited in the opening quotes – by the Government. The quotes have been cited in the media, in a Commons debate and even presented as evidence in a Commons Committee inquiry into disability support (Personal Independence Payments and Employment and Support Allowance).
It seems that no-one has examined the validity and reliability of the survey cited, it has simply been taken at face value. It’s assumed that the methodology, interpretation and underlying motives are neutral, value-free and ‘objective’. In fact the survey has been described as ‘scientific’ by at least one Conservative MP.
There are a couple of problems, however, with that. My first point is a general one about quantitative surveys, especially those using closed questions. This survey was conducted mostly by telephone andmost questions in the used questionnairewere closed.
Some basic problems with using closed questions in a survey:
It imposes a limited framework of responses on respondents
The survey may not have the exact answer the respondent wants to give
The questions lead and limit the scope of responses
Respondents may select answers which are simply the most similar to their “true” response – the one they want to give but can’t because it isn’t in the response options – even though it is different
The options presented may confuse the respondent
Respondents with no opinion may answer anyway
Does not provide us with information about whether or not the respondent actually understood the question being asked, or if the survey response options provided include an accurate capture and reflection of the respondents’ views.
Another problem which is not restricted to the use of surveys in research is the Hawthorne effect. The respondents in this survey had active, open benefit claims or had registered a claim. This may have had some effect on their responses, since they may have felt scrutinised by the Department for Work and Pensions. Social relationships between the observer and the observed ought to be assessed when performing any type of social analysis and especially when there may be a perceived imbalanced power relationship between an organisation and the respondents in any research that they conduct or commission.
Given the punitive nature of welfare policies, it is very difficult to determine the extent to which fear of reprisal may have influenced peoples’ responses, regardless of how many reassurances participants were given regarding anonymity in advance.
The respondents in a survey may not be aware that their responses are to some extent influenced because of their relationship with the researcher (or those commissioning the research); they may subconsciously change their behaviour to fit the expected results of the survey, partly because of the context in which the research is being conducted.
The Hawthorne Effect is a well-documented phenomenon that affects many areas of research and experiment in social sciences. It is the process where human subjects taking part in research change or modify their behaviour, simply because they are being studied. This is one of the hardest inbuilt biasesto eliminate or factor into research design. This was a survey conducted over the telephone, which again introduces the risk of an element of ‘observer bias.’
Methodological issues
On a personal level, I don’t believe declared objectivity in research means that positivism and quantitative research methodology has an exclusive stranglehold on ‘truth’. I don’t believe there is a universally objective, external vantage point that we can reach from within the confines of our own human subjectivity, nor can we escape an intersubjectively experienced social, cultural, political and economic context.
There is debate around verificationism, not least because the verification principle itself is unverifiable. The positivist approach more generally treats human subjects as objects of interest and research – much like phenomena studied in the natural sciences. As such, it has an inbuilt tendency to dehumanise the people being researched. Much human meaning and experience gets lost in the translation of responses into quantified data – the chief goal of statistical analysis is to identify trends.
An example of the employment of ‘objective’ and ‘value-neutral’ methods resulting in dehumanisation is some of the inappropriate questions asked during assessment for disability benefits. The Work and Pensions Select Committee received nearly 4,000 submissions – the most received by a select committee inquiry – after calling for evidence on the assessments for personal independence payment (PIP) and Employment and Support Allowance (ESA).
The recent committee report highlighted people with Down’s syndrome being asked when they ‘caught’ it. Assessors have asked insulting and irrelevant questions, such as when someone with a progressive condition will recover, and what level of education they have.
This said, my own degree and Master’s, undertaken in the 1990s, and my profession up until 2010, when I became too ill to work, were actually used as an indication that I have “no cognitive problems” in 2017, after some 7 years of being unable to work because of the symptoms of a progressive illness that is known to cause cognitive problems. My driving licence in 2003 was also used as evidence of my cognitive functioning.
Yet I explained that have been unable to drive since 2004 because of my sensitivity to flickering (lamp posts, trees, telegraph poles have a strobe light effect on me as the car moves) which triggers vertigo, nausea, severe coordination difficulties, scintillating scotoma and subsequent loss of vision, slurred and incoherent speech, severe drowsiness, muscle rigidity and uncontrollable jerking in my legs. I usually get an incapacitating headache, too. I’m sensitive to flashing or flickering lights, certain patterns such as ripples on a pond, some black and white stripe patterns and even walking past railings on an overcast day completely incapacitates me.
The PIP assessment framework is claimed to be ‘independent, unbiased’ and objective.’ Central to the process is the use of ‘descriptors’, which are a limited set of criteria used to ‘measure’ the impact of the day-to-day level of disability that a person experiences. Assessors useobjective methods such as “examination techniques, collecting robust evidence, selecting the correct descriptor as to the claimant’s level of ability in each of the 10 activities of daily living and two mobility activities, and report writing.” They speak the language of positivism with fluency.
However, it has been long recognised by social researchers and sociologists that positivism does not accommodate human complexity, vulnerability and context very well. In an assessment situation, the assessor is a stranger to the person undergoing the assessment. How appropriate is it that a stranger assessing ‘functional capacity’ asks disabled people why they have not killed themselves? Alice Kirby is one of many people this happened to.
She says: “In this setting it’s not safe to ask questions like these because assessors have neither the time or skills to support us, and there’s no consideration of the impact it could have on our mental health.
“The questions were also completely unnecessary, they were barely mentioned in my report and had no impact on my award.”
So, not only an extremely insensitive and potentially risk-laden question but an apparently pointless one.
It may be argued that some universal ‘truths’ such as the importance of ‘impartiality’, or ‘objectivity’ are little more than misleading myths which allow practitioners and researchers alike to claim, and convince themselves, that they behave in a manner that is morally robust and ethically defensible.
A brief discussion of the methodological debate
Social phenomena cannot always be studied in the same way as natural phenomena, because human beings are subjective, intentional and have a degree of free will. One problem with quantitative research is that it tends to impose theoretical frameworks on those being studied, and it limits responses from those participating in the study. Quantitative surveys tend not to capture or generate understanding about the lived, meaningful experiences of real people in context.
There are also distinctions to be made between facts, values and meanings. Qualitative researchers are concerned with generating explanations and extending understanding rather than simply describing and measuring social phenomena and attempting to establish basic cause and effect relationships.
Qualitative research tends to be exploratory, potentially illuminating underlying intentions, responses, beliefs, reasons, opinions, and motivations to human behaviours. This type of analysis often provides insights into social problems, helps to develop ideas and establish explanations, and may also be used to formulate hypotheses for further quantitative research.
The dichotomy between quantitative and qualitative methodological approaches, theoretical structuralism (macro-level perspectives) and interpretivism (micro-level perspectives) in sociology, for example, is not nearly so clear as it once was, however, with many social researchers recognising the value of both means of data and evidence collection and employingmethodological triangulation, reflecting a commitment to methodological and epistemological pluralism.
Qualitative methods of research tend to be much more inclusive, detailed and expansive than quantitative analysis, lending participants a dialogic, democratic and first hand voice regarding their own experiences.
The current government has tended to dismiss qualitative evidence from first hand witnesses of the negative impacts of their policies – presented cases studies, individual accounts and ethnographies – as ‘anecdotal.’ This presents a problem in that it stifles legitimate feedback. An emphasis on positivism reflects a very authoritarian approach to social administration and it needs to be challenged.
A qualitative approach to research is open and democratic. It potentially provides insight, depth and richly detailed accounts. The evidence collected is much more coherent and comprehensive, because it explores beneath surface appearances, and reaches above causal relationships, delving much deeper than the simplistic analysis of ranks, categories and counts. It provides a reliable and rather more authentic record of experiences, attitudes, feelings and behaviours, it prompts an openness and is expansive, whereas quantitative methods tend to limit and are somewhat reductive.
Qualitative research methods encourage people to expand on their responses and may then open up new issues and topic areas not initially considered by researchers.
Government ministers like to hear facts, figures and statistics all the time. What we need to bring to the equation is a real, live human perspective. We need to let ministers know how the policies they are implementing directly impact on their own constituents and social groups more widely.
Another advantage of qualitative methods is that they are prefigurative and bypass problems regarding potential power imbalances between the researcher and the subjects of research, by permitting participation (as opposed to respondents being acted upon) and creating space for genuine dialogue and reasoned discussions to take place. Research regarding political issues and policy impacts must surely engage citizens on a democratic, equal basis and permit participation in decision-making, to ensure an appropriate balance of power between citizens and the state.
Quantitative research draws on surveys and experimental research designs which limit the interaction between the investigator and those being investigated. Systematic sampling techniques are used, in order to control the risk of bias. However not everyone agrees that this method is an adequate safeguard against bias.
Kantar say in their published survey report: “As the Personal Independence Payment has become more established and its customer base increased, there has been an increase in overall satisfaction from 68 per cent in 2014/15 to 76 per cent in 2015/16. This increase is driven by an increase in the proportion of customers reporting that they were ‘very satisfied’ which rose from 25 per cent in 2014/15 to 35 per cent in 2015/16.
Sampling practices
The report states clearly: “The proportion of Personal Independence Payment customers who were ‘very dissatisfied’ fell from 19 per cent to 12 per cent over the same period.
Then comes the killer: “This is likely to be partly explained by the inclusion in the 2014/15 sample of PIP customers who had a new claim disallowed who have not been sampled for the study since 2015/16. This brings PIP sampling into line with sampling practises for other benefits in the survey.
In other words, those people with the greatest reason to be very dissatisfied with their contact with the Department for Work and Pensions – those who haven’t been awarded PIP, for example – are not included in the survey.
This introduces a problem in the survey called sampling bias. Sampling bias undermines theexternal validityof a survey (the capacity for its results to be accurately generalised to the entire population, in this case, of those claiming PIP). Given that people who are not awarded PIP make up a significant proportion of the PIP customer population who have registered for a claim, this will skew the survey result, slanting it towards positive responses.
Award ratesfor PIP (under normal rules, excluding withdrawn claims) for new claims are 46 per cent. However, they are at 73 per cent for Disability Living Allowance (DLA) reassessment claims. This covers PIP awards made between April 2013 and October 2016. Nearly all special rules (for those people who are terminally ill) claimants are found eligible for PIP.
If an entire segment of the PIP claimant population are excluded from the sample, then there are no adjustments that can produce estimates that are representative of the entire population of PIP claimants.
The same is true of the other groups of claimants. If those who have had a new claim disallowed (and again, bearing in mind that only 46 per cent of those new claims for PIP resulted in an award), then that excludes a considerable proportion of claimants registering across all types of benefits who were likely to have registered a lower level of satisfaction with the Department because their claim was disallowed. This means the survey cannot be used to accurately track the overall performance of the Department or monitor in terms of whether it is fulfilling its customer charter commitments.
The report clearly states: “There was a revision to sample eligibility criteria in 2014/15. Prior to this date the survey included customers who had contacted DWP within the past 6 months. From 2014/15 onwards this was shortened to a 3 month window. This may also have impacted on trend data.”
We have no way of knowing why those peoples’ claim was disallowed. We have no way of knowing if this is due to error or poor administrative procedures within the Department. If the purpose of a survey like this is to produce a valid account of levels of ‘customer satisfaction’ with the Department, then it must include a representative sample of all of those ‘customers’, and include those whose experiences have been negative.
Otherwise the survey is reduced to little more than a PR exercise for the Department.
The sampling procedure is therefore a way of only permitting an unrepresentative sample of people to participate in a survey, who are likeliest to produce the most positive responses, because their experiences have been of a largely positive outcome within the survey time frame. If those who have been sanctioned are also excluded across the sample, then this will also hide the experiences and comments of those most adversely affected by the Department’s policies and administration procedures, again these are claimants who are the likeliest to register their dissatisfaction in the survey.
Measurement error occurs when a survey respondent’s answer to a survey question is inaccurate, imprecise, or cannot be compared in any useful way to other respondents’ answers. This type of error results from poor question wording and questionnaire construction. Closed and directed questions may also contribute to measurement error, along with faulty assumptions and imperfect scales. The kind of questions asked may also have limited the scope of the research.
For example, there’s a fundamental difference in asking questions like “Was the advisor polite on the telephone?” and “Did the decision-maker make the correct decision about your claim?”. The former generates responses that are relatively simplistic and superficial, the latter is rather more informative and tells us much more about how well the DWP fulfils one of its key functions, rather than demonstrating only how politely staff go about discussing claim details with claimants.
This survey is not going to produce a valid range of accounts or permit a reliable generalisation regarding the wider populations’ experiences with the Department for Work and Pensions. Nor can it provide a template for a genuine learning opportunity and commitment to improvement for the Department.
With regard to the department’s Customer Charter, this survey does not include valid feedback and information regarding this section in particular:
Getting it right
We will: • Provide you with the correct decision, information or payment • Explain things clearly if the outcome is not what you’d hoped for • Say sorry and put it right if we make a mistake • Use your feedback to improve how we do things
One other issue with the sampling is that the Employment and Support Allowance (ESA) and Job Seeker’s Allowance (JSA) groups were overrepresented in the cohort.
Kantar do say: “When reading the report, bear in mind the fact that customers’ satisfaction levels are likely to be impacted by the nature of the benefit they are claiming. As such, it is more informative to look at trends over time for each benefit rather than making in-year comparisons between benefits.”
The sample was intentionally designed to overrepresent these groups in order to allow “robust quarterly analysis of these benefits”, according to the report. However, because a proportion of the cohort – those having their benefit disallowed – were excluded in the latest survey and not the previous one, so cross comparison and establishing trends over time is problematic.
To reiterate, the report also says: “When reading the report, bear in mind the fact that customers’ satisfaction levels are likely to be impacted by the nature of the benefit they are claiming. As such, it is more informative to look at trends over time for each benefit rather than making in-year comparisons between benefits.”
With regard to my previous point: “Please also note that there was a methodological change to the way that Attendance Allowance, Disability Living Allowance and Personal Independence Payment customers were sampled in 2015/16 which means that for these benefits results for 2015/16 are not directly comparable with previous years.”
And: “As well as collecting satisfaction at an overall level, the survey also collects data on customers’ satisfaction with specific transactions such as ‘making a claim’, ‘reporting a change in circumstances’ and ‘appealing a decision’ (along with a number of other transactions) covering the remaining aspects of the DWP Customer Charter.These are not covered in this report, but the data are presented in the accompanying data tabulations.”
The survey also covered only those who had been in touch with DWP over a three month period shortly prior to the start of fieldwork. As such it is a survey of contacting customers rather than all benefits customers.
Again it is problematic to make inferences and generalisations about the levels of satisfaction among the wider population of claimants, based on a sample selected by using such a narrow range of characteristics.
The report also says: “Parts of the interview focus on a specific transaction which respondents had engaged in (for example making a claim or reporting a change in circumstances). In cases where a respondent had been involved in more than one transaction, the questionnaire prioritised less common or more complex transactions. As such, transaction-specific measures are not representative of ALL transactions conducted by DWP”.
And regarding subgroups: “When looking at data for specific benefits, the base sizes for benefits such as Employment and Support Allowance and Jobseeker’s Allowance (circa 5,500) are much larger than those for benefits such as Carer’s Allowance and Attendance Allowance (circa 450). As such, the margins of error for Employment and Support Allowance and Jobseeker’s Allowance are smaller than those of other benefits and it is therefore possible to identify relatively small changes as being statistically significant.”
Results from surveys are estimates and there is a margin of error associated with each figure quoted in this report. The smaller the sample size, the greater the uncertainty.
In fairness, the report does state: “In the interest of avoiding misinterpretation, data with a base size of less than 100 are omitted from the charts in this report.”
On non-sampling error, the report says: “Surveys depend on the responses given by participants. Some participants may answer questions inaccurately and some groups of respondents may be more likely to refuse to take part altogether. This can introduce biases and errors. Nonsampling error is minimised by the application of rigorous questionnaire design, the use of skilled and experienced interviewers who work under close supervision and rigorous quality assurance of the data.
Differing response rates amongst key sub-groups are addressed through weighting. Nevertheless, it is not possible to eliminate non-sampling error altogether and its impact cannot be reliably quantified.”
As I have pointed out, sampling error in a statistical analysis may also arise from the unrepresentativeness of the sample taken.
The survey response rates were not discussed either. In the methodological report, it says: “In 2015/16 DWP set targets each quarter for the required number of interviews for each benefit group to either produce a representative proportion of the benefit group in the eventual survey or a higher number of interviews for sub-group analysis where required. It is therefore not strictly appropriate to report response rates as fieldwork for a benefit group ceased if a target was reached.”
The Government says: “This research monitors claimants’ satisfaction with DWP services and ensures their views are considered in operational and policy planning.”
Again, it doesn’t include those claimants whose benefit support has been disallowed. There is considerable controversy around disability benefit award decisions (and sanctioning) in particular, yet the survey does not address this important issue, since those experiencing negative outcomes are excluded from the survey sample. We know that there is a problem with the PIP and ESA benefits award decision-making processes, since a significant proportion of those people who go on to appeal DWP decisions are subsequently awarded their benefit.
The DWP, however, don’t seem to have any interest in genuine feedback from this group that may contribute to an improvement in both performance and decision-making processes, leading to improved outcomes for disabled people.
Last year, judges ruled 14,077 people should be given PIP against the government’s decision not to between April and June – 65 per cent of all cases. The figure is higher still when it comes to ESA (68 per cent). Some 85 per cent of all benefit appeals were accounted for by PIP and ESA claimants.
The system, also criticised by the United Nations because it “systematically violates the rights of disabled persons”, seems to have been deliberately set up in a way that tends towards disallowing support awards. The survey excluded the voices of those people affected by this government’s absolute callousness or simple bureaucratic incompetence. The net effect, consequent distress and hardship caused to sick and disabled people is the same regardless of which it is.
Given that only 18 per cent of PIP decisions to disallow a claim are reversed at mandatory reconsideration, I’m inclined to think that this isn’t just a case of bureaucratic incompetence, since the opportunity for the DWP to rectify mistakes doesn’t result in subsequent correct decisions, in the majority of cases, for those refused an award.
Without an urgent overhaul of the assessment process by the Government, the benefit system will continue to work against disabled people, instead of for them.
The Government claim: “The objectives of this research are to:
capture the views and experiences of DWP’s service from claimants, or their representatives, who used their services recently
identify differences in the views and experiences of people claiming different benefits
use claimants’ views of the service to measure the department’s performance against itscustomer charter“
The commissioned survey does not genuinely meet those objectives.
“There is an alternative reality being presented by the other side. The use of figures diminishes disabled peoples’ experiences.”
I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.
Laura Pidcock, Labour MPfor North West Durham, says: “I’m delighted to say that I’ve been able to secure a Westminster Hall debate on Personal Independence Payments (PIP) next Wednesday, the 31st of January. As the debate will be focusing on claimant experience, it would be really useful if those people who have been through PIP could share their experiences of the process, either on here [Facebook] or by emailing laura.pidcock.mp@parliament.uk”.
It’s very important to raise both political and public awareness of the consequences of government policies and the harmful and distressing impact these are having on so many of us. The government have denied a ‘causal link’ between their policies and the correlated distressing experiences of disabled citizens. This is a good opportunity for us to present the government with the empirical evidence of that link.
I don’t make any money from my work. But you can support Politics and Insights and contribute by making a donation which will help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated, and helps to keep my articles free and accessible to all – thank you.
The government have persistently denied that there is a “causal link” between their welfare “reforms” (a Conservative euphemism for savage cuts) and an increase in suicides, premature deaths, psychological distress and severe hardship. However, a number of researchers and many campaigners have demonstrated a clear correlation that the government have so far refused to investigate further. Correlation quite often implies a causal relationship, and as such, requires further research.
Each case that has been presented to the government as evidence that their policies are causing severe harm has been dismissed as “anecdotal”.
Dr Simon Duffy, Director of the Centre for Welfare Reform said: “It is not enough to just stop introducing new policies to attack the rights and lives of disabled people and the poorest in society. These policies have been in place for six years and many are designed to increase poverty year on year. The Government should apologise for the harm it has caused since 2010,calculate the full impact of cuts that targeted the most disadvantaged and begin a full programme of reparations.”
This is the third harrowing article I have written this week about the devastating impact of the Conservatives’ punitive welfare policies on some of our most vulnerable citizens. I wish with all my heart that this is the last such article.
There will continue to be a need of witnesses like myself and other campaigners until the political denial stops.
Last month, an inquest in Ipswich heardhow Peter, a disabled man, struggling to cope with mental health problems, committed suicide by setting himself on fire because of fear that he would lose his lifeline support, following his compulsory re-assessment for Personal Independence Payment (PIP).
The government introduced the controversial PIP to replace Disability Living Allowance (DLA) in order to save costs and to “target those most in need” in 2013.
Peter Sherwood set fire to himself in front of horrified onlookers in Lowestoft town centre on September 4, 2015. The retired builder died in Broomfield Hospital, Chelmsford, which has a specialist burns unit, on September 8, 2015, following the horrific incident in Lowestoft town centre four days before.
Peter had received a letter from the Department for Work and Pensions, informing him that his DLA was ending and that he needed to reapply for PIP.
He suffered with a recurrent depressive disorder and psychosis. Peter had attempted to take his own life on a number of occasions previously. He also had a condition called tardive dyskinesia, which caused involuntary movements to his mouth and is a known side-effect of anti-psychotic medications.
Giving evidence at the inquest, Lucinda Stapleton, care coordinator from the Waveney Recovery Team, said this had affected Peter’s self-confidence as he was worried people were laughing and staring at him when he left the house.
In a statement read during the hearing, Mr Sherwood’s niece, Sarah Wilby, said: “I knew he was feeling a bit low the last time I saw him, which was two weeks before he died. He held me close on the sofa and told me he loved me.
“He was a loving person and had a great sense of humour.
“He was angry at many things in life, but could put a good front on.
“I loved him very much and miss him dreadfully.”
Ms Wilby said she was shocked at the drastic way her uncle took his own life.
She added: “He seemed to want to make some kind of a statement, but I don’t know what.”
During the inquest Ms Wilby said that Peter was claiming Disability Living Allowance but not long before his death he received a letter informing him he needed to reapply for Personal Independence Payment, which she believes contributed to his low mood at that time.
She said: “I personally think quite anunderlying cause of his anger was the change in benefits.
“Knowing Peter as we did that would have had a huge impact on him.”
Paul Anderson, a community support worker for the Norfolk and Suffolk Foundation Trust, said Peter had claimed that the Government was trying to take money off him.
The Coroner, Peter Dean, read statements from witnesses, who described seeing Peter spraying something on the pavement starting with the letter ‘h’ with an aerosol can.
The inquest heard passer-by William Groves asked Peter if he was a street artist, to which he replied “no, I’m a suicide artist”.
Peter then poured liquid over his head and set himself on fire using a lighter.
Members of the public tried to douse the flames by first throwing their jackets onto Peter, and then using a fire extinguisher from a nearby shop.
Police at the scene reported that Peter had muttered the word “humanity” to them a couple of times following the incident.
On September 4, 2015, Peter was visited at home by the community mental health team and he had expressed plans to end his life.
An urgent appointment was made for Peter to see a psychiatrist the following week, but it was tragically too late.
Norfolk and Suffolk NHS Foundation Trust has since updated its criteria of when patients should be referred to the 24-hour crisis team, following its routine investigation into Peter’s death.
The medical cause of death was given as 75% non-survivable full thickness burns, and mental health concerns.
The coroner’s conclusion was suicide.
—
If you are experiencing distress and feel suicidal, please don’t suffer in silence. The Samaritans have launched a free telephone national helpline number, 116 123.
People who are going through a difficult time can access the service round the clock, every single day of the year.
This number is free to call from both landlines and mobiles, including pay-as-you-go mobiles. You do not need to have any credit or call allowance on your plan to call 116 123.
I don’t make any money from my work. I am disabled because of illness and have a very limited income.
But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.
A Department for Work and Pensions spokesperson has denied allegations that people with mental health conditions claiming Personal Independence Payment (PIP) are being treated differently to those with physical disabilities: “At the core of PIP’s design is the principle that mental health conditions should be given the same recognition as physical ones”, the spokesperson said.
“In fact, there are more people with mental health conditions receiving the higher rates of both PIP components than the DLA equivalents.
This Government is also investing more in mental health than ever before – spending more than £11 billion this year.”
However, following two independent tribunal rulings that the Department for Work and Pensions (DWP) should expand the scope and eligibility criteria of PIP, which helps both in-work and out-of work disabled people fund their additional living costs,the government is rushing in an “urgent change”to the law to prevent many people with mental health conditions being awarded the mobility component of PIP. The court held that people with conditions such as severe anxiety can qualify for the enhanced rate of the mobility component, on the basis of problems with “planning and following a journey”, or “going out”.
The government’s new regulations will reverse the recent tribunal ruling and will mean that people with mental health conditions such as severe anxiety who can go outdoors, even if they need to have someone with them, are much less likely to get an award of even the standard rate of the PIP mobility component. The regulations also make changes to the way that the descriptors relating to taking medication are interpreted, again in response to a ruling by a tribunal in favour of disabled people.
The first tribunal said more points should be available in the “mobility” element for people who suffer “overwhelming psychological distress” when travelling alone. The second tribunal recommended more points in the “daily living” element for people who need help to take medication and monitor a health condition.
It’s worth noting that the Coalition Government enshrined in law a commitment to parity of esteem for mental and physical health in the Health and Social Care Act 2012. In January 2014 it published the policy paperClosing the Gap: priorities for essential change in mental health(Department of Health, 2014), which sets out 25 priorities for change in how children and adults with mental health problems are supported and cared for. The limiting changes to PIP legislation does not reflect that commitment.
PIP is defined by Capita, the private company employed by the government to carry out “functional assessments of disabled people as “a non means tested benefit for people with a long-term health condition or impairment, whether physical, sensory, mental, cognitive, intellectual, or any combination of these.” It is an essential financial support towards the extra costs that ill and disabled people face, to help them lead as socially and economically inclusive, active and independent lives as possible.
Who will be affected by the reversal of the tribunal rulings?
As I reported previously, from 16 March (today) the law will be changed so that the phrase “For reasons other than psychological distress” will be added to the start of descriptors c, d and f in relation to “Planning and following journeys” on the PIP form.
New guidelines circulated by the DWP instruct assessors to disregard the physical impact of mental illness, in relation to how the impairments affect a person’s mobility in completing a journey unaccompanied, which will effectively exclude them from eligibility to the higher mobility component of PIP.
This means that claimants with severe mental illness that impacts on their mobility will be refused the same level of financial support as people with physical disabilities.
It effectively means that people suffering with debilitating mental health conditions are to be denied equal access to the disability benefits system.
People with the following conditions are likely to be affected by the reversal of the independent tribunal’s ruling regarding PIP mobility awards, with conditions in the general category of “severe psychological distress”:
Mood disorders – Other / type not known, Psychotic disorders – Other / type not known, Schizophrenia, Schizoaffective disorder, Phobia – Social Panic disorder, Learning disability – Other / type not known, Generalized anxiety disorder, Agoraphobia, Alcohol misuse, Anxiety and depressive disorders – mixed Anxiety disorders – Other / type not known, Autism, Bipolar affective disorder (Hypomania / Mania), Cognitive disorder due to stroke, Cognitive disorders – Other / type not known, Dementia, Depressive disorder, Drug misuse, Stress reaction disorders – Other / type not known, Post-traumatic stress disorder (PTSD), Phobia – Specific Personality disorder, Obsessive compulsive disorder (OCD).
A case study is included in the new guidance, which says: “Sukhi has sought an award under mobility descriptor 1f as she cannot follow the route of a familiar journey without another person.
However, the [decision maker] determines that because of the wording of mobility descriptor 1f (“for reasons other than psychological distress, cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid”), any problems following the route due to psychological distress are not relevant.”
PIP consists of two separate components – a daily living component and a mobility element – each paying a standard or enhanced rate, with the enhanced rate paying more than the lower rate.
In response to the rulings, government have simply chosen to rewrite the law in a way that denies higher PIP payments for those claimants who would have benefited from the rulings, without consulting medical experts, disabled people, advocacy organisations and MPs – including the Work and Pensions parliamentary committee.
Responding to the new guidelines, Paul Farmer, chief executive of the mental health charity Mind, said: “The purpose of PIP is to cover the extra costs people incur because of a disability – decisions makers shouldn’t discriminate between disabilities on the basis of their cause, but decisions should be based on the impact of the disability.
People who struggle to leave the house without support may face the same costs whether their difficulties arise from, for example, a sensory disability or severe anxiety or other mental health problems.
Yet those making decisions about the level of support someone will receive will now be explicitly told to disregard those barriers if they are a result of someone’s mental health problem.”
He added: “This move undermines the Government’s commitment to look at disabled people as individuals, rather than labelling them by their condition, and completely goes against the Government’s commitment to putting mental health on an equal footing with physical health.
Meanwhile, the government’s own expert welfare advisors have said that the changes to PIP – affecting the mentally ill – should be delayed until they have been properly tested and “clearly understood”.
The Social Security Advisory Committee (SSAC) said in their report that they are “particularly concerned” that overturning the tribunal’s ruling will cause confusion. They warn it is “not clear” how assessors will interpret the changes, raising concerns over a real possibility that claimants will not be “consistently treated”.
The committee have disputed ministers’ claims that emergency legislation must be rushed through today, suggesting the feared increase in costs has been “over-hyped”.
The government claimed the tribunal ruling would cost at least £3.7bn over the next five years – money which should go to “really disabled people who need it”, according to one minister.
The committees’ damning conclusions have sparked angry exchanges in the Commons, with some Tory MPs joining Labour and the Liberal Democrats in criticising the impact of the PIP regulations on some of the most vulnerable citizens.
However, Damian Green, the Work and Pensions Secretary, refused to allow MPs to vote on the changes – insisting that was “above my pay grade”.
Green also acknowledged “a handful of people” could now have their PIP payments cut, having been awarded higher sums in the last few months.
Debbie Abrahams, Labour’s Work and Pensions spokeswoman, said that contradicted repeated assurances – including by Theresa May – that no disabled people would lose money, with only new claimants affected.
And she said: “The Government’s decision to change the law on PIP is a clear example of the way people with mental health conditions are not given equal treatment.”
The SSAC have urged the DWP to consider “testing the proposed changes with health care professionals and decision makers to ensure the policy intent behind the regulation is clearly understood”.
They concluded: “The department should both (a) consult more widely with representative bodies and health care professionals; and (b) improve the estimate of likely impact before the changes are introduced.”
Answering an urgent question in parliament, Mr Green insisted the SSAC was “not challenging the decision” to tighten the criteria for PIP.
But he added: “We think there may be a handful of people whose appeals have gone through the courts in this very, very small period.”
While “that money will not be clawed back from them” they would receive lower PIP payments once those appeals were struck out by the new regulations.
In their recent Equality Analysis PIP assessment criteria document, the government concede that: “Since PIP is a benefit for people with a disability, impairment or long-term health condition, any changes will have a direct effect on disabled people. The vast majority of people receiving PIP are likely to be covered by the definition of “disability” in the Equality Act 2010.
By definition, therefore, the UT [upper tribunal] judgment results in higher payments to disabled people, and reversing its effect will prevent that and keep payments at the level originally intended. The difference in income will clearly make a real practical difference to most affected claimants, and (depending on factors such as their other resources) is capable of affecting their ability to be independently mobile, access services etc – all matters covered by the UN Convention on the Rights of Persons with Disabilities as set out at the start of this Analysis.”
It goes on to say in the document: “However, this does not necessarily mean that the increased payments that would result from the judgment are a fair reflection of the costs faced by those affected, or represent a fair approach as between different groups of PIP claimants.”
I think it’s much less likely that the government’s decision to subvert the ruling of the upper tribunal reflects any consideration of a fair reflection of costs faced by those affected, or a “fair approach” between different groups of PIP claimants.
The purpose of Upper Tribunals
The government introduced the restrictive regulations after losing two cases at tribunals, showing an utter contempt for the UK judiciary system. However, the UK tribunal system is part of the national system of administrative justice.
Administrative law is the body of law that governs the activities of administrative agencies of government. It is designed to independently review the decisions of governments, and as such, it provides protection and promotion of fundamental rights and freedoms for citizens.
The Tribunals, Courts and Enforcement Act 2007 created a new unified structure for tribunals and recognises legally qualified members of tribunals as members of the judiciary of the United Kingdom who are guaranteed continued judicial independence. This means that the judiciary is kept discrete from other branches of government. That is so that courts are not subjected to improper influence from the other branches of government, or from private or partisan interests.
Judicial Independence is vital and important to the idea of separation of powers. The intent behind this concept is to prevent the concentration of political power and provide for checks and balances. It has been significantly influenced by judicial independence principles developed by international human rights constitutional documents. in the application of the European Convention on Human Rights in British law through the Human Rights Act 1998, which came into force in the UK in 2000.
The government’s new regulations are a particularly autocratic move, aimed at simply overturning two legal rulings that the government did not like, partly because their zealotry concerning their anti-welfarism and “small state” neoliberal ideology has been challenged. The regulations were ushered in and imposed so that they would not be subjected to parliamentary scrutiny and debate or democratic dialogue with disabled people or groups and organisations that support and advocate for those with disability.
I don’t make any money from my work. I am disabled because of illness and have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.
He’s not very bright our chancellor, is he? Self-employed people face an increase in their National Insurance (NI) contributions as the Chancellor says he wants to “tackle the unfair burden on people in employment”. Presumably he means self employed people are not in employment. Yet they certainly aren’t included in unemployment figures, either. Last time I checked, employment means “the state of having paid work.”
That’s yet another broken manifesto pledge.
Gutto Bebb, Conservative Welsh minister, hit out at the proposals and called on the Government to “apologise.” Iain Duncan Smith added his voice to calls for a rethink of proposed changes to the National Insurance contributions after Hammond suggested that Brexit is responsible for the Government’s tax raid – conveniently mentioning Brexit for the first time regarding his budget. But he later denied that self-employed workers were paying the price for Brexit. Hard to keep up with what passes as the Conservative brand of reasoning and justification. It certainly makes me feel dizzy and nauseous, that’s for sure.
Hammond could have simply reduced the rate of NI that employees pay instead. He’s a bit of a wally. We did have a period of economic growth last year, second to only Germany, apparently. Good old Tories, eh? Hurrah!
But I wonder who will benefit from that, assuming it’s really a growth in the economy? It won’t be disabled people claiming Personal Independence Payment (PIP) with severe psychological distress who can’t leave the house, that’s for sure. Or those suffering epilepsy, both types of diabetes and blackouts who need support with managing their treatments and monitoring their health conditions.
A period of Orwellian growth. The economy is currently being propped up by increasing personal debt.
All of these conditions in fact: Diabetes mellitus (category unknown), Diabetes mellitus Type 1 (insulin dependent), Diabetes mellitus Type 2 (non-insulin dependent), Diabetic neuropathy, Diabetic retinopathy, Disturbances of consciousness – Nonepileptic – Other / type not known, Drop attacks, Generalised seizures (with status epilepticus in last 12 months), Generalised seizures, (without status epilepticus in last 12 months), Narcolepsy, Non epileptic Attack disorder (pseudoseizures), Partial seizures (with status epilepticus in last 12 months), Partial seizures (without status epilepticus in last 12 months), Seizures – unclassified Dizziness – cause not specified, Stokes Adams attacks (cardiovascular syncope), Syncope – Other / type not known.
And these: Mood disorders – Other / type not known, Psychotic disorders – Other / type not known, Schizophrenia, Schizoaffective disorder, Phobia – Social Panic disorder, Learning disability – Other / type not known, Generalized anxiety disorder, Agoraphobia, Alcohol misuse, Anxiety and depressive disorders – mixed Anxiety disorders – Other / type not known, Autism, Bipolar affective disorder (Hypomania / Mania), Cognitive disorder due to stroke, Cognitive disorders – Other / type not known, Dementia, Depressive disorder, Drug misuse, Stress reaction disorders – Other / type not known, Post-traumatic stress disorder (PTSD), Phobia – Specific Personality disorder, Obsessive compulsive disorder (OCD).
What kind of government cuts support for those needing help to manage medication, monitor a health condition, or both?
What kind of government cuts mobility support for people who can’t leave the house alone?
It seems that most people who are actually ill won’t be eligible for PIP. I wonder which people the government have in mind when they say “those in greatest need”?
Oh, it’s the millionaires again. Phew! Silly me.
From the Equality Trust:
The poorest people lose out from the budget yet again, of course. The distribution of wealth won’t change, with many households in the lowest deciles being worse off. The graph above does not show the full extent of the difference between the richest and the rest of society. This is because the top 1% have incomes substantially higher than the rest of those in the top 10%. In 2012, the top 1% had an average income of £253,927 and the top 0.1% had an average income of £919,882.
If you earn a few hundred thousand, you are set to do rather well yet again from another Tory budget. It’s remarkable how those need it least always get the financial “incentive” isn’t it? Carrots for the fat cats. It’s the delux model of “incentives”.
Meanwhile those who need it most pay for those who need it least. Poor people get the budget premium “incentive”, which includes standing on the naughty step, and thinking about what you have not done.
The Tories like wielding a stout stick and giving out a good thrashing for those who dare to fall ill.
And just to clarify, social justice, equality and inclusion are NOT the same thing as work. They should exist independently of someone’s employment status. Otherwise, “inclusion” takes an Orwellian turn to the far right. We know from history that work doesn’t really set us free. People “enjoying the security and dignity of work” does not entail ensuring those who can’t work or who lost their job are utterly insecure, hungry or destitute.
The government’s “pledge” to increase adult social care funding is being paid for by increases in council tax, some of which will be paid by those previously exempted from council tax because they are sick, disabled or unemployed. Social security was originally calculated to meet only the cost of fuel and food on the assumption that people needing support would be exempt from rent and council tax. That no longer is the case.
The rises due to come into force from April will not be sufficient to avoid strapped for cash councils having to make deep cuts to essential services, including road repair, parks, children’s centres, leisure centres and libraries. All of this in a time of “economic growth”. It looks like austerity is to be a permanent feature of Conservative neoliberal policy-making.
For many families who are just about managing, the withdrawal of state support for those who are in low paid work is hardly an incentive to “make work pay”. Of course Hammond has ignored the scandal of in-work poverty. This is one of the other austerity measures that he has chosen to keep. Introducing sanctions for those claiming social security because their employers don’t pay them enough to live on is simply a big bully’s stick, which would be better aimed at exploitative and miserly big business employers. Fancy punishing people because profit driven businesses pay as little as possible.
It’s all the same peevish and spiteful mentality as “making work pay.” Instead of ensuring workers get a decent rate of pay, like you’d think from the Tory claim, the truly nasty party cut benefits and decided to impose punishing conditions on people who need state support indiscriminately, regardless of the reason, instead.
That’s pure upper class prejudice and malice.
And greed.
Meet Brexit, by the way, he’s the big elephant in the room, Mr Hammond
I don’t make any money from my work. I am disabled because of illness and have a very limited income. The budget didn’t do me any favours at all.
But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.
In a letter to the national news media, an organisation representing mental health professionals in the UK write:
“The Alliance for Counselling and Psychotherapy is a nationally recognised interest group of mental health professionals from diverse clinical and academic backgrounds.
In response to the latest Government attack on benefits claimants with mental health and physical disabilities, the Alliance (which is part of the Mental Wealth Alliance) has written to the press and to the major psy-organisations, who we call upon to take a much more critical stance on these issues.
Emergency legislation has over-ridden the rulings of two tribunals that the Department for Work and Pensions (DWP) should expand the reach of Personal Independence Payments (PIP). At stake is mobility support for over 140,000 people who suffer “overwhelming psychological distress” when travelling alone, and more than 1,000 people who need help to take medication and monitor a health condition.
The courts ruled both categories of support needed to be included in the PIP assessment of people’s needs. The DWP itself admits this will include for example those who have a learning disability, diabetes, epilepsy, anxiety or dementia.
In September 2016, Theresa May and her DWP ministers promised there would be no more welfare cuts on top of the string of draconian measures agreed last year as the final contribution of Cameron and Osborne’s campaign to punish those who cannot work. It seems her promise was another lie.
With delicious irony, Disabilities Minister Penny Mordaunt said this latest move would “make sure we are giving support to those who need it most”. Meanwhile on Marr this Sunday, Tory party chairman Patrick McGloughlin responded to criticism of the emergency legislation by stating “as far as supporting disabled people in this country is concerned, we do very proudly.
This is a government determined, come hell or high water, to strip welfare provision to the absolute bone, an ideological commitment it justifies in terms of the fiscal necessity of austerity savings and the therapeutic magic for all benefit claimants of getting themselves into work.
As mental health professionals, we find it tragic and painful to be living through a period in which the social contract between the advantaged and the disadvantaged is under full-frontal attack.
More particularly, we find it shameful that our own professional bodies – psychotherapists, counsellors, psychologists and psychiatrists – continue to participate in the abuse of human rights and of their own ethical codes through their involvement in the psycho-compulsion of benefits complainants through the DWP’s workfare and Work and Health policies.
We call on the government to reverse its policies of welfare cuts as a minimum step to honouring Theresa May’s promises for a fairer deal for those struggling to cope to maintain any decent conditions of life.
And we call upon our fellow ‘psy’ professionals to now insist on a withdrawal of all involvement in supporting the psychological coercion and punishment by the DWP of the most disadvantaged members of our society.
Yours sincerely,
Paul Atkinson and Professor Andrew Samuels (for the Alliance for Counselling and Psychotherapy)“
See both letters from the Alliance by clicking on the link below .
George Freeman, MP for Norfolk and chair of the Prime Minister’s Policy Board, has defended the government’s decision to subvert the judicial system, by disregarding the rulings of two independent tribunals concerning Personal Independence Payment (PIP) for disabled people.
In an interview on Pienaar’s Politics, on BBC 5 Live, Freeman said:
“These tweaks [new regulations to cut PIP eligibility] are actually about rolling back some bizarre decisions by tribunals that now mean benefits are being given to people who are taking pills at home, who suffer from anxiety”.
He claimed that the “bizarre” upper tribunal rulings meant that “claimants with psychological problems, who are unable to travel without help, should be treated in a similar way to those who are blind.”
He said: “We want to make sure we get the money to the really disabled people who need it.”
He added that both he and the Prime Minister “totally” understood anxiety, and went on to say: “We’ve set out in the mental health strategy how seriously we take it.”
He said: “Personal Independence Payments reforms were needed to roll back the bizarre decisions of tribunals.”
Freeman’s controversial comments about people with anxiety “at home taking pills” implies that those with mental health problems are faking their disability. He trivialises the often wide-ranging disabling consequences of mental ill health, and clearly implies that he regards mental illnesses as somehow not “real” disabilities.
His comments contradict the government’s pledge to ensure that mental health and physical health are given a parity of esteem, just months after the Prime Minister pledged to take action to tackle the stigma around mental health problems.
Yet people with the following mental health conditions are likely to be affected by the reversal of the Independent Tribunal’s ruling on PIP mobility awards – those in particular who suffer “overwhelming psychological distress” when travelling alone:
Mood disorders – Other / type not known, Psychotic disorders – Other / type not known, Schizophrenia, Schizoaffective disorder, Phobia – Social Panic disorder, Learning disability – Other / type not known, Generalized anxiety disorder, Agoraphobia, Alcohol misuse, Anxiety and depressive disorders – mixed Anxiety disorders – Other / type not known, Autism, Bipolar affective disorder (Hypomania / Mania), Cognitive disorder due to stroke, Cognitive disorders – Other / type not known, Dementia, Depressive disorder, Drug misuse, Stress reaction disorders – Other / type not known, Post-traumatic stress disorder (PTSD), Phobia – Specific Personality disorder, Obsessive compulsive disorder (OCD).
Note that some of the listed conditions have known physiological causes, too, such as “Cognitive disorder due to stroke”, whereas Agoraphobia, “Stress reaction disorders”, PTDS, some anxiety and depressive disorders, substance use and PTDS, for example, most often arise because of context, circumstances, events and experiences, whilst the aetiology of some of the other listed conditions is not yet clearly understood by medical experts.
Regardless of the cause of an illness, it is not possible or appropriate to use constructed and arbitrary taxonomies and hierarchical ranks of disability to decide in advance of an assessment how those conditions negatively impact on disabled people’s capacity to live their lives, to perform tasks, their dignity, social inclusion and independence. Freeman’s generalisation was therefore completely inappropriate.
Freeman’s comments signposted the Conservative’s “deserving” and “undeserving” narrative, implying that some disabled people are faking their illnesses. However, disabled people do not “cheat” the social security system: the system has been redesigned by the government to cheat disabled people.
Criticism
Despite some scathing comments and challenges from the opposition, Freeman maintains: “My point was that these PIP reforms are partly about rolling back some frankly bizarre decisions in tribunals which have seen money that should go to the most disabled spent on people with really much less urgent conditions.”
The chief executive of Scope, Mark Atkinson. said: “It is unhelpful to make crude distinctions between those with physical impairments and mental health issues because the kind of impairment someone has is not a good indicator of the costs they will face.
Many disabled people will be now be anxiously waiting to hear as to whether or not these tighter rules will affect their current PIP award.
The government must offer clarity and reassurance that these new measures will not negatively affect the financial support that disabled people receive now or in the future, and that they stand by their commitment to making no further changes to disability benefits in this Parliament.”
Debbie Abrahams MP, Shadow Work and Pensions Secretary has also responded to the comments by Freeman. She said:
“Mr Freeman must immediately apologise for the comments he made regarding sick and disabled people.
Freeman dismissed the needs of people with mental health conditions saying support should go to “really disabled people” rather than those who are “taking pills at home, who suffer from anxiety.
Not only does this fly in the face of the commitment to ‘parity of esteem’ for people with mental health conditions, but it directly contradicts Theresa May’s comments on mental health and two recent tribunal judgements.”
The Shadow Chancellor, John McDonnell, has called on Philip Hammond not to go ahead with the £3.7bn worth of cuts to PIP which will hit 160,000 disabled people.
The announcement about the two controversial regulations to be imposed without any parliamentary scrutiny and debate, and without any democratic dialogue with disabled people, was sneaked out last week by the government. It will mean 160,000 disabled people are likely to see a loss in their income as a direct effect of the changes made by the government to how PIP is awarded.
“Theresa May has used the cover of the by-elections to sneak out this announcement hurting so many vulnerable disabled people.
His is a return to the worst politics of spin that so tarnished our politics for so long. It is an act of immense bad faith. She is degrading politics and demeaning the role of Prime Minister.
Next week the Tories will make out that the economy and the public finances are doing better, however, they are planning to go ahead with a £3.7 billion cut to the disabled.
This time last year when the economy and public finances were not doing as well, and the then Chancellor George Osborne tried to cut PIP, Labour stopped him. And in his u-turn he claimed that he could “absorb” the cost of reversing this cut.
Hammond can’t hide from these PIP cuts in his Budget. He needs to explain why he can’t absorb them like his predecessor while he is still going ahead with tax giveaways to the very wealthiest in our country.”
But cutting PIP may cost more than it will save.
PIP is an in-work benefit as well as being accessible to disabled people out of work. Cutting PIP will invariably mean that some disabled people can no longer remain sufficiently independent to work. Many have lost their higher mobility rate component when they were reassessed for PIP after claiming Disability Living Allowance (DLA), and as a consequence, have lost their motability vehicles – which includes wheelchairs as well as specially adapted cars – leaving many completely housebound and unable to work.
The mental-physical illness distinction is a false dichotomy
It’s not appropriate to dichotomise mental and physical illness, as they are not clearly distinct. Most people would probably recognise that trauma, anxiety and stress can exacerbate illnesses that have a clear physiological basis. However, illnesses that have clearly defined “physical” symptoms can often also cause mental illness. Depression resulting from dealing with chronic pain and adapting to progressive illness and increasing disability is one example of the overlap between the physical and mental dimensions of illness.
I have lupus, which is an autoimmune illness that potentially progressively damages the joints, tendons, muscles, nerves, skin, eyes, blood cells, capacity to fight infections, heart, lungs, kidneys, stomach and liver. And the brain.
Most people with lupus complain of severe headaches, cognitive dysfunction, short-term memory loss and often, coordination difficulties. However, some suffer from depression and anxiety as a direct consequence of inflammatory changes in the brain, and some people also experience mood disorders. Other forms of neuropsychiatric lupus include psychosis, seizures, stroke and vascular dementia, chorea and cerebrovascular disease. There is often no clear boundary between the mental and physical symptoms of illness.
Health and wellbeing have socioeconomic determinants
Another important consideration is the context in which people live, this also has a significant impact on health and wellbeing. There isan extremely unequal distribution of power and wealth in the UK. There are also corresponding unequal distributions of opportunity, health and psychological wellbeing, inclusion, human rights and citizen freedoms more generally, such as freedom of choice and participation in democracy.
Precarity and anxiety directed by the state through targeted and discriminatory policies at the poorest citizens mediates and maintains a repressive state–citizen power relationship.
There is also an emerging and clear “cognitive” hierarchy: those in positions of power are formulating policies that are premised on a fundamental assumption that poverty happens because of something that poor people don’t do, or that they do “wrong”, and this happens because of cognitive errors and “wrong” behaviours and attitudes. The assumption, of course, is that the policy decision-makers are more cognitively and behaviourally competent than those they are “nudging” to change their thinking and behaviour.
However, we know that an economic system founded on mythical “market forces, an even more mythical meritocracy – amongst other just-world fallacies – and competitive individualism, which sets citizen groups fighting for increasingly scarce resources, creates just a few “winners”(around 1%) and many more who are dispossessed (99%).
Policies controversially aimed at “correcting behaviours” are increasingly punitive (benefit sanctions, increased welfare conditionality generally and restrictions on child tax credits are examples of the government’s behaviourist approach) that draw on psychosocial dynamics – imported from techniques of persuasion at the low end of the advertising industry – build and reproduce socioeconomic hierarchies, not only materially, but through dominant discursive practices, and also through inflicting precarity and perpetual anxiety on those people who have the least share of national wealth.
It’s remarkable that a government that claims “work is beneficial to health” also fail to recognise the impact of neoliberal socioeconomic organisation, prejudiced political narratives and draconian policies, the relationship between growing inequality and increasing poverty, and how this toxic context has a detrimental effect on people’s physical health and psychological wellbeing.
The Conservatives are so busy diverting public attention, and pointing out what they think those people who need mitigation from the worst ravages of neoliberalism are “doing wrong”, they fail to recognise and acknowledge what it is that the government is doing wrong.
When people are attacked, oppressed and controlled psychologically by a so-called democratic government that embeds punishment at the heart of public policies to target the poorest citizens, it’s hardly surprising they become increasingly ill.
I don’t make any money from my work. I am disabled because of illness and often struggle as have a very limited income. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.
Politics and Insights 