Category: Sickness and Disability

Initial thoughts on the work, health and disability green paper

November 6, 2016November 15, 2017 · 68 Comments ·

I’ve read the government’s Work, health and disability green paper: improving lives and consultation from end to end. It took me a while, because I am ill and not always able to work consistently, reliably and safely. It’s also a very long and waffling document. I am one of those people that the proposals outlined in this green paper is likely to affect. I read the document very carefully.

Here are a few of my initial thoughts on what I read. It’s organised as best I can manage, especially given the fact that despite being dismally unsurprised, I am scathing.

The context indicates the general intent

“The fact is that Ministers are looking for large savings at the expense of the poorest and most vulnerable. That was not made clear in the general election campaign; then, the Prime Minister said that disabled people would be protected.” – Helen Goodman, MP for Bishop Auckland, Official Report, Commons, 2/3/16; cols. 1052-58.

I always flinch when the government claim they are going to “help” sick and disabled people into work. That usually signals further cuts to lifeline support and essential services are on the way, and that the social security system is going to be ground down a little further, to become the dust of history and a distant memory of a once civilised society.

If the government genuinely wanted to “help” sick and disabled people into work, I’m certain they would not have cut the Independent Living Fund, which has had a hugely negative impact on those trying their best to lead independent and dignified lives, and the Access To Work funding has been severely cut, this is also a fund that helps people and employers to cover the extra living costs arising due to disabilities that might present barriers to work.

The government also made the eligibility criteria for Personal Independence Payment (PIP) – a non-means tested out-of- work and an in-work benefit – much more difficult to meet, in order to simply reduce successful claims and cut costs. This has also meant that thousands of people have lost their motability vehicles and support.

Earlier this year, it was estimated at least 14,000 disabled people have had their mobility vehicle confiscated after the changes to benefit assessment, which are carried out by private companies.

Under the PIP rules, thousands more people who rely on this support to keep their independence are set to lose their vehicles – specially adapted cars or powered wheelchairs. Many had been adapted to meet their owners’ needs and many campaigners warn that it will lead to a devastating loss of independence for disabled people.

A total of 45% or 13,900 people, were deemed as not needing the higher rate of PIP, and therefore lost their vehicles after reassessment. And out of the 31,200 people who were once on the highest rate of Disability Living Allowance (DLA) who have been reassessed, just 55%, or 17,300 – have kept their car.

In 2012, Esther McVey, then the Minister for people with disabilities, as good as admitted there are targets to reduce or remove eligibility for the new disability benefit PIP, which was to replace DLA. How else could she know in advance of people’s reassessment that “330,000 of claimants are expected to either lose their benefit altogether or see their payments reduced“ as she had informed the House of Commons.

This was a clear indication that the new assessment framework was designed to cut support for disabled people. A recent review led the government to conclude that PIP doesn’t currently fulfil the original policy intent, which was to cut costs and “target” the benefit to an ever-shrinking category of “those with the greatest need.”

The Government was twice defeated in the Lords over their proposals to cut Employment and Support Allowance (ESA) for sick and disabled people in the work related activity group (WRAG) from £103 to £73. However the £30 a week cut is to go ahead after bitterly disappointed and angry peers were left powerless to continue to oppose the Commons, which has overturned both defeats.

The government hammered through the cuts of £120 a month to the lifeline income of ill and disabled people by citing the “financial privilege” of the Commons, and after Priti Patel informing the Lords, with despotic relish, that they had “overstepped their mark” in opposing the cuts twice.

A coalition of 60 national disability charities condemned the government’s cuts to benefits as a “step backwards” for sick and disabled people and their families. The Disability Benefits Consortium said that the cuts, which will see people lose up to £1,500 a year, will leave disabled people feeling betrayed by the government and will have a damaging effect on their health, finances and ability to find work.

Research by the Consortium suggests the low level of benefit is already failing to meet disabled people’s needs. A survey of 500 people in the affected group found that 28 per cent of people had been unable to afford to eat while in receipt of the benefit. Around 38 per cent of respondents said they had been unable to heat their homes and 52 per cent struggled to stay healthy.

Watching the way the wind blows

Earlier this year I wrote that a government advisor, who is a specialist in labor economics and econometrics, has proposed scrapping all ESA sickness and disability benefits. Matthew Oakley, a senior researcher at the Social Market Foundation, recently published a report entitled Closing the gap: creating a framework for tackling the disability employment gap in the UK, in which he proposes abolishing the ESA Support Group.

To meet extra living costs because of disability, Oakley says that existing spending on PIP and the Support Group element of ESA should be brought together to finance a new extra costs benefit. Eligibility for this benefit should be determined on the basis of need, with an assessment replacing the WCA and PIP assessment.

I think the word “need” is being redefined to meet politically defined neoliberal economic outcomes.

Oakely also suggests considering a “role that a form of privately run social insurance could play in both increasing benefit generosity and improving the support that individuals get to manage their conditions and move back to work.”

I’m sure the rogue company Unum would jump at the opportunity. Steeped in controversy, with a wake of scandals that entailed the company denying people their disabilty insurance, in 2004, Unum entered into a regulatory settlement agreement (RSA) with insurance regulators in over 40 US states. The settlement related to Unum’s handling of disability claims and required the company “to make significant changes in corporate governance, implement revisions to claim procedures and provide for a full re-examination of both reassessed claims and disability insurance claim decisions.

The company is the top disability insurer in both the United States and United Kingdom. By coincidence, the company has been involved with the UK’s controversial Welfare Reform Bill, advising the government on how to cut spending, particularly on disability support. What could possibly go right?

For people with Parkinson’s disease, rheumatoid arthritis, lupus and multiple sclerosis, cancer and kidney failure, for example, mind over matter doesn’t fix those problems, positive thinking and sheer will power cannot cure these illnesses, sadly. Nor does refusing to acknowledge or permit people to take up a sick role, or imposing benefit conditionality and coercive policies to push chronically ill people into work by callous, insensitive and inept and often medically unqualified assessors, job advisors and ministers.

The Reform think tank has also recently proposed scrapping what is left of the disability benefit support system, in their report Working welfare: a radically new approach to sickness and disability benefits and has called for the government to set a single rate for all out of work benefits and reform the way sick and disabled people are assessed.

The Reform think tank proposes that the government should cut the weekly support paid to 1.3 million sick and disabled people in the ESA Support Group from £131 to £73. This is the same amount that Jobseeker’s Allowance claimants receive. It is claimed that the cut will somehow “incentivise” those people to find work, as if they simply lack motivation, rather than being ill and disabled. However, those people placed in the Support Group after assessment have been deemed by the state as unlikely to be able to work again in the near future, many won’t be able to work again. It would therefore be very difficult to justify this proposed cut, given the additional needs that disabled people have, which is historically recognised, and empirically verified by research.

The report recommended savings which result from removing the disability-related additions to the standard allowance should be reinvested in support services and extra costs benefits – PIP. However, as outlined, the government have ensured that eligibility for that support is rapidly contracting, with the ever-shrinking political and economic re-interpretation of medically defined sickness and disability categories and a significant reduction in what the government deem to be a legitimate exemption from being “incentivised” into hard work.

The current United Nations investigation into the systematic and gross violations of the rights of disabled people in the UK because of the Conservative welfare “reforms” is a clear indication that there is no longer any political commitment to supporting disabled people in this country, with the Independent Living Fund being scrapped by this government, ESA for the work related activity group (WRAG) cut back, PIP is becoming increasingly very difficult to access, and now there are threats to the ESA Support Group. The Conservative’s actions have led to breaches in the CONVENTION on the RIGHTS of PERSONS with DISABILITIES – CRPD articles 4, 8, 9, 12, 13, 14, 15, 17, and especially 19, 20, 27 and 29 (at the very least.)

There are also probable violations of articles 22, 23, 25, 30, 31.

The investigation began before the latest round of cuts to ESA were announced. That tells us that the government is unconcerned their draconian policies violate the human rights of sick and disabled people.

And that, surely, tells us all we need to know about this government’s intentions.

Coercing those deemed to ill to work into work. It’s not “nudge”: it’s psycho-compulsion

The casual discussion in the green paper about new mandatory “health and work conversations” in which work coaches will use “specially designed techniques” to “help” some ESA claimants “identify their health and work goals, draw out their strengths, make realistic plans, and build resilience and motivation” is also cause for some concern.

Apparently these conversations were “co-designed with disabled people’s organisations and occupational health professionals and practitioners and the Behavioural Insights Team – the controversial Nudge Unit, which is part-owned by the Cabinet Office and Nesta.

Most people who read my work regularly will know by now that I am one of the staunchest critics of nudge, which is being used as an antidemocratic, technocratic, pseudoscientific political tool to provide a prop and disguise for controversial neoliberal policies. It’s very evident that “disabled people’s organisations” were not major contributors to the design. It’s especially telling that those people to be targeted by this “intervention” were completely excluded from the conversation. Sick and disabled people are reduced to objects of public policy, rather than being seen as citizens and democratic subjects capable of rational dialogue.

John Pring at Disability News Service (DNS) adds: “Grassroots disabled people’s organisations (DPOs) have criticised the government’s decision to exclude them from an event held to launch its new work, health and disability green paper.

The event for “stakeholders” was hosted by the disability charity Scope at its London headquarters, and attended by Penny Mordaunt, the minister for disabled people.

The Department for Work and Pensions (DWP) said in its invitation – it turned down a request from Disability News Service to attend – that the event would “start the consultation period” on its green paper, Improving Lives.

It said that it was “launching a new conversation with disabled people and people with health conditions, their representatives, healthcare professionals and employers”.

But DWP has refused to say how many disabled people’s user-led organisations were invited to the event, and instead suggested that DNS submit a freedom of information request to find out.
But DNS has confirmed that some of the most prominent user-led organisations with the strongest links to disabled people were not invited to the launch, including Shaping Our Lives, Inclusion London, Equal Lives, People First (Self Advocacy) and Disabled People Against Cuts.”

For further discussion of the policy context leading up to the green paper, see The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work from October 2015.

Also see G4S are employing Cognitive Behavioural Therapists to deliver “get to work therapy” and Stephen Crabb’s obscurantist approach to cuts in disabled people’s support and also Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records from earlier this year.

The dismal and incoherent contents of the green paper were entirely predictable.

The Conservatives claim work is a “health” outcome: crude behaviourism

A Department for Work and Pensions research document published back in 2011 – Routes onto Employment and Support Allowance – said that if people believed that work was good for them, they were less likely to claim or stay on disability benefits.

It was then decided that people should be “encouraged” to believe that work was “good” for health. There is no empirical basis for the belief, and the purpose of encouraging it is simply to cut the numbers of disabled people claiming ESA by “encouraging” them into work. Some people’s work is undoubtedly a source of wellbeing and provides a sense of purpose. That is not the same thing as being “good for health”. For a government to use data regarding opinion rather than empirical evidence to claim that work is “good” for health indicates a ruthless mercenary approach to a broader aim of dismantling social security.

From the document: “The belief that work improves health also positively influenced work entry rates; as such, encouraging people in this belief may also play a role in promoting return to work.”

The aim of the research was to “examine the characteristics of ESA claimants and to explore their employment trajectories over a period of approximately 18 months in order to provide information about the flow of claimants onto and off ESA.”

The document also says: “Work entry rates were highest among claimants whose claim was closed or withdrawn suggesting that recovery from short-term health conditions is a key trigger to moving into employment among this group.”

“The highest employment entry rates were among people flowing onto ESA from non-manual occupations. In comparison, only nine per cent of people from non-work backgrounds who were allowed ESA had returned to work by the time of the follow-up survey. People least likely to have moved into employment were from non-work backgrounds with a fragmented longer-term work history. Avoiding long-term unemployment and inactivity, especially among younger age groups, should, therefore, be a policy priority. ”

“Given the importance of health status in influencing a return to work, measures to facilitate access to treatment, and prevent deterioration in health and the development of secondary conditions are likely to improve return to work rates”

Rather than make a link between manual work, lack of reasonable adjustments in the work place and the impact this may have on longer term ill health, the government chose instead to promote the cost-cutting irrational belief that work is a “health” outcome. Furthermore, the research does conclude that health status itself is the greatest determinant in whether or not people return to work. That means that those not in work are not recovered and have longer term health problems that tend not to get better.

Work does not “cure” ill health. To mislead people in such a way is not only atrocious political expediency, it’s actually downright dangerous.

As neoliberals, the Conservatives see the state as a means to reshape social institutions and social relationships based on the model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged. Social groups that don’t conform to ideologically defined economic outcomes are stigmatised and outgrouped.

Othering and outgrouping have become common political practices, it seems.

Stigma is a political and cultural attack on people’s identities. It’s used to discredit, and as justification for excluding some groups from economic and political consideration, refusing them full democratic citizenship.

Stigma is being used politically to justify the systematic withdrawal of support and public services for the poorest – the casualties of a system founded on competition for allegedly scarce wealth and resources. Competition inevitably means there are winners and losers. Stigma is profoundly oppressive.

It is used as a propaganda mechanism to draw the public into collaboration with the state, to justify punitive and discriminatory policies and to align citizen “interests” with rigid neoliberal outcomes. Inclusion, human rights, equality and democracy are not compatible with neoliberalism.

Earlier this year, I said: The Conservatives have come dangerously close to redefining unemployment as a psychological disorder, and employment is being redefined as a “health outcome.” The government’s Work and Health programme involves a plan to integrate health and employment services, aligning the outcome frameworks of health services, Improving Access To Psychological Therapies (IAPT), Jobcentre Plus and the Work Programme.

But the government’s aim to prompt public services to “speak with one voice” is founded on questionable ethics. This proposed multi-agency approach is reductive, rather than being about formulating expansive, coherent, comprehensive and importantly, responsive provision.

This is psychopolitics, not therapy. It’s all about (re)defining the experience and reality of a social group to justify dismantling public services (especially welfare), and that is form of gaslighting intended to extend oppressive political control and micromanagement. In linking receipt of welfare with health services and “state therapy,” with the single intended outcome explicitly expressed as employment, the government is purposefully conflating citizen’s widely varied needs with economic outcomes and diktats, isolating people from traditionally non-partisan networks of relatively unconditional support, such as the health service, social services, community services and mental health services.

Public services “speaking with one voice” will invariably make accessing support conditional, and further isolate already marginalised social groups. It will damage trust between people needing support and professionals who are meant to deliver essential public services, rather than simply extending government dogma, prejudices and discrimination.

Conservatives really seem to believe that the only indication of a person’s functional capacity, value and potential is their economic productivity, and the only indication of their moral worth is their capability and degree of willingness to work. But unsatisfactory employment – low-paid, insecure and unfulfiling work – can result in a decline in health and wellbeing, indicating that poverty and growing inequality, rather than unemployment, increases the risk of experiencing poor mental and physical health. People are experiencing poverty both in work and out of work.

Moreover, in countries with an adequate social safety net, poor employment (low pay, short-term contracts), rather than unemployment, has the biggest detrimental impact on mental health.

There is ample medical evidence (rather than the current raft of political dogma) to support this account. (See the Minnesota semistarvation experiment, for example. The understanding that food deprivation in particular dramatically alters cognitive capacity, emotions, motivation, personality, and that malnutrition directly and predictably affects the mind as well as the body is one of the legacies of the experiment.)

Systematically reducing social security, and increasing conditionality, particularly in the form of punitive benefit sanctions, doesn’t “incentivise” people to look for work. It simply means that people can no longer meet their basic physiological needs, as benefits are calculated to cover only the costs of food, fuel and shelter.

Food deprivation is closely correlated with both physical and mental health deterioration. Maslow explained very well that if we cannot meet basic physical needs, we are highly unlikely to be able to meet higher level psychosocial needs. The government proposal that welfare sanctions will somehow “incentivise” people to look for work is pseudopsychology at its very worst and most dangerous.

In the UK, the government’s welfare “reforms” have further reduced social security support, originally calculated to meet only basic physiological needs, which has had an adverse impact on people who rely on what was once a social safety net. Poverty is linked with negative health outcomes, but it doesn’t follow that employment will alleviate poverty sufficiently to improve health outcomes.

In fact record numbers of working families are now in poverty, with two-thirds of people who found work in 2014 taking jobs for less than the living wage, according to the annual report from the Joseph Rowntree Foundation a year ago.

Essential supportive provision is being reduced by conditionally; by linking it to such a narrow outcome – getting a job – and this will reduce every service to nothing more than a political semaphore and service provision to a behaviour modification programme based on punishment, with a range of professionals being politically co-opted as state enforcers.

The Government is intending to “signpost the importance of employment as a health outcome in mandates, outcomes frameworks, and interactions with Clinical Commissioning Groups.”

I have pointed out previously that there has never been any research that demonstrates unemployment is a direct cause of ill health or that employment directly improves health, and the existing studies support the the idea that the assumed causality between unemployment and health may actually run in the opposite direction. It’s much more likely that inadequate social security support means that people cannot meet all of their basic survival needs (food, fuel and shelter), and that contributes significantly to poor health outcomes.

It’s not that unemployment is causing higher ill health, but that ill health and discrimination are causing higher unemployment. If it were unemployment causing ill health, at a time when the government assures us that employment rates are currently “the highest on record,” why are more people becoming sick?

The answer is that inequality and poverty have increased, and these social conditions, created by government policies, have long been established by research as having a correlational relationship with increasing mental and physical health inequalities.

For an excellent, clearly written and focused development of these points, the problem of “hidden” variables and political misinterpretation, see Jonathan Hulme’s Work won’t set us free.

Semantic thrifts: being Conservative with the truth

Prior to 2010, cutting support for sick and disabled people was unthinkable, but the “re-framing” strategy and media stigmatising campaigns have been used by the Conservatives to systematically cut welfare, push the public’s normative boundaries and to formulate moralistic justification narratives for their draconian policies. Those narratives betray the Conservative’s intentions.

Not enough people have questioned what it is that Conservatives actually mean when they use words like “help”, “support”, and “reform” in the context of government policies aimed at disabled people. Nor have they wondered where the evidence of “help” and “support” is hiding. If you sit on the surface of Conservative rhetoric and the repetitive buzzwords, it all sounds quite reasonable, though a little glib.

If you scrutinise a little, however, you soon begin to realise with horror that Orwellian-styled techniques of neutralisation are being deployed to lull you into a false sense of security: the ideologically directed intentions behind the policies and the outcomes and consequences are being hidden or “neutralised” by purposefully deceptive, misdirectional political rhetoric. It’s a kind of glittering generalities tokenism ; a superficial PR ritual of duplicitous linguistic detoxification, to obscure deeply held traditional Conservative prejudices and ill intent.

Rhetoric requires the existence of an audience and an intent or goal in the communication. Once you stand back a little, you may recognise the big glaring discrepancies between Conservative chatter, policies, socioeconomic reality and people’s lived experiences. At the very least, you begin to wonder when the conventional ideological interests of the Conservatives suddenly became so apparently rhetorically progressive, whilst their policies have actually become increasingly authoritarian, especially those directed at the most disadvantaged social groups.

The ministerial foreword from Damian Green, Secretary of State for Work and Pensions and Jeremy Hunt, Secretary of State for Health, is full of concern that despite the claim that “we have seen hundreds of thousands more disabled people in work in recent years”, there are simply too many sick and disabled people claiming ESA.

They say: “We must highlight, confront and challenge the attitudes, prejudices and misunderstandings that, after many years, have become engrained in many of the policies and minds of employers, within the welfare state, across the health service and in wider society. Change will come, not by tinkering at the margins, but through real, innovative action. This Green Paper marks the start of that action and a far-reaching national debate, asking: ‘What will it take to transform the employment prospects of disabled people and people with long-term health conditions?’”

I think mention of the “engrained attitudes, prejudices and misunderstandings within the welfare state and across the health service” is the real clue here about intent. What would have been a far more authentic and reassuring comment is “we have met with disabled people who have long-term health conditions and asked them if they feel they can work, and what they need to support them if they can.”

Instead, what we are being told via subtext is that we are wrong as a society to support people who are seriously ill and disabled by providing civilised health and social care, social security and exempting them from work because they are ill or injured.

Ministers say: “Making progress on the government’s manifesto ambition to halve the disability employment gap is central to our social reform agenda by building a country and economy that works for everyone, whether or not they have a long-term health condition or disability. It is fundamental to creating a society based on fairness [..] It will also support our health and economic policy objectives by contributing to the government’s full employment ambitions, enabling employers to access a wider pool of talent and skills, and improving health.”

I think that should read: “By building a country where everyone works for the [politically defined] economy.”

There’s patronising discussion of how disabled people should be “allowed to fulfil their potential”, and that those mythic meritocratic principles of talent determination and aspiration should be “what counts”, rather than sickness and disability. There are some pretty gaping holes in the logic being presented here. It is assumed that prejudice is the reason why sick and disabled people don’t work.

But it’s true that many of us cannot work because we are too ill, and the green paper fails to acknowledge this fundamental issue.

Instead “inequality” has been redefined strictly in terms of someone’s employment status, rather than as an unequal social distribution of wealth, resources, power and opportunities. All of the responsibility and burden of social exclusion and unemployment is placed on sick and disabled people, whilst it is proposed that businesses are financially rewarded for employing us.

Furthermore, it’s a little difficult to take all the loose talk seriously about the “injustice” of ill people not being in work, or about meritocratic principles and equal opportunities, when it’s not so long ago that more than one Conservative minister expressed the view that disabled people should work for less than the minimum wage. This government have made a virtue out of claiming they are giving something by taking something away. For example, the welfare cuts have been casually re-named reforms in Orwellian style. We have yet to see how cutting the lifeline benefits of the poorest people, and imposing harsh sanctioning can possibly be an improvement for them, or how it is helping them.

The Conservatives are neoliberal fundamentalists, and they have supplanted collective, public values with individualistic, private values of market rationality. They have successfully displaced established models of welfare provision and state regulation through policies of privatisation and de-regulation and have shifted public focus, instigating various changes in subjectivity, by normalising individualistic self-interest, entrepreneurial values, and crass consumerism. And increasing the social and material exclusion of growing numbers living in absolute poverty.

Basically, the Tories tell lies to change perceptions, divert attention from the growing wealth inequality manufactured by their own policies, by creating scapegoats.

Another major assumption throughout the paper is that disabled people claiming ESA are somehow mistaken in assuming they cannot work: “how can we improve a welfare system that leaves 1.5 million people – over 60% of people claiming Employment and Support Allowance – with the impression they cannot work and without any regular access to employment support, even when many others with the same conditions are flourishing in the labour market? How can we build a system where the financial support received does not negatively impact access to support to find a job? How can we offer a better user experience, improve system efficiency in sharing data, and achieve closer alignment of assessments?”

The government’s brand of armchair pseudo-psychology, propped up by the Nudge Unit, is used to justify increasingly irrational requirements being embedded in policy. The government intend to merge health and employment services, redefining work as a clinical health outcome. According to the government, the “cure” for unemployment due to illness and disability and sickness absence from work, is… work.

The new work and health programme, “support” for disabled people, is actually just another workfare programme. We know that workfare tends to decrease the likelihood of people finding work.

Work is the only politically prescribed “route out of poverty” for disabled people, including those with mental distress and illness, regardless of whether or not they are actually well enough to work. In fact the government implicitly equates mental health with economic productivity. Work will set us free. Yet paradoxically, disabled people haven’t been and won’t be included in the same economic system which is responsible for their exclusion in the first place.

Competitive market economies exclude marginalised groups, that’s something we ought to have learned from the industrial capitalism of the last couple of centuries. GPs inform us that employers are not prepared to make the necessary inclusive workplace adjustments sick and disabled people often need to work.

But in a dystopic Orwellian world where medical sick notes have been  politically redefined as ”fit notes”, sick and disabled people are no longer exempt from work, which is now held to be a magic “cure”. People are already being punished and coerced into taking any available job, regardless of its appropriateness, in an increasingly competitive and exclusive labor market.

The nitty gritty

You know the government are riding the fabled rubber bicycle when they calmly propose coercing the most disabled and ill citizens who are deemed unlikely to work by their doctors and the state (via the Work Capability Assessment) into performing mandatory work-related activities and finding jobs. Previously, only those assessed as possibly capable of some work in the future and placed in the Work Related Activity Group (WRAG) were expected to meet behavioural conditionality in return for their lifeline support.

However, the government have cut the WRAG component of Employment and Support Allowance (ESA) – another somewhat Orwellian name for a sickness and disability benefit – so that this group of people, previously considered to have additional needs because of their illness and disability, are no longer supported to meet the extra costs they face. The ESA WRAG rate of pay is now to be the same as Job Seeker’s Allowance.

If the government make work related activity mandatory for those people in the ESA Support Group, it will mean that very sick and disabled people will be sanctioned for being unable to comply and meet conditionality. This entails the loss of their lifeline support. The government have the cheek to claim that they will “protect and support” the most vulnerable citizens.

Hello, these ARE among our most vulnerable citizens. That’s why they were placed in the ESA support group in the first place.

Apparently, sick citizens are costing too much money. Our NHS is “overburdened” with ill people needing healthcare, our public services are “burdened” with people needing… public services. It is claimed that people are costing employers by taking time off work when they are ill. How very dare they.

Neoliberals argue that public services present moral hazards and perverse incentives. Providing lifeline support to meet basic survival requirements is seen as a barrier to the effort people put into searching for jobs. From this perspective, the social security system, which supports the inevitable casualties of neoliberal free markets, has somehow created those casualties. But we know that external, market competition-driven policies create a few “haves” and many “have-nots.” This is why the  welfare state came into being, after all – because when we allow such competitive economic dogmas to manifest without restraint, we must also concede that there are always ”winners and losers.”

Neoliberal economies organise societies into hierarchies.The UK currently ranks highly among the most unequal countries in the world.

Inequality and poverty are central features of neoliberalism and the causes of these sociopolitical problems therefore cannot be located within individuals.

The ESA Support Group includes people who are terminally ill, and those with degenerative illnesses, as well as serious mental health problems. It’s suggested that treating this group of people with computer based Cognitive Behaviour Therapy (cCBT), and addressing obesity, alcohol and drug dependence will “help” them into work.

Ministers claim that this group merely have a “perception” that they can’t work, and that they have been “parked” on benefits. It is also implied that illness arises mostly because of lifestyle choices.

Proposals include a punitive approach to sick and disabled people needing support, whilst advocating financial rewards for employers and businesses who employ sick and disabled people.

And apparently qualified doctors, the public and our entire health and welfare systems have ingrained “wrong” ideas about sickness and disability, especially doctors, who the government feels should not be responsible for issuing the Conservatives recent Orwellian “fit notes” any more, since they haven’t “worked” as intended and made every single citizen economically productive from their sick beds.

So, a new “independent” assessment and private company will most likely soon have a lucrative role to get the government “the right results”.

Meanwhile health and social care is going to be linked with one main outcome: work. People too ill to work will be healthier if they… work. Our public services will cease to provide public services: health and social care professionals will simply become co-opted authoritarian ideologues.

Apparently, the new inequality and social injustice have nothing to do with an unequal distribution of wealth, resources, power and opportunities. Apparently our society is unequal only because some people “won’t” work. I’m just wondering about all those working poor people currently queuing up at the food bank, maybe their poorly paid, insecure employment and zero hour contracts don’t count as working.

I’ve written as I read this Orwellian masterpiece of thinly disguised contempt and prejudice. I don’t think I have ever read anything as utterly dangerous and irrational in all my time analysing Conservative public policy and the potential and actual consequences of them. These utterly deluded and sneering authors are governing our country, shaping our life experiences, and those of our children.

The sick role and any recovery time from illness or accident that you may need has been abolished. Work will cure you.

Well, at least until you die.

Pictures courtesy of Robert Livingstone

The closing date for the consultation is 17 February 2017.
You can download the full consultation document from this link.
You can take part in the consultation from this link.

I don’t make any money from my work. But you can support me by making a donation and help me continue to research and write informative, insightful and independent articles, and to continue to provide support to others. The smallest amount is much appreciated – thank you.

Government guidelines for PIP assessment: a political redefinition of the word ‘objective’

October 14, 2016February 21, 2019 · 40 Comments ·

Thousands of disabled people have already lost their specialist Motability vehicles because of Conservative PIP cuts and many more are likely to be affected.

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.

The Department for Work and Pensions (DWP) have issued a guidance document for providers carrying out assessments for Personal Independence Payment (PIP), which was updated last month. It can be found here: PIP Assessment Guide.

The DWP Chief Medical Officer states that this is a supplementary guidance, in addition to “the contract documents agreed with providers as part of the commercial process, providing guidance for health professionals [HPs] carrying out assessment activity and for those responsible for putting in place and delivering processes to ensure the quality of assessments.”

Words like “fair”, “quality”, “support”, “reform” and even “objective” have been given a very subjective, highly specific Conservative semantic make-over, to signpost and reference a distinctive underpinning ideology, and to align them with neoliberal and New Right anti-welfare discourse and outcomes, over the last five years.

There is some preemptive dodging of criticism and patronising get-out clauses in the document, for example: “It must be remembered that some of the information may not be readily understood by those who are not trained and experienced HPs.”

This comment is indicative of the lack of transparency in the terms, conditions and process of assessments, and how they are generally carried out. It also emphasises the professional gap between the “health professional” employed by the state to carry out the “functional capacity” assessments in the context of a neoliberal welfare state, and medical health professionals, whose wider work is generally not directly linked to the politically defined conditionality of welfare support.

If you fundamentally disagree with any of the approach outlined in the content of the document, or the policy, it’s because you “fail to comprehend it”, simply because you haven’t trained as a HP.

I had no idea that HPs are the only people who can work out policy outcomes and who recognise government cuts, small state ideology and general cost-cutting measures for what they are, despite the thumping Orwellian semantic shifts and language use that is all about techniques of neutralisation (where the rhetoric used obscures or “neutralises” the negative aims and harmful consequences of the policy.)

Firstly, the HPs are not so much “health professionals”, but rather, “re-trained disability analysts.” Their role entails assessing the impact of illness and disability on the “functional capacity” of individuals in direct relation to justification or refusal of a PIP award only. Furthermore, it is the decision of the HP to “determine whether any additional evidence needs to be gathered from health or other professionals supporting the claimant.”

Often at the appeal stage, it turns out HPs frequently decide not to ask for further evidence. The DWP must take all medical evidence into account when making a decision about PIP claims. Yet the DWP say: “In many cases, appeals are granted because further medical evidence is provided.”

However, neither HPs nor the DWP decision-makers contact people’s GP or other professionals for more information about their health condition very often. This indicates that people are having to go to court, often waiting months for their appeal to be heard, because of deliberately under-informed, poorly evidenced DWP decisions.

Furthermore, it says in the government guidance to GPs: “Your patient should complete the forms to support their [PIP] claim using information that they have to hand, and should not ask you for information to help them do this, or to complete the forms yourself.”

It seems that the DWP are determined to continue making ill-informed, medically unevidenced decisions as long as they can get away with it.

The ‘functional’ assessment

From the document: “The assessment for PIP looks at an individual’s ability to carry out a series of key everyday activities. The assessment considers the impact of a claimant’s health condition or impairment on their functional ability rather than focusing on a particular diagnosis. Benefit will not be paid on the basis of having a particular health condition or impairment but on the impact of the health condition or impairment on the claimant’s everyday life.”

This process of assessment, however, is a very speculative one, with inferences drawn from seemingly unrelated questions and assumed circumstances, such as “do you have a pet?” This translates into “can bend from the waist to feed a cat/dog” on the HP’s report to the DWP.

During examination, people are asked to perform a series of movements, and inferences are drawn from these regarding the performance of day to day tasks. The movements bear no resemblance to ordinary day to day tasks, nor do they take into account the use of aids and adaptations that people may use to carry out daily tasks.

Furthermore, the person being assessed isn’t presented with the assumptions drawn from the examination and questions, which means they are not provided with an opportunity to verify any claim made by the HP, or to say if they can manage to feed their pet “reliably, safely and consistently”, or if their family have to feed the animal for much of the time.

From the document: “The HP should check the consistency of what is being said by using different approaches, asking questions in different ways or coming back to a previous point. When considering inconsistencies, HPs should bear in mind that some claimants may have no insight into their condition, for example claimants with cognitive or developmental impairments.”

I know of a lady who wore a gold locket. It was simply assumed at her assessment that despite her extremely arthritic fingers, and information about her pain and the lack of movement in her hands from her GP, that she had sufficient dexterity to fasten and unfasten the clasp. Had she been asked, she would have informed the HP that she never took the locket off, even in the shower.

This approach – “checking for inconsistencies” by using indirect questioning and assumption is NOT “objective”. It is a calculated strategy to justify a starting point of disbelief and skepticism regarding the accounts provided by ill and disabled people about the impact of their conditions and disabilities on their day-to-day living. As such, it frames the entire assessment process, weighting it towards evidence gathering to justify refusing awards, rather than being “objective”.

It’s simply a method based on side-stepping and discounting people’s own accounts and experiences of their disability, and any medical evidence submitted to verify that.

This approach is also mirrored in the Work Capability Assessment, reflecting Conservative cynicism and prejudice towards sick and disabled people. (See: What you need to know about Atos Assessments – it provides a good overview from a whistle-blower of how responses to seemingly casual observations and apparently conversational questions are re-translated into “inconsistencies” which are then used to justify refusing a claim.)

The introduction of PIP was framed by New Right anti-welfarism

Secondly, “PIP is replacing Disability Living Allowance (DLA), which has become outdated and unsustainable. The introduction of PIP will ensure the benefit is more fairly targeted at those who face the greatest barriers, by introducing a simpler, fairer, more transparent and more objective assessment, carried out by health professionals” [All boldings mine].

In other words, PIP is aimed at cutting welfare costs and support for people who would previously have been eligible for Disability Living Allowance (DLA). We are told that it’s no longer possible as a society to support all disabled people who need help with the additional costs that they face simply because they are ill and disabled, so the government propose to establish those “with the greatest need” by using a more stringent assessment process, which is claimed to be fair and more “objective”.

A recent review led the government to conclude that PIP “doesn’t currently fulfil the original policy intent”, which was to cut costs and “target” the benefit to “those with the greatest need.” That originally meant a narrowing of eligibility criteria for people formerly claiming Disability Living Allowance, increasing the number of reassessments required, and limiting the number of successful claims.

Controversially, the cuts to disability benefits (including the £30 per week cut from those claiming ESA in work related activity group) will fund tax cuts for the most affluent – the top 7% of earners. The chancellor raised the threshold at which people start paying 40p tax, in a move that will probably see many wealthier people pulled out of the higher rate of income tax. Osborne said he wanted to “accelerate progress” towards the Conservative’s manifesto pledge of raising the threshold for the 40p rate to £50,000 in 2020.

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.”

Fiona Colegrave, who is chief medical adviser, clinical governance and in charge of training for PIP at Capita, says: “As a disability assessor (DA), you are required to assess objectively how someone’s health conditions affect them and submit a report that is fair, reliable and can be justified with evidence because, if necessary, it may need to be scrutinised through an appeals process.

For these reasons, it is essential we equip DAs with the skills required to manage the assessment process, including: time management; questioning techniques; non-advocacy; collating all available evidence and identifying contradictions; and using an analytical but empathetic approach.

It is important for DAs to establish a rapport with the claimant, so that claimants feel like they have been able to express, in their own words, how their disability affects them and so they know that a DA will produce a report that accurately reflects their functional ability.”

Only “feel like”? Feedback from “claimants” says that DAs do NOT accurately reflect their “functional ability” in reports. And note the reductive use of the word “claimant” – language use that places the other at a psychological distance from the author and administrators, objectifying them, as if people claiming PIP and other benefits are a homogenous group of people, bound by characteristics rather than circumstances, in a context of political decision-making.

It becomes easier to disassociate from someone you view “objectively” and to distance yourself from the impact of your calculated and target-led decision-making, constrained within a highly political framework. Such an objectification of a person or group of people serves to de-empathise us, which is a key characteristic requirement of neoliberal ideology, embedded in inhumane “small state” policy and extended via administrative (and outsourced, privatised) practices. It leaves us much less likely to relate to the circumstances, emotions or accept the needs and choices of others.

Surely a considerable part of our experience of being objectively diagnosed as ill and/or disabled, in any case, is a person’s subjective experience of it, rather than categories and counts; quantifiable, reductive and speculative statements about how we may perform highly specific tasks.

Quantitative medical evidence is important, because it does often give a general indication of conditions that would entail loss of function. But considering medical evidence isn’t a central part of the assessment process. Whether or not we can perform certain tasks, and inferences drawn from that are the central considerations for PIP eligibility.

Many conditions “fluctuate” – they vary so much that it’s difficult to assess performance of specific tasks consistently. Many conditions become progressively worse at a varied pace, often leaving little scope for a person developing coping strategies and adapting their everyday lives to the changes as they happen, such as a progressive loss of mobility, cognitive impairment, mood changes, anxiety, depression, sleep disruption and other psychological impacts, and the increasing pain and fatigue that they may experience.

If the process were genuinely “fair, accurate and objective” then there would be no need for mandatory reviews and scrutiny through the appeals process. The introduction of the mandatory review – another layer of bureaucracy and a barrier to justice, where the DWP decide whether their first decision should be changed – has deterred many from appealing wrong decisions.

Those making the decisions about PIP awards are: “trained DWP staff who are familiar with the legislation governing PIP, but who do not have a healthcare background. The HP enables CMs to make fair and accurate decisions by providing impartial, objective and justified advice.“

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.”

What can we do to try to counter the state bias towards political cost-cutting, which is embedded in the assessment process?

Well, we can use the guidelines and existing legislation to ensure that we are heard clearly. We can also raise awareness that, whilst most ill and disabled people tend to emphasise how well we cope, and remain positive about what we can do independently, and we often tend to understate our needs for support, in assessment situations, that tendency is likely to be used to trivialise the impact of our condition and disabilities on day-to-day “functioning.”

Reliability

The government says in the PIP handbook: “For a descriptor to apply to a claimant, they must be able to reliably complete the activity as described in the descriptor. Reliably means whether they can do so:

 safely – in a manner unlikely to cause harm to themselves or to another person, either during or after completion of the activity

 to an acceptable standard

 repeatedly – as often as is reasonably required, and

 in a reasonable time period – no more than twice as long as the maximum period that a non-disabled person would normally take to complete that activity.”

If you cannot complete an activity reliably, safely and repeatedly, as outlined, then you must be regarded as unable to complete that task at all. The reliability criteria are an important key protection for disabled people claiming both PIP and Employment and Support Allowance (ESA).

From the document: “Symptoms such as pain, fatigue and breathlessness should be considered when determining whether an activity can be carried out repeatedly. While these symptoms may not necessarily stop the claimant carrying out the activity in the first instance, they may be an indication that it cannot be done as often as is required.”

And: “The following situations highlight examples where an individual may be considered unable to repeatedly complete a descriptor in the way described due to the impact this would have:

A person who is able to stand and move 20 metres unaided, but is unable to repeat it again that day cannot do it repeatedly as you would reasonably expect people to move 20 metres more than once a day • A person who is able to prepare a meal, but the exhaustion from doing so means they cannot then repeat the activity at subsequent meal times on the same day. This means they cannot complete the activity repeatedly as it is reasonable to expect people to prepare a meal more than once a day.”

This also applies to people with mental health conditions, which may also impact on a person being able to carry out tasks reliably, repeatedly and safely.

Time periods, fluctuations and descriptor choices

The document says: “The impact of most health conditions and disabilities can fluctuate. Taking a view of ability over a longer period of time helps to iron out fluctuations and presents a more coherent picture of disabling effects. The descriptor choice should be based on consideration of a 12-month period.

This should correlate with the Qualifying Period and Prospective Test for the benefit – so in the 3 months before the assessment and in the 9 months after. A scoring descriptor can apply to claimants in an activity where their impairment(s) affect(s) their ability to complete an activity, at some stage of the PIP regulations.

The following rules apply: If one descriptor in an activity is likely to apply on more than 50% of the days in the 12-month period – the activity can be completed in the way described on more than 50% of days – then that descriptor should be chosen.

If more than one descriptor in an activity is likely to apply on more than 50% of the days in the period, then the descriptor chosen should be the one that is the highest scoring. For example, if D applies on 100% of days and E on 70% of days, E is selected. Where one single descriptor in an activity is likely to not be satisfied on more than 50% of days, but a number of different scoring descriptors in that activity together are likely to be satisfied on more than 50% of days, the descriptor likely to be satisfied for the highest proportion of the time should be selected.

For example if B applies on 20% of days, D on 30% of days and E on 5% of days, D is selected. If someone is awaiting treatment or further intervention, it can be difficult to accurately predict its level of success or whether it will even occur. Descriptor choices should therefore be based on the likely continuing impact of the health condition or disability as if any treatment or further intervention has not occurred.

The timing of the activity should be considered, and whether the claimant can carry out the activity when they need to do it. For example, if taking medication in the morning (such as painkillers) allows the individual to carry out activities reliably when they need to throughout the day, although they would be unable to carry out the activity for part of the day (before they take the painkillers), the individual can still complete the activity reliably when required and therefore should receive the appropriate descriptor.”

Again, “fluctuating conditions” include many mental health conditions.

Risk and safety

“When considering whether an activity can be carried out safely it is important to consider the risk of a serious adverse event occurring. However, the risk that a serious adverse event may occur due to impairments is insufficient – the adverse event has to be likely to occur.”

Even if complex probability calculations were used – and I am certain HPs are unlikely to have been trained to use such formulae – there is no “objective” way of calculating risk of serious “adverse” events over time.

However, it is not such a big inferential leap to recognise that continually cutting essential lifeline support for sick and disabled people will ultimately lead to harm, distress, hardship and other negative consequences for individuals and will have wider social, cultural and economic “adverse” consequences, too.

“Making work pay” for whom?

Personal Independence Payment handbook

Government Toolkit of information for support organisations

Relevant:

PIP and the Tory monologue

Government plans further brutal cuts to disability support

Consultation as government seek to limit disabled people’s eligibility for Personal Independence Payment

Second Independent Review of Personal Independence Payment assessment

Department for Work and Pensions Recruits Staff to Reduce ESA and PIP Appeal Success Rates

Request For Evidence – PIP: Mobility Criterion – Politics and Insights

I don’t make any money from my work. I’m a disabled person with lupus, and I’m stuggling to get by. But you can help by making a donation and enable me to continue to research and write informative, insightful and independent articles, and to provide support to others going through disability benefit assessment processes and appeals. The smallest amount is much appreciated – thank you.

Thanks Mr Green, but we want more than token gestures and political opportunism

October 1, 2016February 15, 2017 · 9 Comments ·

519670

The work and pensions secretary, Damian Green, is expected to announce at the Conservative conference that those people with severe, lifelong conditions will no longer face six-monthly reassessments.

Employment and support allowance (a misleading title for sickness and disability support for those people whose doctors say are too unwell to work) will now continue automatically for people who have lifelong, severe health conditions, with no prospect of improvement, according to Green.

However, the retesting of chronically ill or disabled people for another key disability benefit – personal independence payments – is to remain, and thousands with unchanging or degenerative conditions are preparing to be put through that pointless assessment again.

I can’t help wondering how “chronic” and “degenerative” will be defined and how exemption from reassessment will be decided. It’s unclear which medical conditions will be considered grounds for a reprieve from further WCAs, but apparently the criteria will be drawn up by “health professionals“. There were no details provided about who these “health professionals” will be. Many people have no faith whatsoever in the medical judgments of the assessors themselves – especially when they have previously been known to ask woefully ignorant questions like “how long are you likely to have Parkinson’s disease?”

It may be the case that those claiming Employment and Support Allowance, placed in the support group will be exempt from the reassessments. However, as Samuel Miller, a human rights specialist and campaigner for disabled people, points out:

“The Department for Work and Pensions says that it is scraping retesting for people with severe, lifelong conditions at the same time that there has been a sharp drop in Support Group awards and a sharp increase in people placed in the Work Related Activity Group (WRAG). Charities report that 45% of people who put in a claim for Employment Support Allowance (ESA), and had Parkinson’s, Cystic Fibrosis, Multiple Sclerosis, or Rheumatoid Arthritis, were placed in the WRAG.“

Disability rights campaigners are concerned that the figures show the government is cutting spending on disability benefits “below the radar”, after being forced to abandon its attempts to reduce expenditure on personal independence payment (PIP) in April.

The Department for Work and Pensions (DWP) statistics, released last month, show the proportion of disabled people applying for ESA who were placed in the support group – for those assessed with “the highest barriers to work” – plunged by 42 per cent in just three months. There are concerns that the Work Capability Assessment has been made even more harsh by stealth.

For assessments completed during November 2015, 57 per cent of claimants were placed in the support group; but by February 2016 that had dropped by 24 percentage points to just 33 per cent.

Far too little far too late

This small change will not undo the suffering of sick and disabled people who have already been caught in the revolving door of the assessment and reassessment process. It’s not uncommon for people fighting a wrong “fit for work” decision to wait for many months before they win at tribunal, only to find that within three months of their successful appeal, they have another appointment for reassessment.

You would think that if someone has just won an appeal, common sense would prevail – that someone at the DWP would acknowledge that it’s highly unlikely these people have suddenly got better in such a short space of time. The strain of being put through this callous revolving door process has an adverse impact on people with chronic conditions, exacerbating their symptoms. It is profoundly stressful and anxiety-provoking.

This political token gesture will not undo the profound physical and psychological damage that the WCA has caused some of our most vulnerable citizens. And for many who did not feel vulnerable – those who felt they coped pretty well with their illness ordinarily – the constant strain of having to prove themselves ill and the loss of lifeline income whilst they await mandatory review and appeal, has led to increased vulnerability.

It’s also tragic and painful that it’s far too late to help the people who have died as a consequence of being told they are fit for work when they are not, and being forced to fight for lifeline social security to meet their basic needs.

I am happy to see the announced decision to stop reassessing chronically sick people every six months, because it’s unlikely they will get better. (The clue was always in the word “chronic,” curiously enough). If that brings about a reduction in the widespread suffering caused by the callous cost-cutting WCA , it’s a small step towards much needed positive change. This move would have been more credible as a signal of good intentions had Green also intended to announce the reversal of the cuts planned for those in the work related activity group, claiming ESA.

That a UK government feels it’s acceptable to financially penalise and punish a previously protected social group – comprised of people judged as too ill to work by doctors – shows how far our society has regressed in terms of equality and human rights. And democracy.

Labour have already pledged to abolish the Work Capability Assessment

Call me a cynic, but didn’t the Labour party pledge to completely scrap the Work Capability Assessment at their conference? Debbie Abrahams, shadow work and pensions secretary, spoke of strong ethical and empirically evidenced reasons for doing so.

She says: “As ever with this government though, the devil is in the detail. While the end to repeated assessments will be a relief to those that have been affected, this announcement falls far short of the fundamental shift to a more holistic, person-centred approach we so desperately need.

“Too many sick and disabled people will remain subject to this harmful, ineffective assessment. We will continue to push the Tories for a better deal for disabled people.”

After years of people suffering and evidenced feedback from victims of their policies, campaigners and academic researchers, the government decide NOW that chronic actually means “chronic”?

Duncan Smith, whose resignation from the role of work and pensions secretary was seen as an attack on the then leadership of David Cameron and George Osborne, told the Today programme he “completely agreed with the changes.”

“We worked to change this process, it was one we inherited and it just functioned badly on this area,” he said.

That isn’t true.

Some historical context

The Work Capability Assessment was piloted under the last Labour government, but Duncan Smith passed it into law after disregarding the concerns that the Labour party had raised following their review, regarding the assessment process being insensitive to fluctuating conditions and mental health status. In fact Duncan Smith modified the assessment process, making it even less sensitive. In early 2011, the Conservative-Liberal Democrat coalition government initiated the planned expansion of the programme to reassess 1.5 million people whom previous governments had judged to be entitled to Incapacity Benefit.

At the same time the DWP introduced long-planned revisions to the test’s eligibility criteria, which became more stringent overall: most notably, the 03/11 version awarded no points when a claimant who had difficulty walking could overcome the disability by using a wheelchair, if reasonably practicable. When Atos were recontracted in 2010, targets to remove the higher rate benefits from seven out of eight claimants were built into the new contract. Dr Steven Bick reported that “experts” testing Incapacity Benefit claimants were told they should rate only about one in eight as so disabled they will never work. The “quota” was enforced by French firm Atos, paid £100 million a year for the testing, and was revealed by undercover GP Bick on Channel 4’s Dispatches.

In February 2011, Professor Paul Gregg, an economist and one of the original architects of ESA, warned that the WCA was “badly malfunctioning” and urged further pilot studies before the more stringent 03/11 version was used as the default assessment. Nevertheless, the mammoth Incapacity Benefit reassessment programme got under way in the spring of 2011, using the new version of the test.

In January 2016, the National Audit Office (NAO) published its evaluation of the DWP’s health and disability assessment contracts. It said the cost of each WCA had risen from £115 under Atos to £190 under Maximus.

The report went on to say that Maximus was facing “significant challenges with staff failing to complete training requirements” and revealed that in July 2015 – less than six months into the new contract – the DWP had been obliged to draw up a “performance improvement plan” with Maximus because “volume targets were not being met”.

Perhaps the real reasons for stopping the six-monthly assessments are entirely financial – merely cost-cutting measures. As well as the heavy cost of each assessment to the public purse, there is also the considerable cost of many tribunals, because of the many “wrong decisions”.

Green told the Press Association: “We are building a country that works for everyone – not just the privileged few. A key part of that is making sure that all those who are able to work are given the support and the opportunity to do so. But it also means ensuring that we give full and proper support to those who can’t.”

(You can laugh now. I’m just wondering when an assessment for tax-dodging millionaires who were awarded at least £107,000 each per year in the form of a “tax break” will happen. This was at the same time the first round of welfare cuts were announced. It would be refreshing to see the minority of privileged citizens shouldering some of the burden of austerity and “paying down the the deficit” for a change. It would be fair to expect those who have gained the most from society to put something back, after all.)

He went on to say: “That includes sweeping away any unnecessary stress and bureaucracy – particularly for the most vulnerable in society.

“If someone has a disease which can only get worse then it doesn’t make sense to ask them to turn up for repeated appointments. If their condition is not going to improve, it is not right to ask them to be tested time after time. So we will stop it.”

I find it incredible that it’s taken six years for this “revelation” to hit home. Overwhelming empirical evidence that the assessment process is harming sick and disabled people has been presented to the government on many occasions, only to prompt what is, after all, a very small and inadequate policy change.

Green has almost always voted for a reduction in spending on welfare benefits, generally voted against raising welfare benefits at least in line with prices, almost always voted against paying higher benefits over longer periods for those unable to work due to illness or disability, and almost always voted for reducing housing benefit for social tenants deemed to have excess bedrooms (the “Bedroom Tax”), which has disproportionately affected sick and disabled people and their carers.

Earlier this year, a report for the Social Market Foundation thinktank recommended that the government entirely scrap the work capability assessment. The report also said the government should introduce a properly funded system – making use of trial projects and extensive consultation with benefit claimants – which would identify those disabled people closest to being able to get a job, while those too ill or disabled to work should have a “level of benefit provided … sufficient to allow them to live comfortably and engage fully in society.”

It also recommended that the government abandon the failing benefit sanction system for people with chronic illness or a disability – instead putting an emphasis on support meetings and financial incentives through a “steps to work wage” on top of their unemployment benefit.

Remarkably, the report was written by Matthew Oakley – a former Treasury adviser who until 2013 was head of economics at the right-of-centre Policy Exchange thinktank. He was also on Iain Duncan Smith’s own social security advisory committee.

What Green has offered falls far short of Oakley’s recommendations.

Let’s not accept politically opportunistic sops and scraps of small comfort.

Sick and disabled people deserve so much better than this. The Work Capability Assessment is not only consistently empirically demonstrated as being unfit for purpose, arbitrary and cruel, but it is also one of the most shocking political betrayals of those most in need that has ever been allowed to go unchecked.

The Tories are epistemological tyrants: about the DWP’s Mortality Statistics release

Labour pledge to scrap punitive Tory sanctions and the Work Capability Assessment

The Government’s brutal cuts to disability support isn’t ‘increasing spending’, Chancellor, but handing out tax cuts to the rich is

Government Finally Reveals That More Than 4,000 Died Within Six Weeks Of Being Deemed ‘Fit For Work’

Research finds strong correlation between Work Capability Assessment and suicide

What you need to know about the Work Capability Assessment

I don’t make any money from my work. But you can help me by making a donation and support me to continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

Man leaves coroner letter as he fears Work Capability Assessment will kill him

September 22, 2016June 20, 2017 · 22 Comments ·

The government have persistently denied any “causal relationship” between their welfare reforms and an increase in premature deaths and suicides, despite an existing correlation. Ministers have also denied a link between disability assessments and an increase in mental distress and ill health.

Figures released last year show that between December 2011 to February 2014, 4,010 people died after being told they were fit for work, following a Work Capability Assessment (WCA). 40,680 died within a year of undergoing the WCA, making a bleak mockery of any claim that the WCA is a real and valid “health assessment” of any kind. Or that our welfare system is “supportive” to those in most need, in any real or meaningful sense. Those people were clearly not at all “fit for work.” The figures were only released after the Information Commission overruled a Government decision to block the statistics from the public.

Research last year from Leonard Cheshire, a charity that works with disabled people, also showed that the assessments are making people who are ill more sick. Almost three quarters (72 per cent) said they found the assessment had a negative impact on their mental or physical health, or both. The same number described the face to face appointment as very stressful.

David Sugg would agree with those research findings. David suffered a life threatening subarachnoid haemorrhage (bleeding in the brain) because of an aneurysm (a swollen and very weakened point in a blood vessel) in 2013, and faces more life saving surgery because he has developed two more aneurysms that threatens to rupture, putting him at risk of another catastrophic brain haemorrhage. Whilst he waits for his operation, he has been told that if his blood pressure goes up, he is likely to die.

He had a Work Capability Assessment with Maximus this week. He was so afraid of the adverse health impacts that the strain of the WCA may have on him that he left a letter for the local coroner, to be opened in the event of his sudden death.

The letter said: “You may be looking into the reason for my death. I am hoping I can save you some time. This uncaring and spiteful Tory government killed me.”

He told me: “My neuro-surgeon says I mustn’t get stressed, but I have been called by the Department for Work and Pensions for an assessment even though I’ve told them about my situation.

If I don’t go for an assessment my benefits will be stopped. But I fear it may cost me my life.”

Although David survived his appointment, he has been suffering with a violent headache since, and hasn’t been able to eat for a week.

“That appointment might still kill me. If my blood pressure goes up I could be dead before I hit the floor. I asked the assessor why she was putting my life at risk, but she said it wasn’t her decision,” he said.

Aneurisms are quite often caused by an increase in blood pressure. The majority of people don’t survive a subarachnoid haemorrhage, and those who do are remarkably lucky if they escape without serious disability. Most people don’t survive if they have a second one.

David added that he felt the situation he is in has “Orwellian” parallels. It’s a terrible choice to have to make: he either risks his life and complies with the assessment or loses his lifeline support – his benefit is the only income he has.

David explained to me that like many people needing to claim Employment Support Allowance – which is a very misleading name for a sickness benefit – he had worked all of his life before becoming ill. He worked in IT and security until a couple of years ago. He became unemployed at that time, and was struggling to find work.

“I’d paid tax and national insurance all my life – since I was 15,” he said.

“The battle to get Job Seekers Allowance was so stressful I actually think that led me to having the aneurysm in the first place. Then I had to battle to get support. The first work capability assessment I had was just six months after I’d had seven-hour brain surgery.”

He told me that his assessor recognised how inappropriate the appointment was, telling him “you shouldn’t actually be here.”

Despite the fact that David was awaiting life saving surgery, the Department for Work and Pensions (DWP) demanded that he was assessed again. He returned the form, explaining that he was awaiting life saving surgery and must avoid stress, but to his horror, was forced to attend nonetheless.

He said “It’s brutal bullying by the DWP. No wonder people are committing suicide, pushed over the edge. You either die because of your condition or from suicide. All I would have to do is stop taking my pills for a couple of days and I would die.”

Debbie Abrahams, the shadow Work and Pensions Secretary, said that David’s case is far from unique.

She said: “This WCA process, revised by this Government, is not only not fit for purpose, there is growing evidence of the harm it is doing. These assessments need to be completely overhauled. Labour want to see a holistic, person-centred approach, not the dehumanising, harmful, inefficient process we have now.”

David wrote to his own MP, Stephen Metcalfe, outlining his extremely distressing circumstances, and was told that Stephen would contact the Department for Work and Pensions, but did not yet receive a response.

The system is designed to deter successful claims

I co-run a support group on Facebook for sick and disabled people claiming disability benefits. I know from the accounts and everyday experience of many others just how stressful the assessment process is. It’s a terrible state of affairs when people who are already struggling with severe health problems are made even more vulnerable because of callous cost-cutting government policies.

The assessment is not always an end to the stress, either. Quite often, people are forced to challenge wrong decisions, because the WCA is designed to find ways of passing people off as “fit for work” regardless of whether they actually are, cutting their benefit. It’s worth remembering that people needing sickness benefits have already been assessed as unfit for work by their own doctors.

If people need to appeal a wrong decision, they first have to go through a mandatory review – where the DWP “reconsider” the decision. Sickness benefit is stopped at this stage, leaving people who are often very ill without any lifeline income. Most can’t claim jobseekers allowance because they are too ill to work and so cannot meet the harsh and rigid conditionality requirements of that benefit. There is no set time limit for how long the DWP have to undertake the mandatory review. No-one may appeal until after their review is completed. The appeal process is also very stressful and intimidating, it usually entails another wait of months.

The revolving door of assessments and psychological distress

David is not the only person to contact me this week.

George Vranjkovic has been extremely anxious and distressed about his Work Capability Assessment, too. He is very afraid at the thought that he may lose his lifeline support.

He told me: “I took 5 days filling out the assessment form by hand and I sent it in 12 days before my deadline. But 5 days before the deadline I got a letter saying it had still not been received, so I rang them, and I got some bloke who chuckled. He said it probably got lost and was there anything else he could do.

I blew my top I’m afraid and said he could effing apologise for losing my form!!! He said he deserved to be treated with respect. I was so upset I shouted not if you sit there laughing at desperate people you don’t . Anyway, I ended up filling in the form on line, printing it off and sending one version by fax, and one version by special delivery, which is what I was instructed to do by them… £22.00 that cost me.”

The form showed up, according to another advisor that George spoke to the next day, but by then he had already paid out for the fax and special delivery and was told the likelihood of getting the £22.00 back was pretty remote. This is someone relying on just a lifeline benefit, calculated to meet only basic living costs – essentials: food, fuel and shelter.

Previously, George has been left without any money to live on by the DWP, without them providing any reason. That’s absolutely unacceptable.

“For 6 months when they cut my money off completely, I was made to feel like a criminal. I was spoken to so badly on the phone. I wasn’t being sanctioned. They just weren’t paying me.

This is all just another example of the abject cruelty we, as honest people, are put through,” he said.

Like many other disabled people, George has also worked previously, co-running a photographic service.

George talked to me over a period of 24 hours before his assessment yesterday. He hasn’t slept for weeks. He really needed someone to support him emotionally. He was extremely anxious, agitated and afraid. He knows that the WCA is designed to try and cut costs and take lifeline support from sick and disabled people.

He told me that he is someone who usually copes, and doesn’t like to make a fuss. He said “I try not to fall to pieces in public.” He was in a state of sheer panic, however, when he contacted me.

When he arrived for his appointment, George said that the assessor tried to reschedule the assessment. His distress was so great by this time that he absolutely refused to leave until the assessment was carried out. He simply couldn’t face going through the strain of waiting again.

“He asked me how the rescheduling of the test made me feel. He told me that it wasn’t the first time today he’d heard that forms had got lost or went missing, he asked me if I’d ever thought about committing suicide. Which I have, the last time being a year and a half ago when the DWP cut off my money for 6 months,” he said.

Like many others, George has had several assessments. It’s fairly common experience to have to go through an appeal, only to get another appointment within three months of a successful outcome.

A study published by the Journal of Epidemiology and Community Health last year, showed a correlation between worsening mental health and assessments under the WCA. The study linked the WCA tests with an additional 590 suicides, increased mental health problems and hundreds of thousands of antidepressant prescriptions

In a letter to the Guardian, the study’s main author, Benjamin Barr, said it was crucial the DWP takes seriously concerns that WCAs are “severely damaging” mental health. He called on the department to release data it holds to researchers to allow further analysis of the health impact of the controversial test.

Calls to scrap the WCA

The WCA is not only unfit for purpose, arbitrary and cruel, but it is also one of the most shocking political betrayals of those most in need that has ever been allowed to go unchecked.

Benefits Assessor: How Long Are You Likely To Have Parkinson’s?

Clause 99, Catch 22 – The ESA Mandatory Second Revision and Appeals

Essential Information about ESA claims, assessments and appeals

I don’t make any money from my work. But you can support me by making a donation and 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.

Two-way mirrors, hidden observers: welcome to the Department for Work and Pensions laboratory

August 27, 2016February 4, 2019 · 33 Comments ·

018

I regularly write to raise concerns about the current government’s misuse of psychology in public policies and research. There has been a shift towards the formulation of targeted, prejudiced, class contingent policies which have the central aim of “changing behaviours” and enforcing “compliance” and conformity. This behaviourist approach has some profound implications for democracy. It constrains autonomy and curtails the basic liberties of targeted citizens, it does not include safeguards or a space for citizens’ qualitative accounts and feedback, while also excluding them from any political consideration of their human rights.

On the government website, a contract finder notice for the “Provision of Research Laboratory Facilities” for the Department for Work and Pensions says:

“The Department for Work and Pensions (DWP) requires research to be undertaken, in a research laboratory environment, with recipients of the Carers Allowance and recipients of the Employment and Support Allowance (ESA).

In a typical lab situation DWP shall have one DWP researcher in a room with the participant and other DWP researchers (if appropriate) and invited observers behind a two way mirror evaluating what is happening. As well as viewing the interview they can also see the activity on the web screen via monitors in their room.

The proceedings are currently recorded on MP4 for subsequent use when research findings are being reported. The participants cannot see the people in the viewing facility though they know they are there. There needs to be flexibility to be able to undertake the research in the North West and Leeds and be able to recruit for participants to attend a Government Lab set up at Aviation House in London WC2B 6NH.”

Northern Voices T/A The Talking Shop is a Manchester based market research and public opinion polling company that has been awarded the contract in June this year. This company will be paid up to £60,000 for experimenting on sick and disabled claimants, using covert observation from behind a two-way mirror, studying eye movements, facial expressions and body language.

Eye movement measurements are frequently used, though controversially, in criminal psychology, too, as a somewhat unreliable method of “lie detection.” Questions arise regarding precisely how eye movements, perception and cognition are related, and to date, this question hasn’t been answered by academics.

It struck me that the experimental set up is very reminiscent of the social psychology experiments conducted in the 60s and early 70s to study social conformity and obedience to authority. However, the welfare “reforms” were specifically designed to coerce people claiming welfare into conformity – “to do the ‘right thing'”- and compliance with a harsh “conditionality” regime and ever-shrinking eligibility criteria. It’s hardly a secret that the New Right Conservatives and neoliberals have always loathed the welfare state, and along with the other social gains of our post-war settlement, it is being systematically dismantled.

The wider context is significant, both in terms of its impact on individual citizen’s experiences and behaviours, and on the way that theory is formulated to conflate and align citizen’s needs with neoliberal outcomes, and this is also reflected in how research is being designed and used.

Some context

In the UK, the Behavioural Insight Team has been testing libertarian paternalist ideas for conducting public policy by running experiments in which many thousands of participants receive various policy “treatments.” A lot of the actual research work is contracted out to private providers. Whilst medical researchers generally observe strict ethical codes of practice, in place to protect subjects, the new behavioural economists and profit-driven private companies are less transparent in conducting behavioural research “interventions.” There are no ethical and safeguarding guidelines in place to protect participants.

Earlier this year I wrote about a Department for Work and Pensions Trial that was about “testing whether conditionality and the use of financial sanctions are effective for people that need to claim benefits in low paid work.” A secretly released document (which said: “This document is for internal use only and should not be shared with external partners or claimants.”) was particularly focused on methods of enforcing the “cultural and behavioural change” of people claiming both in-work and out-of-work social security.

Evaluation of the Trial will be the responsibility of the Labour Market Trials Unit (LMTU). Evaluation will “measure the impact of the Trial’s 3 group approaches, but understand more about claimant attitudes to progression over time and how the Trial has influenced behaviour changes.”

Worryingly, claimant participation in the Trial was mandatory. There was no appropriate procedure to obtain and record clearly informed consent from research participants. Furthermore, the Trial is founded on a coercive psychomanagement and political approach to labour market constraints, and is clearly expressed as a psychological intervention, explicitly aimed at “behavioural change” and this raises some serious concerns about the lack of research ethics and codes of conduct in government research. It’s also very worrying that this “intervention” is to be delivered by non-qualified work coaches.

The British Psychological Society (BPS) have issued a code of ethics in psychology that provides guidelines for the conduct of research. Some of the more important and pertinent ethical considerations are as follows:

Informed Consent.

Participants must be given the following information:

A statement that participation is voluntary and that refusal to participate will not result in any consequences or any loss of benefits that the person is otherwise entitled to receive.
Purpose of the research.
Procedures involved in the research.
All foreseeable risks and discomforts to the participant (if there are any). These include not only physical injury but also possible psychological.
Subjects’ right to confidentiality and the right to withdraw from the study at any time without any consequences.

Protection of Participants

Researchers must ensure that those taking part in research will not be caused distress. They must be protected from physical and mental harm. This means you must not embarrass, frighten, offend or harm participants.
Normally, the risk of harm must be no greater than in ordinary life, i.e. participants should not be exposed to risks greater than or additional to those encountered in their normal lifestyles. Withdrawing lifeline support that is calculated to meet the costs of only minimum requirements for basic survival – food, fuel and shelter – as a punishment for non-compliance WILL INVARIABLY cause distress, harm and loss of dignity for the subjects that are coerced into participating in this Trial. Participants should be able to leave a study at any time if they feel uncomfortable.

Behavioural “rights” and the politics of moralising

Consent to a therapy or research protocol must possess a minimum of three features in order to be valid. These are: it should be voluntarily expressed, it should be the expression of a competent subject, and the subject must be be adequately informed of the details.This raises some serious concerns about experimental social research, especially when it may involve people with mental health disabilities who may be highly vulnerable.

It’s highly unlikely that people subjected to the extended use and broadened application of welfare sanctions gave their informed consent to participate in experiments designed to test the nudge theory of “cognitive bias,” for example. The extended use of sanctions in the Welfare Reform Act 2012 was originally advised by the Behavioural Insights Team (the Nudge Unit) back in 2010. It was based on the manipulation of an alleged cognitive bias that we have – loss aversion – and designed as a method of coercing conformity to increasingly unreasonable state-imposed conditionality rules, and as punishment for the perceived “non-compliance” of unemployed people.

There is nothing to prevent a government deliberately exploiting a research framework as a way to test out highly unethical and ideologically-driven policies. How appropriate is it to apply a biomedical model of prescribed policy “treatments” to people experiencing politically and structurally generated social problems, such as unemployment, inequality and poverty, for example?

The fact that this government regards work as a “health outcome” should raise alarm bells. (Please see: Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records). The government have already stigmatised unemployment, and redefined it as a psychological disorder.

Furthermore, the research models being used are framed by a profoundly undemocratic conservative neopositivism, which emphasises directed quantitative data collection and excludes the accounts, experiences, narratives and language of research participants. Much of the research is prejudiced, and starts from an authoritarian premise that people experiencing socioeconomic problems do so because they make the “wrong choices” and that they need to be “incentivised to change their behaviours”.

An element of the “laboratory research environment” research went ahead in March last year. It’s stated aim was to “to improve the Carer’s Allowance Digital Service.” The recruitment brief specifies that:

“These self employed people shouldn’t have accounts prepared by an accountant however it’s mandatory that they bring with them details of their self-employment eg a log book or papers of incoming and outgoings. We also need these people to be looking after someone who has a disability.”

It’s become normalised that many millionaires avoid paying taxes and contributing to the society that they have gained so much from. I don’t see anyone intimidating them, demanding details of their “incoming and outgoings,” yet that would profit society far, far more.

Wouldn’t you think that if this were genuinely about supporting carers using software or accessing services online, it would be designed to be USER LED – a direct face-to-face approach would be the usual way, with an input from those service users, which is qualitative and much more reliable, authentic and useful than the account of a group of strangers hiding behind mirrored glass, observing people and applying controversial psychology techniques.

Measuring eye movements is usually coupled with other more inclusive qualitative methodologies, such as introspective verbal protocols, since used on its own, it is unreliable in that it fails to indicate specific kinds of cognitive processing or content. This dialogic approach, however, isn’t included in the government’s research brief. (Please see The importance of citizen’s qualitative accounts in democratic inclusion and political participation.)

The central premise of justifications for “behavioural interventions” is that the general public has numerous cognitive biases that lead to “faulty” decision-making. Current research and interventions are largely aimed at the poorest citizens, however, exposing a government bias that wealthy people are somehow cognitively competent. Yet many of this powerful, offshore hoarding minority class want to see worker’s rights, welfare support and our public services dismantled.

Not a rational or civilised class, on the whole, then.

As I have previously stated, the behavioural approach removes people from the socioeconomic and political context that they inhabit and isolates them from meaningful and impacting socio-structural events and political decision-making, placing the burden of responsibility and obligation entirely within those who are suffering the inevitable systemic consequences of neoliberal policies. In such an economic system of “market forces” based on competition, there are invariably winners and losers. It’s hardly rational or fair to punish those who are simply adversely affected by an intrinsically flawed and unfair system of socioeconomic organisation for which there was never a consensus. It was simply imposed on the UK public, without any legitimate, informed consent.

Can you imagine the government carrying out this kind of research and stigmatising, intimidating methodology on billionaires interacting with their accountants, completing their tax returns or interacting with their offshore banks? No, I thought not.

It’s noteworthy that current Nudge Unit policy is to keep those being targeted for nudges “naive” as people tend to temporarily alter their behaviour when they know they are being observed and that skews research results. In sociology and social psychology, this is called the Hawthorne effect.

However, that approach is profoundly incompatible with established ethical research frameworks, and fundamental human rights, which, as I’ve outlined, always specify a central requirement of participants’ informed consent.

Similarly, the starting premise of laboratory usability testing is that “what people say they do with products is not always what they actually do.” In other words, we cannot trust the public to tell us what they need.

Userbility testing, an American import, is designed to “target” users’ needs and preferences by observing their behaviour. However, a big part of the motivation for this kind of research is “Building credibility for usability activities within an organization.” The government often use research like this to formulate justification narratives for controversial, coercive and punitive policies.

Democracy is meant to involve the election of a government that reflects on social problems objectively, recognises and serves public needs, and designs policy in response to what citizens actually need; it’s not about governments that coerce people to “change their behaviour” in accordance to a partisan, ideological agenda. We call the kind of government that does that “totalitarian.”

I am not the only person who is very concerned about this development.

A spokesperson for Fightback 4 Justice said:

“This is the company that has won the tender experimenting with Carers claimants using body language techniques and 2 way mirrors. If anyone gets called into one of these meetings please get in touch as I’d be happy to attend. I am very very concerned about a potential breach of a person’s human rights here particularly where mental health is one of the claimants conditions. Nothing about this “study” seems ethical in my legal opinion. A room with a 2 way mirror and capacity for 12 people studying body language and facial expressions is wrong in so many ways, DWP are giving the wrong impression that claimants are potential criminals with this latest research in my view.” Michelle (legal advocate).

The Talking Shop’s research studios

images

Nudging conformity and benefit sanctions

G4S are employing Cognitive Behavioural Therapists to deliver “get to work therapy”

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

The importance of citizen’s qualitative accounts in democratic inclusion and political participation

Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records

The Conservative approach to social research – that way madness lies

A critique of Conservative notions of social research

I don’t make any money from my work. But you can contribute by making a donation and 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.

Second Independent Review of Personal Independence Payment assessment

August 27, 2016February 24, 2017 · 8 Comments ·

Any social security policy that is implemented with the expressed aim of “targeting those most in need” is invariably about cost cutting and reducing eligibility criteria for entitlement. The government were explicit in their statement about the original policy intent of Personal Independence Payment. The government has already considered ways of reducing eligibility criteria for the daily living component of Personal Independence Payment by narrowing definitions of aids and appliances, earlier this year.

In July, the Department for Work and Pensions appointed Paul Gray CB to undertake the second “independent review” of the Personal Independence Payment (PIP) assessment. This is the second independent review as required by Section 89 of the Welfare Reform Act 2012.

This review includes a call for evidence of the PIP assessment. It seeks information about how the PIP assessment is “working.” The consultation includes all stages of the PIP process, with a particular focus on the use of further evidence in the claim process, data sharing and the claimant experience.

However, I’m just wondering where the ever-reductive targeting quest for the ever-shrinking category of “those with the greatest need” will end. The evidence that a policy “working” is usually related to the stated original aim. In this case, PIP isn’t a policy aimed at meeting the needs of disabled people. It’s a policy that is ultimately aimed at cutting support for ill and disabled people.

We have already witnessed a shrinking of eligibility criteria for people formerly claiming Disability Living Allowance, a marked increase in the number of reassessments required, and a limiting of the number of successful claims. 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.

Any “review” will therefore be framed by the original intent of the policy. However, that does not mean we should not respond to reviews and submit evidence, as a review provides us with an opportunity to flag up concerns regarding inadequacies experienced by those the policy is meant to support, too. The policy is not meant to serve the government, who are on an ideological crusade to dismantle all social security support, ultimately.

Disability benefits were originally designed to help sick and disabled people meet their needs, additional living costs and support people sufficiently to allow a degree of dignity and independent living. You would be mistaken in thinking, however, that Personal Independent Payment was designed for that. It seems to have been designed to be the Treasury’s ever-increasing pocket money. Or as profits for private providers who constantly assess, monitor, coerce and attempt to “incentivise” those people being systematically impoverished by the state to make “behaviour changes” by taking any low paid, insecure and poor quality work, regardless of how suitable or appropriate that is.

Apparently, that is the Conservative psychobabble “cure” for “worklessness,” which, regardless of market conditions, health, socioeconomic circumstances and poor political decision-making, is always down to an individual’s “bad behavioural choices.” The government regard work as a “health outcome.” I expect that soon, work coaches will replace doctors, and the Department for Work, health and Pensions will subsume the NHS.

For what it’s worth, Paul Gray will use evidence from the second review to inform his report to the Secretary of State for Work and Pensions. The second review will be laid before Parliament by April 2017.

Individuals and organisations are invited to submit evidence to help inform the review by answering the following questions. Where the Department for Work and Pensions use the word “condition” in these questions they mean disabilities, health conditions and impairments. They use “condition” for short.

Your responses can only be taken into account if you press submit at the end of the survey form, if you send a submission using that method.

The deadline for submissions is 5pm on 16 September 2016.

Your privacy
The note on privacy: “By providing personal information for the purposes of this call for evidence, it is understood that you consent to its disclosure and publication. If you want the information in your response to be confidential, please explain why and we will endeavour to do so. However we cannot guarantee to do this.”

Terms of reference for the second independent review of the PIP assessment
First independent review of the PIP assessment
www.gov.uk/pip – who is entitled to PIP and how to claim it

Ways to respond

Respond online

Email: pip.independentreview@dwp.gsi.gov.uk

Write to:
PIP Independent Review Team
Department for Work and Pensions
Floor 4
Caxton House
Tothill Street
London
SW1H 9NA

—

Related

“Consideration of the ability of a claimant to carry out an activity safely, to an acceptable standard, repeatedly and in a reasonable time period is key to the PIP assessment. We recognise that these ‘reliability criteria’ and the rules setting out how fluctuating conditions should be considered are an important protection for claimants, and these are enshrined in legislation” – Government’s second response to the first Independent Review of the Personal Independence Payment Assessment

Consultation as government seek to limit disabled people’s eligibility for Personal Independence Payment

Request For Evidence – PIP: mobility Criterion

PIP and the Tory monolgue

Disabled people’s human rights in further jeopardy because of Brexit

June 29, 2016October 10, 2018 · 9 Comments ·

equality+act+image

The UK government has tended to regard human rights as optional; as being rather more like ‘guidelines’ than laws, and often, as a mere inconvenience and barrier to the fulfillment of their ideological commitments.

Opportunities for disabled people in the workplace are likely to come under further threat unless government prioritises the recreation of EU safeguards into British statute. That is according to diversity consultancy, The Clear Company, which contributes to the government’s Disability Confident Campaign.

Former Paralympian Baroness Grey-Thompson has also warned that leaving the European Union would prevent British people with disabilities benefiting from plans to boost accessibility.

She added that Brexit would also risk a recession that would leave less money to be spent on support services. She said:

“Our membership of the European Union has had real, positive benefits for the millions of UK residents with limiting long-term illnesses, impairments or disabilities.

“It has helped to counter workplace discrimination, obliged transport providers to make their services more accessible and secured access to some UK disability benefits for Britons living in other EU countries.

“Not only would leaving Europe jeopardise these, it would close us off from enjoying the rewards of upcoming legislation that will further increase accessibility and risk a recession that would leave less money to be spent on much-needed support services.”

Fiona McGhie, Public Law expert at Irwin Mitchell, said:

“What Brexit would affect is the ability to potentially rely on the European Charter of Fundamental Rights (CFR) which in particular includes many wider social and economic rights, such as the rights to fair and just working conditions, to healthcare and to have personal data protected. If disabled people wished to try and strike down UK legislation as incompatible with rights under CFR under EU law – that avenue may not be available after the vote to leave.”

In the wake of the referendum, the following is an official press release from ResponseSource, which is a journalist enquiry service that provides a press release wire:

The EU promotes the active inclusion and full participation of disabled people in society, in line with the EU human rights approach to disability issues, through priorities including accessibility, participation, social protection and external action. It works around a firm ethos that disability is a rights issue rather than a matter for discretion.

From an employment perspective, the objective of the European Commission’s European Disability Strategy 2010-2020 is to significantly raise the number of people with disabilities working in the open labour market. They represent one-sixth of the EU’s overall working-age population, but their employment rate is comparatively low at around 50%.

Commenting on this morning’s revelation, Kate Headley, Development Director at The Clear Company, said:

“As long as the UK was part of the EU, disabled people had the benefit of EU frameworks and directives to act as a safety-net against British government and any power it may exert. Now, the future of policy which most affects disabled people is in the hands of Whitehall alone.

“There is no doubt that EU-derived laws, and EU-led initiatives, have had a largely positive impact on the disabled community. This may explain why Miro Griffiths, a former government adviser and project officer for the European Network on Independent Living, recently went on record to say he believed that Britain’s exit from the EU “would have dire consequences for disabled people”. Our priority now is to help ensure that the rights disabled people currently hold are protected post-Brexit.

“Aside from the issues of how the UK’s decision to exit will impact the NHS and wider care services, the European Health Insurance Card, and EU Air Passengers Regulation – all of which disproportionately affect those with disabilities – we must also look at the effect on disabled people in the workplace.”

“The EU’s record on assisting disabled workers is strong. Its Employment Equality Directive 2000, for example, led to the removal of the original exemption in the Disability Discrimination Act (DDA) for employers with fewer than 20 staff in the UK, so that in 2004 it became unlawful for any UK employer to discriminate against disabled people. The employment directive also led to the DDA being changed to make direct discrimination by employers against disabled people unlawful.”

“The TUC has identified employment rights that could well be under threat from a government no longer required to comply with EU legislation. Many of these promote health and well-being at work and home, such as the Working Time Directive, which protects from stress and ill-health that arise from working excessive hours including health service workers.”

“I would urge the government, post Article 50, to recreate the safeguards that disabled people have benefited from under EU membership into British statute. We will gladly continue to support the government in the development of strategy and stand by our commitment to support employers and employees alike. Amid the avalanche of new legislation which will almost certainly flood Whitehall in the coming months, laws that safeguard and support disabled workers must be prioritised as EU law recedes.”

Related

Unfortunately, the UK government has systematically violated the human rights of disabled people. It’s highly unlikely, given the current context, that the Conservatives will recreate the EU safeguards and incorporate them in protective legislation.

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

Prime minister dismisses UN inquiry into government’s discriminatory treatment of disabled people

The biggest barrier that disabled people face is a prejudiced government

The Government’s brutal cuts to disability support isn’t ‘increasing spending’, Chancellor, but handing out tax cuts to the rich is

If even the DWP isn’t Disability Confident, how will a million disabled people get jobs? – Bernadette Meaden

Stephen Crabb’s obscurantist approach to cuts in disabled people’s support

May 14, 2016November 6, 2016 · 17 Comments ·

It’s less than two months ago that the new Work and Pensions secretary, Stephen Crabb, assured us that the Government had “no further plans” for specific welfare cuts. Now, he has admitted that welfare is to be the source of further austerity cuts to “bring down the deficit,” bearing in mind that the last budget saw alternative and far more fair, humane measures taken off the table when the Conservatives controversially announced cuts to disability benefits to fund tax cuts for the most affluent – the top 7% of earners. The Chancellor raised the threshold at which people start paying the 40p tax. This leaves the poorest and some of our most vulnerable citizens carrying the entire burden of austerity and the whole responsibility for cutting the deficit.

Of course Crabb assumes we believe that austerity is an economic necessity and not an ideological choice. However, austerity is being used as a euphemism for the systematic dismantling of the gains of our post-war settlement: welfare, social housing, the NHS, legal aid and democracy. There is no such thing as conditional democracy. It can’t be rationed out or applied with prejudice and discrimination. That would make it something else, more akin to totalitarianism and not a necessarily inclusive democracy.

The Government has already made substantial cuts to the Employment and Support Allowance disability benefit, cutting the rate for new claimants in the Work Related Activity Group by £30 a week from 2017. Now the Work and Pensions Secretary has said he wants to go further than the £12 billion welfare cuts declared in the Conservative manifesto and to “re-frame discussion” around disability welfare support, signalling his intention to cut expenditure on disability benefits through further reform to the welfare system. The Conservatives are clearly using the word “reform” as a euphemism for dismantling the welfare state in its entirety.

Crabb said that he will set out a “discursive” Green Paper on the additional proposed cuts to disability benefits later this year. Iain Duncan Smith had previously promised a more formal White Paper which was considered key to persuading Tory rebels to vote through the cuts despite opposition in February.

The shadow Work and Pensions secretary, Owen Smith, said that the Government should reverse the ESA cuts which had already been passed, adding that the Conservatives needed to offer clarity on how the “reforms” would support disabled people into work.

He said: “Yet again the Tories have let down disabled people, by breaking their promise to quickly publish firm plans on supporting disabled people in to work.

“When the Tories forced through cuts to Employment Support Allowance in the face of widespread opposition they bought off their own rebels with a promise to have a firm plan in place by the summer.

“Now the new Secretary of State has confirmed that he is going to downgrade the plan to a Green Paper, effectively kicking the issue in to the long grass for months, if not years.

The flimsy case for the cuts to Employment Support Allowance is now totally blown apart by this broken promise and the Tories must listen to Labour’s calls for them to be reversed.”

Remarkably, Crabb has claimed that disability benefit cuts are among policies “changing things for the better.” However, if cutting people’s income is such a positive move, we do need to ask why the Conservatives won’t consider taxing wealthy people proportionately, distributing the burden of austerity more fairly amongst UK citizens, instead of handing out money for tax cuts to those who need the very least support, at the expense of those who need the most.

The secretary for Work and Pensions has said: “The measures that have either already been legislated for or announced get us to the £12 billion [welfare cuts planned in the Conservative manifesto].

Does that mean welfare reform comes to an end? I would say no. I’ve already pointed to what I see as one of the big challenges of welfare reform – and that’s around work and health.”

Crabb told MPs on Work and Pensions Select Committee that he would deploy “smart strategies” for cutting expenditure on disability and sickness benefits and would hopefully be able to secure the support of disability charities.

“In terms of how you make progress of welfare reform there when you are talking about people who are very vulnerable, people with multiple barriers, challenges, sicknesses, disabilities – I am pretty clear in my mind that you can’t just set targets for cutting welfare expenditure,” he said.

“When you’re talking about those cohorts of people you’ve actually got to come up with some pretty smart strategies for doing it which carry the support and permission of those people and organisations who represent those people who we are talking about.”

Both Crabb and his predecessor, Duncan Smith, have claimed that there are “millions of sick and disabled people parked on benefits,” yet rather than providing support for those who may be able to work, the Conservatives have abolished the Independent Living Fund and made substantial reductions to payments for the Access To Work scheme, creating more barriers instead of providing support for those who feel they are well enough to work.

A government advisor, who is a specialist in labour economics and econometrics, has proposed scrapping all ESA sickness and disability benefits. Matthew Oakley, a senior researcher at the Social Market Foundation, recently published a report entitled Closing the gap: creating a framework for tackling the disability employment gap in the UK, in which he proposes abolishing the ESA Support Group. To meet extra living costs because of disability, Oakley says that existing spending on PIP and the Support Group element of ESA should be brought together to finance a new extra costs benefit. Eligibility for this benefit should be determined on the basis of need, with an assessment replacing the WCA and PIP assessment. The Conservative definition of “the basis of need” seems to be an ever-shrinking category.

I’m sure the private company Unum would jump at the opportunity. Steeped in controversy, with a wake of scandals that entailed the company denying people their disabilty insurance, in 2004, Unum entered into a regulatory settlement agreement (RSA) with insurance regulators in over 40 US states. The settlement related to Unum’s handling of disability claims and required the company “to make significant changes in corporate governance, implement revisions to claim procedures and provide for a full re-examination of both reassessed claims and disability insurance claim decisions.

It’s difficult to see how someone with a serious, chronic and progressive illness, (which most people in the ESA Support Group have) can actually “manage” their illness and “move back into work.” The use of the extremely misinformed, patronising and very misleading term manage implies that very ill people actually have some kind of choice in the matter. For people with Parkinson’s disease, rheumatoid arthritis, lupus and multiple sclerosis, cancer and kidney failure, for example, mind over matter doesn’t fix those problems, positive thinking and sheer will power cannot cure these illnesses, sadly. Nor does refusing to acknowledge or permit people to take up a sick role, or imposing benefit conditionality and coercive policies to push chronically ill people into work by callous and insensitive and medically ignorant assessors, advisors and ministers.

Reform says the government should cut the weekly support paid to 1.3 million sick and disabled people in the ESA Support Group from £131 to £73. This is the same amount that Jobseeker’s Allowance claimants receive. However, those people placed in the Support Group after assessement have been deemed by the state as unlikely to be able to work again. It would therefore be very difficult to justify this proposed cut.

Yet the authors of the report doggedly insist that having a higher rate of weekly benefit for extremely sick and disabled people encourages them “to stay on sickness benefits rather than move into work.”

The report recommended savings which result from removing the disability-related additions to the standard allowance should be reinvested in support services and extra costs benefits – PIP. However, as outlined, the government have ensured that eligibility for that support is rapidly contracting, with the ever-shrinking political and economic re-interpretation of medically defined sickness and disability categories and a significant reduction in what the government deem to be a legitimate exemption from being “incentivised” into hard work.

The current United Nations investigation into the systematic and gross violations of the rights of disabled people in the UK because of the Conservative welfare “reforms” is a clear indication that there is no longer any political commitment to supporting disabled people in this country, with the Independent Living Fund being scrapped by this government, ESA for the work related activiy group (WRAG) cut back, PIP is becoming increasingly very difficult to access, and now there are threats to the ESA Support Group. The Conservative’s actions have led to breaches in the CONVENTION on the RIGHTS of PERSONS with DISABILITIES – CRPD articles 4, 8, 9, 12, 13, 14, 15, 17, and especially 19, 20, 27 and 29 (at the very least.) There are also probable violations of articles 22, 23, 25, 30, 31.

And that, surely, tells us all we need to know about this government.

—

This post was written for Welfare Weekly, which is a socially responsible and ethical news provider, specialising in social welfare related news and opinion.

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.

Request For Evidence – PIP: Mobility Criterion

May 10, 2016May 11, 2016 · 49 Comments ·

On May 4, there was a debate in the House of Lords about discussions with Disability Rights UK and the Disability Benefits Consortium on identifying a mobility criterion in the Personal Independence Payment (PIP) assessment framework, which was led by Liberal Democrat Baroness Thomas.

Baroness Thomas of Winchester tabled a Motion to resolve in the House of Lords:

“That this House calls on Her Majesty’s Government to hold urgent talks with Disability Rights UK and the Disability Benefits Consortium to identify a mobility criterion in the Personal Independence Payment (PIP) “moving around” assessment which is fairer than the current 20 metre distance, in the light of the impact on reassessed disabled claimants and the resulting large number of successful appeals.”

She said: “Tabling a Motion is an unusual course to take, but I assure the House that there is nothing fatal about it. However, if it were to be agreed, it would send a powerful message that this House is very concerned about this particular government policy and is taking a constructive approach to seeing what can be done to help the situation.

Why am I so concerned about the “Moving around” section? Because the relevant walking distance test for PIP has been made much harder than the Disability Living Allowance (DLA) test, meaning that by the Government’s own estimate the number of people on enhanced or higher-rate mobility will go down from around 1 million people to 600,000 by 2018.

Some 400 to 500 Motability cars a week are now being handed back by disabled claimants whose condition may not have improved but who are losing not just their car but, in many cases, their independence. Under DLA, the walking distance was 50 metres, which was in the Department for Transport guidance on inclusive mobility. The new distance of 20 metres is just under two London bus lengths, and is unrecognised in any other setting. There is no evidence that it is a sensible distance for the test, and it is not used anywhere else by the Government.

So someone with a walking frame, say, who can just about manage 20 to 30 metres, will not usually qualify for PIP. I see the Minister even now sharpening her pencil to make a note reminding her to tell me that this is a travesty of the truth. No, I have not forgotten the reliability criteria, which were made statutory in the last Parliament—thanks, in fact, to the intervention of the Liberal Democrats. The full reliability criteria in the PIP guidance are that 20 metres must be able to be walked,

“safely … to an acceptable standard …repeatedly … and … in a reasonable time period”.

Baroness Thomas added: “To sum up, to be told that the bill for PIP is too high and must be cut by more than halving the walking distance test is a real slap in the face for thousands of disabled people, particularly those of working age with lifetime awards under DLA. Of course the bill is going up—because the disabled population is going up. The Government must have factored that into their calculations years ago. The last thing that anyone wants is for more and more disabled people to become socially isolated and totally reliant on other services for everything they need. A great deal of money could actually be saved by other government departments, such as health, social services, employment and transport, by making the PIP walking distance fairer. I beg to move.”

There were also some outstanding contributions made in this debate by Baroness Sherlock (Labour), Baroness Grey-Thompson (Cross Bench), Baroness Masham of Ilton (Cross Bench), Lord Low of Dalston (Cross Bench), Baroness Brinton (Liberal Democrat), Baroness Doocey (Lib Dem), Lord McKenzie of Luton (Labour), amongst others.

I recommend that you read the debate in full here: Personal Independence Payment: Mobility Criterion.

One very important issue raised in this debate was clarified in a statement made by The Minister of State, Department for Work and Pensions, Baroness Altmann (Conservative). She said:

“I would like to clarify what appears to be a widespread misconception regarding the differences between the mobility assessment in PIP and the mobility assessment in DLA. Many noble Lords have spoken of a “20-metre rule”, but there is no such rule. Some people believe that we have changed the assessment of a distance a claimant is able to walk from 50 metres to 20 metres. This is not the case. The higher rate of DLA was always intended to be for claimants who were unable, or virtually unable, to walk. This is still the case in PIP, but we have gone further.

Under PIP, if a claimant cannot walk up to 20 metres safely, reliably, repeatedly and in a timely manner, they are guaranteed to receive the enhanced rate of the mobility component. If a claimant cannot walk up to 50 metres safely, reliably, repeatedly and in a timely manner, then they are guaranteed to receive the enhanced rate of the mobility component. [My bolding]

I can assure the noble Baroness, Lady Brinton, that if a claimant is in extreme pain, they will be assessed as not reliably able to walk that distance. The reliability criteria are a key protection for claimants.

It was after my department’s work with the noble Baroness and noble Lords in 2013 that we set out these terms, not just in guidance but in regulations, confirming our commitment to getting this right. If a claimant cannot walk up to 50 metres without such problems, they will still be entitled to the mobility component at the standard rate. If they cannot walk that distance reliably and in the other ways in which we have protected it, they will be entitled to the enhanced rate. Therefore, the enhanced mobility component of PIP goes to those people who are most severely impacted and who struggle to walk without difficulty.”

I co-run advice and support groups for disabled people, and have to say that the majority of accounts of experiences I witness from those going through the PIP assessment process do not tally with Baroness Altmann’s claims.

So, in light of these claims, which were made despite evidence presented during the debate to the contrary, Baroness Tanni Grey-Thompson is gathering further evidence, and she requests that anyone who can walk less then 50 metres and who has lost their PIP, please get in touch with her: Baroness Tanni Grey-Thompson DBE – Email: greythompsont@parliament.uk

Picture courtesy of Robert Livingstone

Workfare coercion in the UK: an assault on persons with disabilities and their human rights – Anne-Laure Donskoy

April 27, 2016September 26, 2022 · 18 Comments ·

Anne-Laure Donskoy is an independent survivor researcher, this paper was published by the National Survivor User Network (NSUN) for mental health, which is an independent, service-user-led charity that connects people with experience of mental health issues to give us a stronger voice in shaping policy and services.

In a report, titled Workfare coercion in the UK: an assault on persons with disabilities and their human rights, she provides an in-depth consideration of psychocompulsion as a series of state-sponsored human rights violations. I recommend that you read this discussion in full.

She writes: “While there is a lot of focus on coercion organised and implemented in psychiatry, less attention is being paid to state engineered welfare measures based on libertarian paternalism, which have coercive practices at their core. Among them are policies that strongly support behavioural change using positive psychology and cognitive behavioural therapy. Freidli and Stearn (2015) call this ‘psychocompulsion.'”

“The narrative of welfare is changing drastically. As Friedli says, we are moving from a “what people have to do [to find work] to what they have to be [demonstrating the right attitude to be employable]”. This is exemplified through the new ‘Work and Health Programme’ planned to be rolled out in England and Wales. This programme has many strands, including:−

Embedding psychological services within Job Centres
Placing ‘job coaches’ within GP surgeries for people with certain conditions (specifically people with mental health issues): the ‘Working Better’ pilot scheme is funded by the Department for Work and Pensions and the coaches will be provided by welfare to work agency, Remploy (a welfare-to-work subsidiary of the Maximus).”

She goes on to say: “It has come to light that these new programmes are also the subject of ‘research’. The new Work and Health Programme is currently at a research and trialing stage. As Kitty Jones writes, “Part of the experimental nudge element of this research entails enlisting GPs to “prescribe” job coaches, and to participate in constructing “a health and work passport to collate employment and health information.”

However, this ‘research’ (if one can call it so), has been heavily criticised because it is not sanctioned according to the usual robust ethical guidelines. Research that adheres to robust ethical guidelines would absolutely seek not to cause harm to its participants, and would seek their informed consent beforehand. This is not the case here where claimants are the participants, involuntary and ‘unconsented’, of an experiment they know nothing about.

“There are a wide range of legal and Human Rights implications connected with experimentation and research trials conducted on social groups and human subjects.”

A spokesperson for Disabled People Against the Cuts (DPAC), talked of the UN CRPD Committee’s visit to the UK and described the situation thus: It means the UN will examine the vicious and punitive attacks on disabled people’s independent living as well as the cuts which have seen so many placed in inhuman circumstances and has led to unnecessary deaths.”

There is a very detailed and important consideration of the implications of current UK policies within the context of the Convention on the Rights of Persons with Disabilities (CRPD) throughout this excellent article.

Related

Cited on the article:

https://kittysjones.wordpress.com/2015/11/28/the-goverments-reductive-positivistic-approach-to-social-research-is-a-nudge-back-to-the-nineteenth-century/– The idea that it is both possible and legitimate for governments, public and private institutions to affect and change the behaviours of citizens whilst also [controversially] “respecting freedom of choice.”

https://kittysjones.wordpress.com/2015/12/14/the-department-for-work-and-pensions-dont-know-what-their-ethical-and-safeguarding-guidelines-are-but-still-claim-they-have-some/

Friedli L, et al.MedHumanit2015;41:40–47. doi:10.1136/medhum-2014-010622

http://www.disabilitynewsservice.com/coroners-ground-breaking-verdict-suicide-was-triggered-by-fit-for-work-test/

(among other work)

Watch – And This time its Personal Psychocompulsion & Workfare from wellredfilms on Vimeo.

Nudging conformity and benefit sanctions

G4S are employing Cognitive Behavioural Therapists to deliver “get to work therapy”

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

The importance of citizen’s qualitative accounts in democratic inclusion and political participation

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

Stigmatising unemployment: the government has redefined it as a psychological disorder

My work is unfunded and I don’t make any money from it. 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.

Politics and Insights

Public interest issues, policy, equality, human rights, social science, analysis

Category: Sickness and Disability

Thanks Mr Green, but we want more than token gestures and political opportunism

Far too little far too late

Labour have already pledged to abolish the Work Capability Assessment

Some historical context

Two-way mirrors, hidden observers: welcome to the Department for Work and Pensions laboratory

Some context

Behavioural “rights” and the politics of moralising

CONTRIBUTE TO POLITICS AND INSIGHTS

Disabled people’s human rights in further jeopardy because of Brexit

The context indicates the general intent

Watching the way the wind blows

Coercing those deemed to ill to work into work. It’s not “nudge”: it’s psycho-compulsion

The Conservatives claim work is a “health” outcome: crude behaviourism

Semantic thrifts: being Conservative with the truth

The nitty gritty

Share this:

The ‘functional’ assessment

The introduction of PIP was framed by New Right anti-welfarism

Reliability

Time periods, fluctuations and descriptor choices

Risk and safety

Share this:

Far too little far too late

Labour have already pledged to abolish the Work Capability Assessment

Some historical context

Share this:

The system is designed to deter successful claims

The revolving door of assessments and psychological distress

Calls to scrap the WCA

Share this:

Some context

Behavioural “rights” and the politics of moralising

CONTRIBUTE TO POLITICS AND INSIGHTS

Share this:

Related information

Ways to respond

Share this:

Share this:

Share this:

Share this:

Share this: