Category: Uncategorized

Blind chef who accidently set him self on fire deemed ‘fit for work’ by DWP

The 51-year-old was registered partially sighted five months ago (Photo: Russell Marcus)

51 year old Russel Barton was registered partially sighted five months ago (Photo: Russell Burton) 

Russell Burton was registered partially sighted earlier this year, after burning himself with oil and setting his clothing on fire accidently at work. Burton has worked as a professional chef for the 25 years, but says his deteriorating eyesight means that he is unable to carry on in that job.

Now he fears for his future because the Department of Work and Pensions have claimed he is ‘fit for work’ so he isn’t eligible for disability benefit.

Yet he cannot apply for work as a chef and he lacks the skills and experience to be considered for other roles. He says after 10 months of signing on he’s had no help with retraining from the government. 

Burton had tried to keep his health problems hidden from his bosses, but was “let go of” four times in 18 months after repeatedly missing orders and following several accidents in the kitchen. The last time this happened, in January this year, Burton said he had to acknowledge that he had to leave behind the career he’s known and loved all of his life. Then, five months ago, his doctor approved him as registered partially sighted. 

Burton says he has been switched back and forth between Jobseeker’s Allowance (JSA) and Employment Support Allowance (ESA) six times this year – and each time his money is delayed, which is making him depressed and anxious. He added “Each time they switch me between benefits I can be waiting a month of two for my money. They just tell me ‘go to a food bank”.  

“No-one will hire me as a chef anymore and I know myself I just can’t be in a kitchen anymore because I’m a health and safety risk to myself and to others. I tried to hide it for the last five years but I clearly can’t anymore.

“I’m keen to find a new career but no-one gets back to me when I apply for jobs I’ve no experience in. The Job Centre has promised me help with retraining but I’ve had zero support so far.” 

He explains: “One time I was holding a tea towel that caught fire and then the sleeves of my top went up.”

Since birth, Russell’s left eye as been affected by amblyopia. The childhood condition means that vision doesn’t develop properly. Children with this problem can see less clearly out of the affected eye and rely more on the ‘good’ eye. This has caused blind spots and double vision for Burton.

Five years ago, he suffered macular scarring in the righ eye — his ‘good eye’ — as an amateur photographer, as he was trying to capture the sun’s corona, which caused his central vision to go blurred and distorted.

Burton says he’s keen to find a new career path but wants some help with re-training 

He explained how his deteriorating eyesight impacted on his chef work: “I was missing tickets – in a restaurant a chef could get 120 tickets an hour and I was struggling to read them. There were times I cut myself chopping, you’re under pressure to work fast and that’s dangerous without good eyesight.

“One time I was holding a tea towel that caught fire and then the sleeves of my top went up. Other times I’d splashed myself with hot oil as I hadn’t seen there was any there in the pan.”

Burton says: “There’s an awful mentality with Job Centre staff where they think it’s acceptable or normal to leave people for months without money. The system is broken.”

Burton who lives with his partner Rachel and her two children, said the uncertainty and insecurity of his income has had an impact on his mental health: “For months I became a recluse, I didn’t go out anywhere or see anyone,” he said.

He has also lost two stone over the last nine months, which he believes is due to a combination of stress and an undiagnosed stomach condition. 

He said: “The doctors thought I had an ulcer but that’s now been ruled out but they don’t know what’s causing my gastrointestinal problems. It doesn’t help that when I’ve been switched to contributions based JSA or ESA I’ve not been entitled to free prescriptions so I’ve not been able to afford to buy the medicines I need to help settle my stomach.”

Burton said he feels “extremely let down” by the state.

“There’s an awful mentality with Job Centre staff where they think it’s acceptable or normal to leave people for months without money and they just say ‘go to a food bank’ when you complain.

“Food banks should be an absolute last resort for people. The system is broken.” 

A system that coerces people who may, through no fault of their own, pose a danger to themselves or others to work is definitely broken. If Russell Barton has an accident in the work place, who is culpable? Barton has expained the impact of his condition, and outlined some of the consequences. The Department for Work and Pensions have taken absolutely no notice of him. He may find some work he can do, but there are serious restrictions on the kind of work he can now do. 

It’s utterly appalling and cruel that people like Russell Barton are placed in situations where they are left for long periods with no income, and then forced to look for work within an extremely competitive employment market when there are such significant health and safety barriers to the kinds of work he can undertake. 

It’s a social security system that has been set up intentionally to fail people, and furthermore it is placing people in unacceptable situations of danger.

 


I don’t make any money from my research and writing. I’m disabled through illness and on a very low income, but this is something I can do.  If you like, can make a donation to help me continue to research and write free, informative, insightful and independent articles, and to provide support to others going through ESA, PIP and Universal Credit assessment and appeal. The smallest amount is much appreciated – thank you.

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New research shows welfare sanctions are punitive, create perverse incentives and are potentially life-threatening

Image result for 3 year study show sanctions don't work

Two days ago I published an article about people who have been harmed by welfare  sanctions because they were chronically ill. Two of those people died as a consequence of actions taken by the Department for work and Pensions – see Welfare sanctions are killing people with chronic illnesses

Several studies over the last few years have found there no evidence that benefit sanctions ‘help’ claimants find employment, and most have concluded that sanctions have an extremely detrimental impact on people claiming welfare support.

However, the Conservatives still insist that benefit conditionality and sanctions regime is ‘helping’ people into work. 

Yesterday, an important study was published, which warned what many of us have known for a long time – that sanctions are potentially life-threatening. The authors of the study warn that sanctioning is  “ineffective” and presents “perverse and punitive incentive that are detrimental to health”.

The study – Where your mental health just disappears overnightdrew on an inclusive and democratic qualitative methodology, adding valuable insight as well as empirical evidence that verifies that sanctions are harmful, life-threatening and do not work as a positive incentive to ‘help’ people into work. The authors’ conclusions further validate the wide and growing consensus that sanctions should be completely halted.

The researchers say that benefits sanctions and conditions are simply pushing disabled people further from employment as well as damaging their health.

The research was carried out jointly by the University of Essex and Inclusion London, and it was designed to investigate the experiences of people claiming the Work Related Activity (WRAG) component of Employment and Support Allowance (ESA).  

The authors of the report are: Ellen Clifford of Inclusion London, Jaimini Mehta, a Trainee Clinical Psychologist at the University of Essex, Dr Danny Taggart, Honorary Clinical Psychologist and Dr Ewen Speed, both from School of Health and Social Care, also at the University of Essex.

WRAG claimants are deemed suitable for some work related activity and failure to engage can lead to ESA payments being cut or ‘sanctioned’. Under Universal Credit, the ESA WRAG is being replaced by the Limited Capability for Work group (LCW). The ESA Support Group is replaced by the Limited Capability for Work Related Activity group (LCWRA). 

The research team found that all of the participants in the study experienced significantly detrimental effects on their mental health. The impact of sanctions was life threatening for some people.

For many, the underlying fear from the threat of sanctions meant living in a state of constant anxiety and fear. This chronic state of poor psychological welfare and constant sense of insecurity caused by the adverse consequences of conditionality can make it very difficult for people to engage in work related activity and was made worse by the extremely unpredictable way conditionality was applied, leaving some participants unsure of how to avoid sanctions. The researchers concluded that conditionality is an ineffective psychological intervention. It does not work as the government have claimed.

The research report and findings were launched at an event in Parliament hosted by the  cross-bench peer Baroness Tanni Grey-Thompson.

Ellen Clifford, Campaigns and Policy Manager at Inclusion London, said: “This important research adds to the growing weight of evidence that conditionality and sanctions are not only harmful to individuals causing mental and physical negative impacts, but are also counter-productive in their aim of pushing more disabled people into paid work.

“Universal Credit, which is set to affect around 7 million people with 58% of households affected containing a disabled person, will extend and entrench conditionality.

“This is yet another reason why the roll out of Universal Credit must be stopped and a new system designed based on evidence based approaches and co-produced with disabled people and benefit claimants.”

The results also showed that participants wanted to engage in work and many found meaning in vocational activity. However, the WRAG prioritised less meaningful tasks.

In addition, it was found that rather than ‘incentivising’ work related activity, conditionality meant participants were driven by a range of behaviourist “perverse and punitive incentives”, being asked to engage in activity that undermined their self-confidence and required them to understate their previous achievements.

Other themes that emerged during the study included more negative experiences of conditionality, which included feeling controlled, a lack of autonomy and work activities which participants felt were inappropriate or in conflict with their personal values.

The government have claimed that generous welfare creates ‘perverse incentives’ by making people too comfortable and disinclined to look for work. However, international research has indicated that this isn’t true. One study found that generous welfare actually creates a greater work ethic than less generous provision.

Dr Danny Taggart, Lecturer in Clinical Psychology at the University of Essex, said: “Based on these findings, the psychological model of behaviour change that underpins conditionality and sanctioning is fundamentally flawed.

“The use of incentives to encourage people to engage in work related activity is empirically untested and draws on research with populations who are not faced with the complex needs of disabled people.

“The perverse and punitive incentives outlined in this study rendered participants so anxious that they were paradoxically less able to focus on engagement in vocational activity.

“More research needs to be undertaken to understand how to best support disabled people into meaningful vocational activity, something that both the government and a majority of disabled people want.

“This study adds further evidence to support any future research being undertaken in collaboration with disabled people’s organisations who are better able to understand the needs of disabled people.” 

Participants in the study commented on some of the perverse incentives: “The new payments for ESA from this year are £73 a week as opposed to £102. Well if you’re on £102 a week because you’ve been on it for longer than 6 or 12 months and you know if you go back to work and it turns out you’re not well enough to carry on then you’re coming back at the new rate of £73 per week. That’s going make you more cautious and its counter-productive and it increases the stress.” (Daniel). 

“After 13 weeks I have to go and put a new claim in. After 13 weeks if the job doesn’t last, or if I get made redundant, or if I get terminated or the contract stops, I then have to go into starting all over again. Reassessment etc. So, I’m worse off.” (Dipesh).

Another form of perverse and punitive incentive arises because qualifications are regarded as an impediment to employment, not an asset; “So when the Job Centre says to you, you should remove your degree from your CV because they don’t want you to be over qualified when you apply for the jobs they give… The impact on your feeling of self-worth… They told me to remove it and if I didn’t I would be punished and would be sanctioned… This is the way that the Job Centre chip away at your confidence and all those sorts of things.” (Charlie).

The report discusses the stark impact of sanctions, described by ‘Charlie’. The authors say: “We include a fuller narrative in this case as it incorporates a number of the themes that came up for the sample as a whole – the perverse and punitive incentives and double binds involved in the WRAG, the mental health crises caused by Conditionality and Sanctioning, and how these pushed people further away from employment.

Charlie explains: “It became a really stressful time for me… we didn’t have a foodbank that was open regularly so I didn’t have that as an option… So, what I was doing instead, because quite quickly my electricity went out… So, all my food was spoilt that was in the freezer. I managed to last for another 5-6 days of food from stuff that I had in the house. So, after that I started to go, I was on a work programme but was never called in. So, I’d go in anyway and there were oranges and apples in a fruit bowl, so I would just go in there and steal the oranges and bananas so I would have something to eat. Then they finally made a decision that I was going to be sanctioned… And there was this image which will probably stay with me for the rest of my life. 

“On Christmas day I was sat alone, at home just waiting for darkness to come so I could go to sleep and I was watching through my window all the happy families enjoying Christmas and that just blew me away. And I think I had a breakdown on that day and it was really hard to recover from and I’m still struggling with it. And it was only my aunt,
I’ve got an aunt in Scotland, every year she sends me £10 for my birthday and £10 for Christmas. And so on the Saturday after Christmas, the first postal day, I received £20 from her and so then I could buy some electricity and food. I was then promptly sick because I’d gorged myself, because I ate too quickly.” 

The authors add Charlie’s description of a meeting with the same advisor who had sanctioned him following the Christmas break and how it has affected him since: “So finally, when new year had ended and I had to go back and sign with that same woman who had sanctioned me. She said that being sanctioned had shown her that I didn’t have a work ethic. Now I’d been working pretty much solidly since I was 16 and it was only out of redundancy that I was out of work… 

“The problem I had with that was the woman who sanctioned me was in the same place and it made me extremely nervous. I now have a problem going into the Job Centre because I literally start shaking because of the damage that the benefit sanction did to me… So yeah that was part, the sanction was one of the reasons that triggered the mental health and problems I’m having now…it was awful and I ended up trying to commit suicide… to me that was the last straw and I went home and I just emptied the drawer of tablets or whatever and I ended up in A&E for a couple of days after they’d pumped my stomach out.” (Charlie).

The report also echoes a substantial part of my own work in critiquing the behaviourist thinking that underpins the idea of sanctions. The ideas of conditionality and sanctions  arose from Behavioural Economics theories. (See also my take on the hostile environment created by welfare policy and practices that are based on behaviourism and a language of neoliberal ‘incentives’ –  The connection between Universal Credit, ordeals and experiments in electrocuting laboratory rats).

The study finds “no evidence to support the use of this modified form of Behavioural Economics in relation to Disabled people”.

The report authors say: “These models of behaviour change are not applicable for Disabled People accessing benefits. The incentives offered by Conditionality and Sanctioning involve threats of removing people’s ability to access basic resources. This induces a state of anticipatory fear that negatively impacts on their mental health and renders them less able to engage in work related activity.”

The report concludes that the DWP should end sanctions for disabled people. The authors recommended that the DWP works inclusively with disabled groups to come up with a better system.

It was once a common sense view that if you remove people’s means of meeting basic survival needs – such as for food, fuel and shelter –  their lives will be placed at risk. Welfare support was originally designed to cover basic needs only, so that when people faced difficult circumstances such as losing their job, or illness, they weren’t plunged into absolute poverty. Now our social security does not adequately meet basic survival needs. It’s become acceptable for a state to use the threat and reality of hunger and destitution to coerce citizens into conformity.

Why sanctions and conditionality cannot possibly work

One fundamental reason why sanctions can never work as the government has claimed, to ‘incentivise’ people into work centres on Abraham Maslow’s groundbreaking work on human needs. Maslow highlights that people can’t fulfil their ‘higher level’ psychosocial needs when their survival needs are compromised. When people are reduced to a struggle for survival, that takes up all of their motivation and becomes their only priority. 

The Minnesota Starvation experiment verified Maslow’s theory. 


One of the uniquely important features of Britain’s welfare state was the National Insurance system, based on the principle that people establish a right to benefits by making regular contributions into a fund throughout their working lives. The contribution principle has been a part of the welfare state since its inception. A system of social security where claims are, in principle, based on entitlements established by past contributions expresses an important moral rule about how a benefits system should operate, based on reciprocity and collective responsibility, and it is a rule which attracts widespread public commitment. National Insurance is felt intuitively by most people to be a fair way of organising welfare.

The Conservative-led welfare reforms had the stated aim of ensuring that benefit claimants – redefined as an outgroup of free-riders – are entitled to a minimum income provided that they uphold responsibilities, which entail being pushed into any available work, regardless of its pay, conditions and appropriateness. The government claim that sanctions “incentivise” people to look for employment.

Conditionality for social security has been around as long as the welfare state. Eligibility criteria, for example, have always been an intrinsic part of the social security system. For example, to qualify for jobseekers allowance, a person has to be out of work, able to work, and seeking employment.

But in recent years conditionality has become conflated with severe financial penalities (sanctions), and has mutated into an ever more stringent, complex, demanding set of often arbitrary requirements, involving frequent and rigidly imposed jobcentre appointments, meeting job application targets, providing evidence of job searches and mandatory participation in workfare schemes. The emphasis of welfare provision has shifted from providing support for people seeking employment to increasing conditionality of conduct, in a paternalist attempt to enforce particular patterns of behaviour and to monitor claimant compliance.

The Conservatives have broadened the scope of behaviours that are subject to sanction, and have widened the application of sanctions to include previously protected social groups, such as ill and disabled people, pregnant women and lone parents.

Ethical considerations of injustice and the adverse consequences of welfare sanctions have been raised by politicians, charities, campaigners and academics. Professor David Stuckler of Oxford University’s Department of Sociology, amongst others, has found clear evidence of a link between people seeking food aid and unemployment, welfare sanctions and budget cuts, although the government has, on the whole, tried to deny a direct “causal link” between the harsh welfare “reforms” and food deprivation. However, a clear correlation has been established. 

A little more about behavioural economics and welfare policy

I’ve written extensively and critically about how Behavioural Economics and the ‘behaviourist turn’ has become embedded in welfare policies and administration. 

The use of targeted citizen behavioural conditionality in neoliberal policy making has expanded globally and is strongly linked to the growth in popularity of behavioural economics theory (“nudge”) and the New Right brand of “libertarian paternalism.”

Reconstructing citizenship as highly conditional stands in sharp contrast to democratic principles, rights-based policies and to policies based on prior financial contribution, as underpinned in the social insurance and social security frameworks that arose from the post-war settlement.

The fact that the poorest citizens are being targeted with theory-based “interventions” also indicates discriminatory policy, reflecting traditional Conservative class-based prejudices. It’s a very authoritarian approach to poverty and inequality which simply strengthens existing power hierarchies, rather than addressing the unequal distribution of power and wealth in the UK. 

Some of us have dubbed this trend neuroliberalism because it serves as a justification for enforcing politically defined neoliberal outcomes. A hierarchical socioeconomic organisation is being shaped by increasingly authoritarian policies, placing the responsibility for growing inequality and poverty on individuals, sidestepping the traditional (and very real) structural explanations of social and economic problems, and political responsibility towards citizens.

Such a behavioural approach to poverty also adds a dimension of cognitive prejudice which serves to reinforce and established power relations and inequality. It is assumed that those with power and wealth have cognitive competence and know which specific behaviours and decisions are “best” for poor citizens.

Apparently, the theories and “insights” of cognitive bias don’t apply to the theorists applying them to increasingly marginalised social groups. No one is nudging the nudgers. Policy has increasingly extended a neoliberal cognitive competence and decision-making hierarchy as well as massive inequalities in power, status and wealth.

It’s interesting that the Behavioural Insights Team have more recently claimed that the state using the threat of benefit sanctions may be counterproductive”. Yet the idea of increasing welfare conditionality and enlarging the scope and increasing the frequency of benefit sanctions originated from the behavioural economics theories of the Nudge Unit in the first place.

The increased use and rising severity of benefit sanctions became an integrated part of welfare conditionality in the Conservative’s Welfare Reform Act, 2012. The current sanction regime is based on a principle borrowed from behavioural economics theory – an alleged cognitive bias we have called “loss aversion.”

It refers to the idea that people’s tendency is to strongly prefer avoiding losses to acquiring gains. The idea is embedded in the use of sanctions to “nudge” people towards compliance with welfare rules of conditionality, by using a threat of punitive financial loss, since the longstanding, underpinning Conservative assumption is that people are unemployed because of alleged behavioural deficits and poor decision-making. Hence the need for policies that “rectify” behaviour.

I’ve argued elsewhere, however, that benefit sanctions are more closely aligned with operant conditioning (behaviourism) than “libertarian paternalism,” since sanctions are a severe punishment intended to modify behaviour and restrict choices to that of compliance and conformity or destitution. At the very least this approach indicates a slippery slope from “arranging choice architecture” in order to “support right decisions” that assumed to benefit people, to downright punitive and coercive policies that entail psycho-compulsion, such as sanctioning and mandatory workfare. 

For anyone curious as to how such tyrannical behaviour modification techniques like benefit sanctions arose from the bland language, inane, managementspeak acronyms and pseudo-scientific framework of “paternal libertarianism” – nudge – here is an interesting read: Employing BELIEF: Applying behavioural economics to welfare to work, which is focused almost exclusively on New Right small state obsessions. Pay particular attention to the part about the alleged cognitive bias called loss aversion, on page 7.

And this on page 18:

“The most obvious policy implication arising from loss aversion is that if policy-makers can clearly convey the losses that certain behaviour will incur, it may encourage people not to do it”.

And page 46:

“Given that, for most people, losses are more important than comparable gains, it is important that potential losses are defined and made explicit to jobseekers (eg the sanctions regime)”.

The recommendation on that page:

“We believe the regime is currently too complex and, despite people’s tendency towards loss aversion, the lack of clarity around the sanctions regime can make it ineffective. Complexity prevents claimants from fully appreciating the financial losses they face if they do not comply with the conditions of their benefit”.

The paper was written in November 2010, prior to the Coalition policy of increased conditionality and the extended sanctions element of the Conservative-led welfare reforms in 2012. 

The Conservatives duly “simplified” sanctions by extending them in terms of severity and increasing the frequency of use. Sanctions have also been extended to include previously protected social groups, such as lone parents, sick and disabled people.

Unsurprisingly, none of the groups affected by conditionality and sanctions were ever consulted, nor were they included in the design of the government’s draconian welfare policies.

The misuse of psychology by the government to explain unemployment (it’s claimed to happen because people have the “wrong attitude” for work) and as a means to achieve the “right” attitude for job readiness. Psycho-compulsion is the imposition of often pseudo-psychological explanations of unemployment and justifications of mandatory activities which are aimed at changing beliefs, attitudes and disposition. The Behavioural Insights Team have previously propped up this approach.

Techniques of neutralisation

It is unlikely that the government will acknowledge the findings of the new study which presents further robust evidence that unacceptable, punitive welfare policies are causing distress, fear, anxiety, harm, and sometimes, death.

To date, we have witnessed ministers using techniques of neutralisation to express faux outrage and to dismiss legitimate concerns and valid criticism of their policies and the consequences on citizens as “scaremongering”. 

It isn’t ‘scaremongering’ to express concern about punitive policies that are targeted to reduce the income of social groups that are already struggling because of limited resources, nor is it much of an inferential leap to recognise that such punitive policies will have adverse consequences. 

Political denial is oppressive – it serves to sustain and amplify a narrow, hegemonic political narrative, stifling pluralism and excluding marginalised social groups, excluding qualitative and first hand accounts of citizen’s experiences, discrediting and negating counternarratives; it sidesteps democratic accountability; stultifies essential public debate; obscures evidence and hides politically inconvenient, exigent truths.

Research has frequently been dismissed by the Conservatives as ‘anecdotal’. The government  often claims that there is ‘no causal link’ established between policies and harm. However, denial of causality does not reduce the probability of it, especially in cases where a correlation has been well-established and evidenced.

The government have no empirical evidence to verify their own claims that their ideologically-driven punitive policies do not cause harm and distress, while evidence is mounting that not only do their policies cause harm, they simply don’t work to fulfil their stated aim.

You can read the new research report from Inclusion London and the University of Essex in full here.

Related

DWP sanctions have now been branded ‘life-threatening’

Two key studies show that punitive benefit sanctions don’t ‘incentivise’ people to work, as claimed by the government

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

Exclusive: DWP Admit Using Fake Claimant’s Comments In Benefit Sanctions Leaflet

Benefit Sanctions Can’t Possibly ‘Incentivise’ People To Work – And Here’s Why

Nudging conformity and benefit sanctions

Work as a health outcome, making work pay and other Conservative myths and magical thinking


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

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A man with multiple sclerosis lost his PIP award after assessment report was dishonestly edited during ‘audit’

 

DWP

A man with multiple sclerosis and mental health problems had his personal independence payment (PIP) stopped after officials tampered with the assessor’s original report.  The man only discovered the ‘audited’ version of his health assessment report when he asked for copies to make an appeal.

He said that no one spoke to him or the nurse who carried out the assessment before the report was altered and his PIP was stopped.

The man had been in receipt of the basic level of support for two years when he was summoned to be re-assessed for PIP, which is non-means tested and designed to help with the extra cost of living with debilitating conditions.

Private companies Atos and Capita carry out the tests across the UK, but Atos contractor Salus do much of the work in Scotland.

His local SNP MP, Marion Fellows, said: “The tampering of a health assessment report by someone who wasn’t even in the room is utterly disgraceful and deceitful.

“It shows that, for many people, the system is rigged against them and the outcome is a foregone conclusion.”

An approved nurse at Salus Glasgow carried out the assessment in September last year. The Daily Record has seen the original and ‘audited’ versions of the man’s report.

The original document said the man, diagnosed with multiple sclerosis (MS) last year, has “regular specialist input”. The ‘audited’ version says he does not.

The original report outlines the patient’s MS, depression and anxiety and tells of his difficulties with tasks including cooking, dressing and washing. The nurse noted his clothes were dirty and his top inside-out. The ‘auditor’ had removed the second point.

The ‘auditor’ changed a part which said the man needed supervision or prompting to wash or bathe, and a section on preparing food. The original said he “needs prompting” but the ‘audited’ version said he could prepare and cook a simple meal himself.

An ATOS assessment form which Marion Fellows MP claims was altered by officials (Image: Daily Record)

While the original report said that the man had “regular specialist input” and took regular medication for mental health, the altered report stated that he “has no regular specialist input”.

The man, who is from Motherwell, said: “They didn’t ask me any more questions, they just decided to go back and change the document. I’d say this can’t be a one-off situation.

“It’s disgusting. It’s picking on the weak.”

Fellows, MP for Motherwell and Wishaw, wrote to Atos and the Department for Work and Pensions (DWP) in August about the ‘audit’.

Atos, who now call themselves Independent Assessment Services, told her they did not choose which reports were audited. They wrote in an email: “This happens on a random basis. However, independent DWP audits are a DWP process.”

The DWP wrote in their reply to the MP: “If a health professional’s advice is of poor quality which could result in an incorrect decision, the case will fail the audit activity.”

Fellows said that in every section of the report where the man scored points towards his  PIP award, the ‘auditor’ had reduced his score to zero.

She added: “It is outrageous.

“It isn’t even clear who carried out the audit, as Atos say it was the DWP and the DWP say it was someone independent from them.

My constituent is now going to tribunal.

“This sums up the Tories’ austerity-driven welfare regime, which attacks the most vulnerable.

“There needs to be a complete halt to these audits, and an inquiry so that whoever is responsible is held to account.”

The government guidance document for PIP assessments (section 3.4 onwards) says that “audit processes are in place for auditing the quality of assessments through:
• DWP Lot-wide audit (random sample); and
• The provider – Approval-related audit (for trainees).

And: “Audit has a central role in ensuring that decisions on benefit entitlement, taken by DWP, are correct. It supports this by confirming that independent Health Professional advice complies with the required standards and that it is clear and medically reasonable. It also provides assurance that any approach to assessment and opinion given is consistent so that, irrespective of where or by whom the assessment is carried out, claimants with conditions that have the same functional effect will ultimately receive the same benefit outcome.”

It goes on to say: “The DWP Independent Audit Team carries out lot-wide audit, which is an audit of a controlled random sample from across each contract Lot, feeding in to routine performance reporting for DWP.”

Where a report is deemed ‘unacceptable’: “Any changes made to forms should be justified, signed and dated. It should be made clear that any changes are made as a result of audit activity. Where necessary a new report form should be completed.”

The government guidelines also say that: “Any challenge to the reason DWP has returned a case to the Provider for rework must be made via the nominated rework Single Point of Contact (SPOC).”

In the event of a dispute regarding a request for an assessment report to be changed, “the final decision on whether the case requires rework rests with DWP and not the assessor.” 

So ultimately, an official at the DWP who was not present when a person was assessed, may decide that the assessment report is ‘reworked’, and use non-transparent criteria to change the facts established and recorded during the assessment.

This means that the person making the claim has no opportunity to challenge the changes made to ‘reworked’ reports before the decision is made regarding the claim. 

There is increasing evidence that disability benefits are being removed on flimsy and fabricated grounds. Disability News Service (DNS) has been carrying out an investigation into claims of widespread dishonesty in the disability benefit system, with more than 250 PIP claimants alleging assessors repeatedly lied, ignored written evidence and dishonestly reported the results of physical examinations. It’s a regular occurrence for disabled readers to read the reports of their benefit assessment, and find a statement, of an event or comment that never in fact happened.

The government produced guidelines that says assessors must look for ‘inconsistencies’ in disabled people’s accounts. For example, if a person says that they cannot bend because of spinal problems, but they have a pet, such as a cat or dog, a decision will be made that the person making the claim can bend to feed the pet. 

In my own PIP assessment report last year, it says that the HP had to prompt me several times because of my lack of concentration. She also acknowledged that I needed aids to remember to take my medication. Yet the report is riddled with inconsistencies and inaccuracies. It was concluded that there is no evidence that I have ‘cognitive difficulties’ because I have a degree (from 1996), and worked as a social worker (before I became too ill to work in 2010.) It was also mentioned that I had a driving licence as further justification for removing a point, but the report failed to mention I have not been able to drive since 2005 because of flicker-induced seizures, even though I made that clear. I therefore lost one point – which meant I was not awarded the enhanced rate.

As well as widespread allegations of fabricated reports, secret filming has produced claims of a culture of targets, in which assessors are allegedly monitored to ensure they don’t find excessive numbers of disabled people eligible for benefits, and mounting evidence of toxic punitive measures. As one former jobcentre adviser put it when describing her role with benefit claimants, there were “brownie points for cruelty.

Last year, figures released by the government indicated that neither Atos nor Capita – the private companies contracted by the government – paid more than £500m to assess people for Personal Independence Payments (PIP) – are actually meeting the target of 97% of assessments conforming to standards. 

The government released the data to the Commons Work and Pensions Committee, which was due to take evidence from Atos and Capita regarding the assessments.

While private companies carry out the assessments, it is the DWP that makes the final decision on whether to award people financial support. However, those decisions are informed by the contents of reports that privately contracted ‘health professionals’ write during the assessment process.

One of the current performance measure – which sees an independent team pick cases at random – was launched in March 2016. Under the previous method, the private providers audited assessments themselves. 

The NAO found last year that the number of completed ESA assessments were below target, despite an expected doubling of the cost to the taxpayer of the contracts for disability benefit assessments, to £579m a year in 2016/17compared with 2014/15.

The NAO said that nearly 1 in 10 of the reports on disabled people claiming support were rejected as below standard by the government. This compares with around one in 25 before Atos left its contract. The provider was not on track to complete the number of assessments expected last year and has also missed assessment report quality targets.

The proportion of Capita PIP tests deemed ‘unacceptable’ reached a peak of 56% in the three months to April 2015.

For Atos, the peak was 29.1% for one lot in June 2014. 

More than 2.7million people have had a DWP decision regarding PIP since the benefit launched in 2013 – this suggests that tens of thousands went through an ‘unacceptable’ assessment.

However, it’s difficult to acertain what ‘unacceptable’ actually means, in light of the fact that the DWP orders some reports are ‘reworked’. This editing may – and undoubtedly has – result in grossly inaccurate final reports which in turn inform a fatally flawed and unjust decision-making process, aimed at declining disabled people’s claims for lifeline support.

 

Related

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

Thousands of disability assessments deemed ‘unacceptable’ under the government’s own quality control scheme

 


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

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Cohen’s mistake is to call for us to be conservative both in language and politics.

crowtherconsulting's avatarMaking rights make sense

Nick Cohen makes three important points. In his Spectator piece ‘The Cheating Language of Equality’ and its abridged version in last Sunday’s Observer ‘Honeyed Words do nothing to curb prejudice against the disabled’ he notes how insistence on certain adopting forms of language when discussing issues connected to disability have done little to obstruct deep and damaging cuts to services and financial support. Indeed, I would share his analysis and add that the very ideas and language advocated by people such as myself may also sometimes have been weaponised to make the case for cuts, or certainly may have had the effect of diminishing public concern. Cohen also bemoans the reliance on what he labels ‘euphemism’, arguing that ‘it is easier to remove state support if you describe disabilities in a sing-song voice so soft and light you make them sound as if they are not disabilities at…

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Depression and time out

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With Alex Cunningham, Debbie Abrahams and my good friend Gail Ward at the Disability Equality Roadshow a couple of years ago. 

I don’t often talk about myself in my posts. I write about government policies, their socioeconomic consequences, their often devastating impacts on fellow citizens and critical, evidenced exploration of the ideological narratives that underpin them. In particular I write about welfare policies.  

I began campaigning and writing critically about the implications of the Coalition’s controversial Welfare Reform Bill in 2012, prior to it passing into law. It was clear that poor, unemployed and disabled citizens were being politically targeted with cuts of unprecedented intensity to their lifeline income. Social security was calculated originally to provide for essentials only. The cuts, strict conditionality, work fare and sanctions have left many citizens without enough money to cover basic survival needs such as food, fuel and shelter.

I messaged every single peer in 2012 to tell them why the welfare reform bil must not happen, and although many agreed, Cameron pushed this controversial bill through parliament, using the ‘financial privilege of the Commons to override criticism and challenge.

The punitive, regressive welfare reforms transformed social security from being a publicly funded social safety net into a ‘hostile environment’ concerned with administrating work discipline. It struck me that the policy details are very authoritarian and reflect certain traditional Conservative prejudices concerning the characteristics of the poorest citizens. These prejudices have been embodied in extremely discriminatory and oppressive policies. 

These coercive policies are offensive to basic ethical principles, undermine democracy and the fundamental universality of basic human rights, by making them conditional for the poorest citizens with the greatest need for protection from political abuse. Austerity was an ideological choice among several more humane ones. Austerity is a central feature of neoliberalism.

Having gone through the controversial Work Capability Assessment in 2011, when I had to give up my social work because I was too ill to continue in my post, followed by the distressing appeal process, some of my first pieces of work were aimed at providing support for other people going through the same process. I used information that an Atos whistleblower provided to help others navigate the fundamentally unfair assessment for Employment and Support Allowance (ESA), which is based on a biased process, weighted specifically towards finding justification for ending a claim for support and finding disabled or ill people ‘fit for work’.  

My own experience of the Work Capability Assessment was so terrible that I couldn’t face claiming PIP for 6 years. I finally did last year, with support from my local council, who had also provided some adaptations and aids in my home because of the growing extent of my disability. The experience of the PIP assessment was as terrible as I had anticipated.

I also co-run a group on Facebook to support other people going through ESA and PIP claims, assessments, mandatory reviews and appeals. Many of the people we support are experiencing profound psychological distress, anxiety and so many are having suicidal thoughts. Lots of people contact us for psychological and emotional support, and sometimes it feels very overwhelming to see such widescale and profound distress and harm that people are experiencing because of cruel government policies.

Many concerns have been raised regarding the reliability of the assessment in practice, the harmful effects of wrong decisions on vulnerable citizens and even its value-for-money. I submitted evidence to a United Nations’ inquiry from 2012 onwards, which concluded in 2016 that the government’s welfare policies have systematically violated the human rights of disabled people.  

My main aim is to share information, evidence, analysis and insight and to raise awareness of the unjust impacts of neoliberal welfare policies as widely as possible with citizens, politicians, professionals, academics and allied organisations. This has included speaking at conferences about the consequences of neoliberalism and the welfare reforms, meeting regularly with opposition welfare ministers (Conservative ministers have consistently refused to engage); contributing to the design of opposition welfare policies where I can, in addition to writing blogs.  

I’ve been asked a few times to do interviews on TV, and I try to get out to protests but often I’m simply not well enough to do so. My illness – lupus – affects all of my joints, tendons, periodically causing inflammation and pain, affecting my mobility. It also affects my nerves, blood cells, lungs, brain, my gut and my ability to fight infection. I catch a cold and end up with pneumonia.

I often have low platelet counts – autoimmune thrombocytopenia, which is a bleeding disorder. That seriously limits what I can do, sometimes. I’ve also developed a sensitivity to flickering lights, which causes partial seizures and other problems. That’s problematic because it restricts where I can go – shopping areas for example, are often a nightmare and my clubbing days are long over. I’ve always been an outgoing person, but over recent years, my increasing physical vulnerability has left me a little agoraphobic, too. But I do my best. I’m a person that seems to prefer working ‘behind the scenes’ – ideas and scripts. I once worked for the BBC many years ago as a script writer. I was given some acting roles for some of the comedy sketches I had written. I hated the acting, but loved the creative side of my work. It’s not that I couldn’t act – apparently I could and kept getting asked to do it – but I don’t like that kind of being on stage thing, it makes me very uncomfortable. 

Another part of my illness is neurological, and that means I have cognitive problems and depression. Lupus can also sometimes lead to psychosis. All of this said, simply being chronicallly and seriously ill can cause depression because of the constant need to adapt to progressive and ever-expanding symptoms.

Over the last 2 weeks I’ve written several particularly nightmarish articles about nightmarish policies, policy proposals and serial acts more generally of a nightmarish and utterly indifferent, unresponsive government. 

I’m currently in utter despair about the state of the UK and the fact that we have an extremely authoritarian government chiseling away at democracy and our fundamental human rights. The writing and the support work I do can sometimes feel relentless and overwhelming, and those of us supporting others don’t have a professional debrief session. We should probably address that and work together supporting each other a little more. But most of us probably seldom get time to stop and think about it.

I’m going to have to take some time out to deal with serious depression and exhaustion. In the meantime, would you please share my articles, because as depressing as they are, people in the UK need to know the way the wind is blowing.

I also want to say thank you for everyone who has supported my work over the past few difficult years, and those who have very frequently shared it. Also, thank you for all of the feedback you have given, which has kept me going.

I will be back as soon as I’m feeling more myself.

Thank you,
Sue x

dis-eq-roadshowGail Ward and me working with Debbie Abrahams and others


Here are my last few articles:

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

Why private landlords are calling for ‘major overhaul’ of Universal Credit, many refuse to let properties to ‘high risk’ universal credit claimants

The Centre for Social Justice say Brexit is ‘an opportunity’ to introduce private insurance schemes to replace contribution-based social security

The government’s shameful lack of progress on disability rights in the UK – new report update and submission to the UNCRPD Committee

Concerns about the impact of Brexit on the human rights of disabled people in update report to UNCRPD

Damian Hinds rebuked for misusing statistics and being conservative with the truth

Government plans to use your phone and online data to police your lifestyle and predict ‘threats’ to your health

Government changes to Mental Capacity Act threatens human rights of vulnerable citizens

British Medical Association proposals deemed passive ‘euthanasia by stealth’ for disabled people with degenerative illnesses

Research finds ‘inaccuracies and distortions’ in media coverage of antisemitism and the Labour Party

Meet Liam and Michelle. It’s time to listen to the voices of homeless people about the fatal flaws of Universal Credit

Disability campaigners & organisations meet with Labour ministers to discuss devastating impacts of government’s draconian disability policies

I had a spot on message from my friend Hubert, who sometimes shares his excellet posts on this site.

He says this: “This is the long term outcome of Tory Policies: the systematic destruction of people for no real reason. In the words of Jarvis Cocker, fuck the morals does it make any money. In her blog, Kitty Jones asks for Readers to share her writings. Not just this blog but all of her blogs.

As a Writer and Researcher, Kitty Jones is providing analytical, researched articles that are frequently expose stories a year before the mainstream media. These are articles that outrage and upset and depress because they are not pandering to the egos of narrow partisan interests. They are setting out the truth, the facts, the consequences of policies.

Which is depressing. Because Government Policy for almost a decade has been grinding destruction. The destruction of sharing between people who think about consequences. The destruction of sharing between people who care about others. The destruction of sharing of aspirations, utopias and ideals. The grinding destruction of the society that they do not believe in.

The core of changing that is sharing this. Sharing the ideas and research that can transform the world. Becaust the truth is, Government Policy is to create a hostile environment to everybody who is not “one of us”. Yet, some people, like Kitty Jones manage to carry on doing and researching and writing. Sharing her work is just one way to stop that hostile environment from spreading.

Please go to the blog and read. Then cut and paste the url from the address bar of your browser and share one of Kitty Jones’s articles. Please. Thank you.”

He added “Because you actually are making a difference. So it does look grim, but we still have visions like yours. 🙂

 


I don’t make any money from my work. I write because it’s something I can do. We each do what we can, when we can and in our own way. 

If you like you can help by making a donation to 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. 

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

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David Clapson

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

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

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

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

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

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

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

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

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

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

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

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

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

Sanctions led to health deterioration, diabetic ulcers and leg amputation

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

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

David Boyce

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“She was literally killed by the Government.” 

Amy was 27 years old.

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

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

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

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

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

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

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

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

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

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

The government uses techniques of neutralisation:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Related 

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

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


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

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Why private landlords are calling for ‘major overhaul’ of Universal Credit, many refuse to let properties to ‘high risk’ universal credit claimants

A 2011 survey found the most common reasons for landlords to refuse tenants were antisocial behaviour, unpaid rent and damage.

Earlier this year, research by Heriot-Watt University highlighted that England has a backlog of 3.91 million homes, meaning 340,000 new homes need to be built each year until 2031. This figure is significantly higher than the government’s current target of 300,000 homes annually. 

The findings comes as rough sleeping has risen by 169 per cent since 2010, while the number of households in temporary accommodation is on track to reach 100,000 by 2020 unless the government takes steps to deliver more private, intermediate and social housing. The annual Homelessness Monitor shows that 70 per cent of local authorities in England are struggling to find any stable housing for homeless people in their area, while a striking 89 per cent reported difficulties in finding private rented accommodation.

Affordability is a big issue in the private rented sector and a major hurdle to many prospective tenants. The way in which housing benefit is calculated for private tenants has changed drastically in the decade, due to the introduction of the Local Housing Allowance system, (LHA), the erosion of both housing benefit and council tax support and the continued government cuts the welfare system. These changes have made some landlords wary and reluctant to rent to tenants in receipt of benefits.

Most tenants receive significantly less housing benefit than they are expected to pay in rent. While there is some conditional support available for some tenants, in the form of Discretionary Housing Payments (DHP), landlords say they are concerned about what they see as an increased risk of rent defaults amongst tenants relying on benefit payments. DHP is a solution only for the short term. 

Evidence in England shows that increasing numbers of private landlords are not renting to Housing Benefit claimants. The National Landlords Association gave evidence to the House of Commons Works and Pensions Committee stating that “…in the last three years there has been a 50% drop in the number of landlords taking people who are on benefits. It is now down to only one fifth; 22% of our landlord members whom we surveyed say they have LHA tenants, and 52% of those surveyed said they would not look at taking on benefits tenants.”

There are also significant worries that the impact of Universal Credit will make renting to people claiming housing benefit even less attractive to landlords. 

The Residential Landlord Association (RLA) have called for an urgent overhaul of how universal credit is paid, as more than half of landlords applied for the benefit to be paid to them instead of the tenant, which, on average, took more than two months to arrange.

David Smith, RLA policy director, said: “Our research shows clearly that further changes are urgently needed to universal credit. 

We welcome the constructive engagement we have had with the government over these issues but more work is needed to give landlords the confidence they need to rent to those on universal credit.

“The impact of the announcements from the autumn budget last year remain to be seen. However, we feel a major start would be to give tenants the right to choose to have payments paid directly to their landlord.”

As well as meaning claimants could get into debt, the system serves to dissuade private landlords from taking on universal credit tenants.

Last year, research carried out by Politics.co.uk revealed that private landlords across the country are refusing to rent out properties to people who claim Universal Credit. Sixty-nine per cent of estate agents contacted in areas where the new benefit has been rolled out said they had no landlords currently on their books who would accept Universal Credit claimants.

The head of policy at the National Landlords Association (NLA), Chris Norris said:

While the NLA supports the concepts behind Universal Credit, it is clearly divorced from the realities of many tenants’ lives. Problems with its implementation and caps to housing benefit mean that many landlords now view letting to tenants in receipt of housing benefit or Universal Credit as high risk, because they simply do not have the confidence that rent will be paid to them on time.” 

I can’t help wondering precisely which ‘concepts behind Universal Credit’ the NLA actually supports, given the acknowledgement that it clearly isn’t meeting ‘many tenant’s’ needs.

Anti-discrimination legislation protects people from both direct and indirect discrimination.  Indirect discrimination occurs where a policy, which is not discriminatory in itself, if likely to impact disproportionately on people who are protected under the Equality Act.  Some people may argue that this type of policy could be seen as indirect discrimination if, for example, housing benefit claimants were predominantly female, disabled or predominantly from an ethnic minority group. However, this type of discriminatory practice can be legal if it can be reasonably justified.  

A landlord whose mortgage lender imposed certain conditions on him or her would be justified in adopting this practice, and some mortgage lenders already refuse to give mortgages to buy-to-let landlords with tenants who claim welfare support..

Several major lenders have denied rumours that they are planning to refuse to offer mortgages to buy-to-let landlords with tenants claiming universal credit. A survey of almost 3,000 landlords with universal credit claimants as tenants by the Residential Landlords Association (RLA) in March and April 2017 showed 38 per cent experienced tenants going into rent arrears – up from 27 per cent in 2016. The average amount at the time owed in rent arrears by universal credit tenants to private sector landlords was £1,150, the RLA stated. 

However, now claimants owe on average almost £2,400 in rent payments, an increase of nearly 50 per cent on the previous year, where the figure was around £1,600, the RLA have said.. Almost two thirds of private landlords have seen tenants receiving universal creditfall into rent arrears, new research shows, amid growing concern the new benefit system is pushing people into poverty.

At the time of the survey those claiming Universal Credit faced at least a six-week wait before receiving their first payment, meaning they are already two months in rent arrears by the time of the first payment, the RLA stated.

Paul Shamplina, founder of eviction service Landlord Action, told FT Adviser: “The landlords we speak to on a daily basis through our advice line are increasingly concerned because for many, rent arrears could mean they fail to meet their own obligations to lenders.  

“Some lenders are even stipulating buy-to-let loans will not be available where tenants are ‘benefit dependent’ and so as a result, landlords are focusing on private tenants where they can achieve higher rents and the risk of arrears is less.

Many lenders do not lend to landlords with tenants who are welfare recipients, but a number of those that do said they had no plans to change their policies as a result of the switch to universal credit.

However, the State-backed lender NatWest told one of its private landlord customers to evict a vulnerable tenant because she was claiming housing benefits or pay up thousands of pounds in early repayment charges and find another lender. This was after digital broker Habito admitted incorrectly advising the customer. 

Helena McAleer was reduced to tears after NatWest said she had breached her mortgage terms by letting her two-bedroom property in Belfast to a tenant in receipt of support from the state. The tenant is an older woman, who suffers from mental health problems and would struggle with the moving process, according to McAleer.

McAleer was given the harsh ultimatum of making her tenant homeless or footing a £2,500 bill to leave the NatWest deal, after asking for a further advance from the lender.

She told Mortgage Solutions: “I was angry at the fact that another human being could ask me to kick out another human being.

“It was very black and white…  they don’t think about that person, you’re just an anonymised piece of data… that’s what hurt me, that’s not fair.”

She added: “[The tenant] is a vulnerable older lady, she has mental health issues; I’m not putting her out on the street.”

The marketing innovation manager remortgaged to NatWest in January through broker Habito, providing information about her tenant’s situation to the digital adviser.

But when she approached NatWest about taking money out of the property to buy in London in September, the lender said it had not been disclosed that the tenant was in receipt of government support.

McAleer refused to remove the tenant and asked NatWest to reconsider.

The tenant has been in place since 2016 and is set to stay for the foreseeable future.

McAleer said: “I have no doubt the tenant will be there for many years which, as a landlord, is great to know.

“Long-term security and payments, I couldn’t ask for a better tenant.”

But NatWest said it would not change its position.

A spokeswoman for the lender said: “The bank has specific lending criteria and is not able to offer mortgages in certain circumstances, including where the applicant or broker has advised they want to let the accommodation to Department of Social Security tenants.

“There are specialist providers who are better suited for customers in this circumstance.”

Habito admitted that it should not have advised McAleer to take out a deal with NatWest.

The digital broker is to pay any early repayment charges, as well as additional costs including new mortgage fees and charges.

A spokeswoman for Habito said: “We are aware of this issue and have been working with Ms McAleer to resolve it.

“We fully acknowledge that the buy-to-let mortgage product we initially advised her on was not appropriate, in light of Natwest’s policy on DSS tenants.

[It’s clear this policy has been in place some time, as the ‘DSS’ is no more, and was replaced with the DWP some years back.]

“With that, however, we are currently advising Ms McAleer on a remortgage and we will be bearing all the costs associated with it.

“Ms McAleer will not be financially impacted by this, nor will she need to make any changes relating to her current tenants.

“Great customer service is of the utmost importance to us at Habito and we look forward to resolving this matter swiftly and to Ms McAleer’s complete satisfaction.”

Lenders with outdated acronyms and outdated attitudes

If you check out the rental listings on websites such as Rightmove, or browse the window of your local lettings agent, you will often see “No DSS”. It means the landlord or agent won’t rent a property to someone on housing benefit or local housing allowance, though some younger readers might not even know what “DSS” stands for (it’s Department of Social Security, and was replaced by the Department for Work and Pensions 16 years ago).

 A number of brokers told Mortgage Solutions it is difficult to find deals for landlords with tenants on benefits. 

Too many lenders have “draconian criteria” based on ‘particular views’ of tenants on benefits, according to Steve Olejnik, managing director of Mortgages for Business.

He said: “It’s a very outdated view of the type of property that attracts people on benefits… that they’re not going to look after the property properly and therefore going to potentially damage the security.

“I just think it’s wrong.”

Whether a tenant is claiming benefits shouldn’t affect the risk of the mortgage, so in theory there is no reason why banks or building societies will not lend, Olejnik added.

He said: “Lenders are underwriting the landlord. A decision to lend should be based on the borrower’s credit profile and ability to pay along with the quality of the security provided.

“It is irrelevant whether the tenant is in receipt of benefits and should not add any bearing to the risk decision.”

Olejnik has called for legislation to stop lenders discriminating against tenants.

Simon Nunn, executive director of member services at the National Housing Federation, said: “While there are still a handful of lenders that operate these kinds of outdated policies, the majority have abandoned these restrictions.

“Rightly, they recognise that banning tenants on housing benefit is both unfair and unenforceable, based on false assumptions and stigma attached to people who receive welfare support.

“We’d encourage all lenders to follow suit by scrapping these restrictions – there needs to be a step-change across the sector to get away from the view that tenants on housing benefit are unwelcome.

“This needs to be matched by renewed commitments from letting agents, insurers, landlords themselves and the government that they will not allow people on housing benefit to be excluded from the rental market.”

Shelter has a guide on convincing a landlord to rent to you. It says local councils may keep lists of private landlords who accept tenants on housing benefit, and that some websites such as SpareRoom allow you to select a “DSS OK” filter. There is also a website called Dssmove that connects tenants with agents and landlords “that say yes to DSS”.

Smartmove can also help tenants make a claim for housing benefit and Discretionary Housing Payments.

The House of Commons Library has produced a briefing on this issue. 

 


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The Centre for Social Justice say Brexit is ‘an opportunity’ to introduce private insurance schemes to replace contribution-based social security

Image result for demolition of welfare state UK kittysjones

I’ve written two lengthy pieces about the new report and submission this month to the UNCRPD – UK Independent Mechanism update report to the UN Committee on the Rights of Persons with Disabilities (published October 2018 by the Equality and Human Rights Commission) – which provides an independent assessment of the UK Independent Mechanism (UKIM) on the “disappointing” lack of progress by the UK governments to implement the UN’s recommendations since August 2017. You can access the articles here and here

The UKIM report says that the government “has not taken appropriate measures to combat negative and discriminatory stereotypes or prejudice against persons with disabilities in public and the media, including the government’s own claims that ‘dependency’ on benefits is in itself a disincentive of employment.” 

This is important because it shows just how embedded traditional Conservative prejudice is in policy design and within the practices that social security administration has come to entail. 

Image result for welfare state UK

The idea that welfare somehow creates the problems it was designed to alleviate, such as poverty and inequality, has become almost ‘common sense’ and because of that, it’s a narrative that remains largely unchallenged. The Conservatives believe that generous welfare provision creates ‘perverse incentives’. Yet international research has shown that generous welfare provision leads to more, better quality and sustainable employment. 

Moreover, this ideological position has been used politically as a justification to reduce social security provision so that it is no longer an adequate amount to meet citizens’ basic living needs. The aim is to discredit the welfare system itself, along with those needing its support. The government have long wished to replace the publicly funded social security provision ultimately with mandatory private insurance schemes.

The idea that welfare creates ‘dependency’ and ‘disincentivises’ work has been used as a justification for the introduction of cuts and an extremely punitive regime entailing ‘conditionality’ and sanctions. The governenment have selectively used punitive behavioural modification elements of behavioural economics theory and its discredited behaviourist language of ‘incentives’ to steadily withdraw publicly funded social security provision.

However, most of the public have already contributed to social security, those needing support tend to move in and out of work. Very few people remain out of work on a permanent basis. The Conservatives have created a corrosive and divisive myth that there are two discrete groups in society: tax payers and ‘scroungers’ – a class of economic free riders.

This intentionally divisive narrative of course is not true, since people claiming welfare support also pay taxes, such as VAT and council tax, and most have already worked and will work again, given the opportunity to do so. For those who are too ill to work, as a so-called civilised society, we should not hesitate to support them.

The government’s mindset is very disciplinarian. In their view, everyone else needs ‘corrective treatment’ to ensure that society is shaped and ruled the way they think it ought to be. The government believes that rather than addressing social problems – many of which are created and perpetuated by their own policies, such as growing inequality and absolute poverty – can be addressed by ‘incentivising’ people to ‘behave’ differently. In other words, they believe that people can be punished out of poverty, being ill, being out of work, and from being less “competitive”, cost effective citizens, letting down the Conservative’s constructed, overarching neoliberal state.

The ’round table’ report from the Centre for Social Justice 

Public policies that are supposed to address fundamental human needs arising from sickness and disability are tainted by a neoliberal idée fixe. The leitmotif is a total corporacratic commodification of human needs and relationships. This has entailed the government permitting private companies to build toll gates to essential support services, building hierarchies of human worth within the closed and entropic context of a competitive market place, where resources are “scarce” and people are being herded; where the only holding principle that operates is profit over human need.

In a report from the Centre for Social Justice (an Orwellian title if ever there was one) called REFORMING CONTRIBUTORY BENEFITS (2016), David Cameron is quoted in the introduction: 

“We have already come a long way in the last 5 years. In the last Parliament we created Universal Credit so that work would always pay. We capped benefits so we struck the right balance between incentivising work and supporting the most vulnerable. And we set up the largest programme to get people into work since the 1930s with over a million people coming off the main out of work benefits and over 2 million getting into work. But when it comes to reforming, we still have further to go …” David Cameron, June 2015.

The Centre for Social Justice (CSJ) is a neoliberal right wing think tank, founded by Iain Duncan Smith. The CSJ has played an important role in the design and development of Universal Credit. 

In the opening paragraph, the report says: “William Beveridge’s original blueprint for a welfare state had personal contributions at its core. Indeed, there is widespread consensus that the contributory principle inculcates a degree of responsibility and ownership in a system that has been criticised for breeding dependency.” (My emphasis).

These are views widely held by neoliberal Conservatives, not everyone else.

As UKIM pointed out in their report, the term “welfare dependency” is itself controversial, often carrying derogatory connotations that the recipient of welfare support is unwilling to work. This narrative has diverted attention from the structural factors that cause and entrench poverty, such as government policy, labour market conditions and economic change. Instead of focusing on how to tackle the root causes of poverty, the Conservatives have focused instead on attacking the supposed poor character, morals and psychology of those needing social security support.

This narrative transforms individual experiences of social inequality and being in poverty into a personal failing, rather than a failure of the state. The ideas came from political writers such as Lawrence M. Mead. In his 1986 book Beyond Entitlement: The Social Obligations of Citizenship, Mead argued that American welfare was too permissive, giving out benefit payments without demanding anything from poor people in return, particularly not requiring the recipient to work. Mead viewed this as directly linked to the higher incidence of social problems among poor Americans, more as a cause than an effect of poverty. Neoliberal governments in both the US and UK found these ideas appealing, and the government of Margaret Thatcher imported several other similar US ideas. 

Charles Murray argued that American social policy ignored people’s inherent tendency to ‘avoid hard work’ and to be ‘amoral’, and that from the ‘War on Poverty’ onward the government had given welfare recipients disincentives to work, marry, or have children in wedlock. His 1984 book Losing Ground was also highly influential in the welfare reforms of the 1980s and 90s, and remains so among neoliberal Conservatives. 

Murray exhumed social Darwinism and gave the bones of it originally to Bush and Thatcher to re-cast. Murray’s culture of poverty theory popularised notions that poverty is caused by an individual’s personal deficits; that the poor have earned their position in society; the poor deserve to be poor because this is a reflection of their lack of qualities, poor character and level of abilities.

Of course, this perspective also assumes that the opposite is true: wealthy and “successful” people are so because they are more talented, motivated and less lazy, and are thus more deserving. Just like the widely discredited social Darwinism of the Victorian era, proposed by the likes of Conservative sociologist Herbert Spencer, (who originally coined the phrase “survival of the fittest,” and not Darwin, as is widely held) these resurrected ideas have a considerable degree of popularity in upper-class and elite Conservative circles, where such perspectives provide a justification for extensive privilege. In addition, poor communities are seen as socialising environments where values such as fatalism are transmitted from generation to “workshy” generation.

Charles Murray and Lawrence Mead clearly made an impact on the international policy debate in the 1980s, partly due to the legitimisation that they received from the support of the Reagan and Thatcher administrations for their central claims. They were particularly influential in the growth of work fare and a welfare system based on punishment and psycho-compulsion. Murray claimed the underclass of poor people avoid work because of the “overgenerous” nature of welfare benefits. Mead argued that a “culture of poverty” meant that workfare policies are required to ‘reintegrate’ and ‘incentivise’ the ‘unemployed poor.’ 

This toxic brand of neoliberal anti-welfarism, amplified by the corporate media, has aimed at reconstruction of society’s “common sense” assumptions, values and beliefs. Class, disability and race narratives in particular, associated with traditional prejudices and categories from the right wing, have been used to nudge the UK to re-imagine citizenship, human rights and democratic inclusion as highly conditional.  

Leaving the European Union provides an opportunity for the government to shift what is left of social security from public to private provision

The round table paper discusses the ‘further reform’ to welfare that Cameron hinted at:

One of the reasons why this has not happened so far has been the commitment to EU rules on maintaining a benefit programme that is exportable. The British Government succeeded in establishing that Universal Credit would not be exportable as long as contributory benefits were. 

Had contributory benefits been abolished whilst UK social security was bound by EU law, this would have exposed Universal Credit (the significantly larger budget) to exportability. In light of the British vote to leave the EU, however, there is now the possibility of reforming contributory benefits without breaching EU law.” 

The authors of the report say reforming welfare would mean “[a] new insurance model would also allow competition, greater diversification and, finally, the opportunity for claimants to take control over their long term financial support.” 

During the round table discussion, participants discussed a “potential solution”  put forward by private company Legal & General. The report itself carries legal & General’s logo. 

The suggestion was to replace the contributory benefits system with a low premium social insurance scheme delivered by employers through an auto-enrolment structure. This new social insurance scheme would take the form of a ‘rainy day guarantee’, where beneficiaries would make regular payments into the scheme, which would protect against the risk of “future income shocks as a result of long term sickness or unemployment.”

The target for the new social insurance scheme would initially be individuals from “the professional and skilled class who have fewer transactional experiences with Government. They are less likely to suffer a shock to income from illness or sudden unemployment and often need support  infrequently and for less than six months.”

“The infrastructure of this new social insurance scheme could replicate that of the auto-enrolment pension products that have been phased-in under the previous and current Governments. Employers could offer new employees access to a ‘social insurance product’ that could be administered by a private sector organisation, though partially facilitated by the Government.”

The authors also say: “During the roundtable discussion, a significant question emerged over whether a new social insurance product would be compulsoryor voluntary. One concern raised in discussion was that a voluntarysystem risks not gaining a critical mass that enables it to function,whereas a compulsory programme could undermine public confidence in the state welfare system.”

Yes, the one that most citizens have already contributed to. It is not ‘state’ welfare, it is publicly funded social security.

The report continues: One of the barriers to wide-spread acceptability of a private insurance model ahead of a state-contributory benefits model is the emotional reaction by claimants who have paid taxes but are no longer entitled to a benefit payment. Many trust the system to pay out – any alternative outcome could undermine trust in the state welfare system.

“Herein lies a problem: many people place a high degree of trust in the welfare system, only to be disappointed when it delivers less than they expect it to. Part of the challenge in proposing an insurance model, therefore, is to communicate the benefits compared to the state system.”

The benefits to whom, exactly? Legal & General and the wider private insurance sector ?

More of the rub: “Another challenge is the extent to which a new social insurance model could be extended to include both unemployment and sickness support currently covered by ESA and JSA contributory benefits. PwC (PricewaterhouseCoopers) has estimated that the annual cost of sickness absence in the UK is almost £29 billion. (Hyperlinks added by me). 

“Insurance premiums are calculated on risk and probability, such that if the risk and the probability are high,the premiums will also be high. From an insurance perspective, unemployment is seen as a greater long-term risk than sickness. Company efforts to mitigate the risk may thus mean premiums rise to an amount greater than the £11 per month previously stated.” 

Prioritising private business profit over collective human needs: the neoliberal model

In their conclusion and policy recommendations, the authors say:  

“As this report has discussed, the contributory benefits system is ripe for reform and the proposition of a social insurance model poses a potential solution. With regards to the implementation of a social insurance programme to replace contributory benefits  participants at the round table discussion made the following conclusions: 

  •  Premiums should be treated as income in the Universal Credit system, promoting use of the social insurance system.  
  • The notion of a social insurance model must be communicated correctly; Lessons can be learned from past government announcements on, for example, privately run prisons.
  • The support of business is essential, and communication must be clear as this is another product that sits alongside auto-enrolled pensions, the new lifetime ISA, and the apprenticeship levy
  • High opt-out rates risk destabilising the functionality of a voluntary model, and will therefore determine the necessity of a mandatory system or at the least an opt out model.
  • Individuals who do not draw down on their insurance pot could be offered financial recourse in the form of either a savings or pensions benefit.

“Overall, the opportunity to reform contributory benefits has arrived,the political and economic climate allows for it, and the presence of a strong alternative policy makes it possible and practical.”

You can read the full report here.

Some thoughts

The government says it believes that:

  • the current [welfare] system is too complex
  • there are insufficient incentives to encourage people on benefits to start paid work or increase their hours

The government are aiming to:

  • make the benefit system ‘fairer’ and more affordable
  • reduce poverty, ‘worklessness’ and welfare dependency
  • reduce levels of fraud and error. 

However,  ‘worklessness’ and ‘welfare dependency’ are contested categories based on assumptions and not empirical evidence. 

Our welfare state originally arose as a social security safety net – founded on an assurance that as a civilised and democratic society we value the well-being and health of every citizen.

There was a cross-party political consensus that such provision was in the best interests of the nation as a whole at a time when we were collectively spirited enough to ensure that no one should be homeless or starving in modern Britain.

As such, welfare is a fundamental part of the UK’s development –  our progress – the basic idea of improving people’s lives was at the heart of the welfare state and more broadly, it reflects the evolution of European democratic and rights-based societies.

Now the UK “social security” system is anything but. It has regressed to reflect the flawed and discredited philosophy underpinning the 1834 Poor Law Amendment Act, to become a system of punishments aimed at the poorest and most marginalised social groups. The Poor Law principle of less eligibility – which served as a deterrence to poor people claiming poor relief is embodied in the Conservative claim of Making work pay: benefits have been reduced to make the lowest paid, insecure employment a more appealing option than claiming benefits.

Back in the 1970s, following his remarks on the cycle of deprivation, Keith Joseph established a large-scale research programme devoted to testing its validity. One of the main findings of the research was that there is no simple continuity of social problems between generations of the sort required for his thesis. At least half of the children born into disadvantaged homes do not repeat the pattern of disadvantage in the next generation.

Despite the fact that continuity of deprivation across generations is by no means inevitable – the theory is not supported by empirical research – the idea of the cycle of ‘worklessness’ has become common sense. Clearly, common perceptions of the causes of poverty are (being) misinformed. The individual behaviourist theory of poverty predicts that the same group of people remain in poverty. This doesn’t happen.

However, the structural theory predicts that different people are in poverty over time (and further, that we need to alter the economic structure to make things better). Longitudinal surveys show that impoverished people are not the same people every year. In other words, people move in and out of poverty: it’s a revolving door, as predicted by structural explanations of poverty.

Therefore the very ideological premises of Conservative welfare policy is unevidenced and fundamentally flawed.

Problems with social security provision delivered through private insurance schemes

The National Insurance Scheme (NIS) provides cash benefits for sickness and disability,  unemployment, the death of a partner, retirement, and so on. Citizens already  earn entitlement to these benefits by paying National Insurance contributions;

  • The National Health Service (NHS), which provides medical, dental and optical treatment and which is normally available free of charge only to people who live in Great Britain and Northern Ireland;  
  • The child benefit and Child Tax Credit schemes, which provide cash benefits for people bringing up children;   
  • Non-contributory benefits for certain categories of disabled persons or carers;  
  • Other statutory payments made by employers to employees entitled to maternity, paternity and adoption leave.

The government’s ‘low tax low welfare view of society, coupled with a decade of very low wages and rising costs of living has created ‘tax constraints’ that conflict with the demands made on the welfare state, the government says. Substituting private insurance for tax-financed welfare provision is being touted as some kind of painless way out of those self imposed ‘constraints’.  

However, in general, switching from tax-financed social security to private insurance, where premiums are related to each individual’s risk status, will be ‘regressive’, that is, it will benefit the better-off at the expense of the less well-off. Certain citizens will not be offered cover because their level of risk is too high to make it profitable and economic for private insurance companies. This will also add to the regressive effects. Certain risks will be excluded from cover as a result of the nature of the insurance market.  

If the state still provides some kind of safety net, it may end up with all of the ‘downside risk’ but none of the ‘upside gain’: if things turn out badly and insurers are unable to meet their commitments, the state has to fill the gap created, but if things turn out well, it is the insurers who keep the surplus and profit.

In discussing the future of the welfare state, the question of whether the private sector should take on some of the insurance functions currently provided by social security has  almost inevitably arisen. However, much of this debate has a purely ideological basis.

Switching from social security to private insurance generally increases costs for those on low incomes; premium levels for products mean that those with average incomes and average risk also lose. For many insurance products, women, older people and those in poor health lose the most. 

For many with higher incomes, the role of permanent health insurance is already filled by long-term occupational sick pay while for those with lower incomes, affording enough cover to get clear of means-tested benefit entitlement is difficult. 

Uncertainty over future long-term care needs and costs makes policies virtually impossible to assess, for both consumers and providers, making reliance on private insurance a dubious proposition. The nature of the risks leads to policies which limit coverage and exclude some groups, including those without good employment records and people with disabilities.

Tax-financed provision offers not only the most equitable but also the most efficient solution, minimising costs to average-risk as well as high-risk and low-income ‘consumers’ and preserving the advantages of unified public finances.

Furthermore, it retains the integrity of the original aims of the welfare state and ensures a democratic state.

UKIM’s report to the UNCRPD raised other concerns about the potentially negative impact of Brexit on the human rights of disabled people, which you can read about here.

 

Related

This explores the overlapping neoliberal ideas aimed at the reform of both welfare and health care in the UK – Rogue company Unum’s profiteering hand in the government’s work, health and disability green paper

The Poverty of Responsibility and the Politics of Blame 

The connection between Universal Credit, ordeals and experiments in electrocuting laboratory rats

 The government plan social experiments to “nudge” sick and disabled people into work

A critique of benefit sanctions:  the Minnesota Starvation Experiment and  Maslow’s Hierarchy of Needs

The benefit cap, phrenology and the new Conservative character divination

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 by making a donation which will help me continue to research and write informative, insightful and independent articles and to provide support to others.

Damian Hinds rebuked for misusing statistics and being conservative with the truth

The statistics watchdog today issued a stern rebuke to Damian Hinds (pictured last week at the Tory Party conference in Birmingham) accusing his department of misleading the public over school funding and standards

Education Secretary David Hinds’ careful use of numbers doesn’t add up

The chair of the UK’s statistics watchdog has written to education secretary Damian Hinds for the fourth time this year, raising “serious concerns” about his department’s use of school funding statistics.

The UK Statistics Authority (UKSA) launched an investigation into the Department for Education over a minister’s claim that it was spending “record amounts” on school funding, after it emerged that the figures included billions of pounds of university and private school fees.

The figures cited by the DfE and school standards minister Nick Gibb, in defending the government’s spending on education, included the money paid out by university students on tuition fees and money that parents spent on private school fees.

Sir David Norgrove, chair of the UK Statistics Authority, wrote to Hinds this morning, chastising him for repeatedly using misleading statistics to support misleading claims.

Hetan Shah, CEO of the Royal Statistical Society, described the rebuke as “blistering”, and said it was “amazing” for Sir David to send such a letter to a minister. 

“Extraordinary that [the Uk Statistical Authority] has felt it necessary to seek the secretary of state’s reassurance that his department remains committed to the statutory code of practice for statistics and, secondary that [the DfE] will start behaving in a manner that ‘does not mislead’,” he tweeted. 

The row erupted last week after the DfE and Gibb cited figures saying that the UK was the third-highest spender on education as a proportion of economic output in the Organisation for Economic Cooperation and Development, a group of wealthy nations.

His comments came after more than 2,000 headteachers marched to Downing Street to protest at funding cuts. Headteachers also accused the government of eroding trust. Jules White, the head of Tanbridge House school in West Sussex and leader of the Worth Less? group, which has lobbied for fairer funding, said: “Parents and the wider public have a right to know the facts and the government cannot have it both ways; you cannot slash our budgets and then pretend all’s well. 

“The constant use of misinformation is placing an intolerable strain on headteachers’ relationships with the DfE. Trust is being eroded. We respectfully request the DfE to publicly set the record straight and, much more crucially, work with the chancellor to make a real-terms investment in our schools in the upcoming budget. ”

Paul Whiteman, the general secretary of the National Association of Head Teachers, said: “If trust goes, there is little left for the profession to hold on to. Failing to face up to the truth will cheat an entire generation. The chancellor must now step up and rescue education funding. It is in the national interest.”

Mary Bousted, joint leader of the NEU teaching union, branded the DfE’s use of figures as “appalling.”  

Hinds has defended the department’s use of figures today in a letter to the Statistics Authority, and pledged to work closely with it to ensure that “all departmental statistics to be both factually accurate and used in the right context”.

The shadow education secretary, Angela Rayner, said the UKSA letter represented a “humiliating rebuke” for Conservative ministers and called on the government to come clean over the crisis in school funding.

The intervention by the UKSA follows a row last week over a claim by the DfE and the schools standards minister, Nick Gibb, that the UK’s spending on education was the third highest in the world.

Complaints were made to the UKSA after it emerged in a BBC report that the OECD figures on which the claim was based included university student tuition fees as well as fees paid by private school pupils.

Hinds wrote to MPs over the weekend defending his department’s claims, but following its investigation, the UKSA ruled the figure “included a wide range of education expenditure unrelated to publicly funded schools … rather than a comparison of school spending alone. 

The result was to give a more favourable picture. Yet the context would clearly lead readers to expect that the figures referred to spending on schools

An accompanying letter by Ed Humpherson, UKSA’s director general for regulation, to the DfE’s chief statistician piled on the criticism.

“The way statistics have been presented gives a potentially misleading picture of changes in schools funding,” he wrote. “It is important that the department present statistics and data professionally and I encourage you to continue to work with communication teams to minimise the risk of misleading the public.”

The UKSA complained about a DfE tweet on school funding featuring a graph with a truncated axis which had the effect of “exaggerating” school spending figures. The information was also presented in cash terms rather than real terms.

It also criticised Gibb’s claim that in an international survey of reading abilities of nine-year-olds, England had leaped up the rankings last year after decades of falling standards, moving from 19th out of 50 countries to 8th. “This is not correct,” Norgrove pointed out. “Figures published last year show the increase was from 10th place in 2011 to 8th place in 2016.”

The UKSA also ruled on a complaint from shadow education secretary, Angela Rayner, about the DfE’s oft-repeated claim that there were now “1.9 million more young people studying in good or outstanding schools”. The authority said the figure did not give a full picture and should be set in the context of increasing pupil numbers, changes to the inspection framework and out-of-date inspections.

“I am sure you share my concerns that instances such as these do not help to promote trust and confidence in official data, and indeed risk undermining them,” said David Norgrove.

The education secretary responded to the UKSA saying his department was “looking into the precise issues raised” but he went on to largely defend the disputed claims.

Here are both letters:

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The Rt Hon Damian Hinds MP
Secretary of State for Education
(via email)

8 October 2018

Dear Secretary of State

I am writing to raise with you serious concerns about the Department for Education’s presentation and use of statistics. 

The UK Statistics Authority has had cause to publicly write to the Department with concerns on four occasions in the past year. 1 

I regret that the Department does not yet appear to have resolved issues with its use of statistics. Last week, the Minister of State for School Standards wrote that, in an international survey of reading abilities of nine-year-olds, England “leapfrogged up the rankings last year, after decades of falling standards, going from 19th out of 50 countries to 8th.”2. This is not correct. Figures published last year show the increase was from 10th place in 2011 to 8th place in 2016. 

My attention has also been drawn to a recent tweet and blog issued by the Department regarding education funding. 3 As the Authority’s Director General for Regulation has noted in a letter to the Department today, figures were presented in such a way as to misrepresent changes in school funding. In the tweet, school spending figures were exaggerated by using a truncated axis, and by not adjusting for per pupil spend. In the blog about government funding of schools (which I note your Department has now updated), an international comparison of spend which included a wide range of education expenditure unrelated to publicly funded schools was used, rather than a comparison of school spending alone. The result was to give a more favourable picture. Yet the context would clearly lead readers to expect that the figures referred to spending on schools. 

The Shadow Secretary of State for Education has written to express concerns about your use of a figure that appears to show a substantial increase in the number of children in high performing schools, as judged by OFSTED. While accurate as far as it goes, this figure does not give a full picture. It should be set in the context of increasing pupil numbers, changes to the inspection framework and some inspections that are now long in the past, as an earlier letter to the Department from the Office of Statistics Regulation pointed out. 

I am sure you share my concerns that instances such as these do not help to promote trust and confidence in official data, and indeed risk undermining them.

I seek your reassurance that the Department remains committed to the principles and practices defined in the statutory Code of Practice for Statistics. In particular, I urge the Department to involve the analysts closely in the development of its communications, to ensure that data are properly presented in a way that does not mislead. 

I have asked the Authority’s Director-General for Regulation, Ed Humpherson to speak with Jonathan Slater, Permanent Secretary at the Department for Education, and to Neil McIvor, Head of Profession for Statistics at the Department for Education, about what the Department might do to improve its practice. 

I am copying this letter to the Minister of State for School Standards, to Mr Slater and Mr McIvor, and to John Pullinger, the National Statistician. 

  Yours sincerely
Sir David
  Sir David Norgrove

1 Letter from Ed Humpherson to Head of Profession (March 2018) National Pupil Database Access
Letter from Sir David Norgrove to Shadow Secretary of State for Education (March 2018), School Funding
Letter from Ed Humpherson to Head of Profession (January 2018) International Reading Literacy Study
Letter from Ed Humpherson to Jonathan Slater (November 2017) Department for Education breaches of the Code of Practice

2 The Telegraph (27 September 2018): Our whizzpopping phonics revolution is transforming literacy in schools
3 Department for Education (28 September 2018): Tweet regarding school funding
Department for Education (28 September 2018): Education in the Media: Funding

 

response
Dear David,

Thank you for your letter. 

I appreciate you drawing your concerns to my attention and very much welcome the work by the UKSA to ensure communication of statistics across Government meets the highest standards. We are keen to work closely with the UKSA and we want all departmental statistics to be both factually accurate and used in the right context.

We are looking into the precise issues that you raise, and the Permanent Secretary will write to the UKSA shortly with a more detailed response. It may be helpful though to respond on the points of substance, including for the public including for the public
record.

Taking funding first – we need to be clear about different types of funding and spending. However, several statistics in the OECD’s 2018 report comparing expenditure in 2015 (which as you know are the latest comparative data published by the OECD) demonstrate the UK as being among the higher spenders on education at primary and secondary level, whether you look at spend as a share of GDP, spend as a share of government spending or spend per pupil. It is true to say that the OECD has ranked the UK as the third highest for total education spending – the figure which includes tertiary and private education for every country. A more direct statistic about school spending
specifically is that among G7 nations the UK government spent the highest percentage of its GDP on institutions delivering primary and secondary education.

On overall school funding, core funding is rising to £43.5bn by 2019-20. Of course, I recognise that pupil numbers are rising, we are asking schools to do more and schools are facing cost pressures. I am on record setting this out with a range of different audiences and agree that context is important.

Moving on to the survey of reading abilities, it is true to say that we have achieved our highest score in PIRLS since it first began in 2001 – in 2016 we were placed joint 8th. We agree that we could have been clearer that the improvement from 19th to 8th was between 2006 and 2016. We have put a great deal of emphasis on the teaching of phonics, introducing the phonics screening check in 2012, and since then many more six year olds are on track to be fluent readers.

Regarding the 1.9m statistic, I believe it is important to establish that the proportion of children in schools whose last Ofsted judgement was Good or Outstanding has risen from 66% in 2010 to 86% in March 2018; to make this more intelligible we tend to use the number of children rather than a percentage figure – hence we express it as 1.9m more children in Good or Outstanding schools. 

Our methodology is published at: https://www.gov.uk/government/publications/children-in-good-or-outstandingschools-august-2018As you know, Ofsted use a range of triggers for a reinspection, such as an unexpected fall in exam performance.

Naturally we want to ensure we always present those factually accurate statements, and all others, in line with your Code of Practice for Statistics and I look forward to working with your team further on that. More widely, in the interests of making sure the public debate is well-informed, I hope that others who produce and use statistics which become regularly cited will also aspire to the highest standards of data integrity, and that the UKSA can play a role in challenging where data could easily be open to misinterpretation.

Thank you once again and please be assured of my, and my department’s, continued commitment to working with you on the integrity of statistics and informing the public debate.

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Related

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Esther Mcvey forced to apologise for being conservative with the truth

It’s truly priceless that Iain Duncan Smith can accuse anyone of misrepresenting statistics with a straight face.

 


 

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Government plans to use your phone and online data to police your lifestyle and predict ‘threats’ to your health

“Artificial Intelligence in healthcare is currently geared towards improving patient outcomes, aligning the interests of various stakeholders, and reducing healthcare costs.” CB Insights.

healthcare_AI_map_2016_1

The Care.Data scandal

Back in 2014, public concerns rose because drug and insurance companies were able to buy information about patients – including mental health conditions and diseases such as cancer, as well as smoking and drinking habits – from a single English database of medical data that had been created.

Harvested from GP and hospital records, medical data covering the entire population was uploaded to the repository controlled by an arms-length NHS information centre. Never before had the entire medical history of the nation been digitised and stored in one place. Advocates said that sharing data will make medical advances easier and ultimately save lives because it will allow researchers to investigate drug side effects or the performance of hospital surgical units by tracking the impact of interventions on patients. 

However, data protection campaigners warned at the time that individuals were at risk of being identified and claimed notes were often inaccurate. The Department of Health was also criticised for failing to inform people they would be automatically opted into the scheme and would need to fill in a form if they wanted their medical records removed. 

All 26 million households in England were notified about the Care.data scheme, so that individuals could choose to opt out, but many didn’t know they had that choice. Those behind the £50million data-sharing plan said it would “improve healthcare and help medical research.”

Many doctors were so incensed about the failure to protect patients’ data that they opted out their entire surgeries from the database, and the roll-out was eventually aborted in 2014. Privacy experts warned there will be no way for the public to work out who has their medical records or to what use their data will be put. The extracted information contained NHS numbers, date of birth, postcode, ethnicity and gender.

The controversial £7.5 million NHS database (Care.data) was scrapped very quietly on same day as Chilcot Report was released.

Phil Booth of medConfidential – campaigning for medical data privacy – said: “The toxic brand may have ended, but government policy continues to be the widest sharing of every patient’s most private data.” 

Personal data is now used not only to deliver but to deny services, so it’s more important than ever to check what’s on your records.” 

He goes on to say: “Quite apart from the appalling mistreatment of generations of people, the Windrush scandal highlighted two deep problems about government’s handling of personal data. It confirms the government’s default position is one of disbelief – “guilty until proven innocent”, for some groups at least.

And it also confirms that – despite years of experience of the consequences, the government remains utterly cavalier in its stewardship of your data.

From the Home Office hunting people down through their NHS data and their children’s school records, to Google DeepMind’s secret deal intending to feed 1.6 million Royal Free Hospital patient records to its Artificial Intelligence project to Job Centre bosses interfering in medical records, and the Department for Education packaging up students’ personal data for private exploitation – as many have learned, “the power of data” is not always benign. Whether destroying the Windrush generation’s vital records or losing 25 million people’s records in the post, the consequences of poor information handling practices by Departments of the database state are always damaging to citizens.”

He’s right of course. The principle is one of private profits while the public carry the burden of risks every time. 

There is widespread concern over insurance and marketing companies getting access to our personal health data. The bottom line is that patients must have clear information about what happens to their data, how it may be used, and must be given a clearly stated opportunity to opt out.

The ‘business friendly’ government: deja Vu and AI

Theresa May has again pledged millions of pounds to use Artificial Intelligence (AI) to “improve early diagnosis of cancer and chronic disease.” In a speech delivered earlier this year, May also called for the industry and charities to “join the NHS in creating algorithms that can predict a patient’s care requirements based on their medical records and lifestyle information.” 

The government believes that early intervention would provide “less invasive, more affordable and more successful care than late intervention,” which they claim “often fails.”  

While the government has assumed that the unmatched size of the NHS’s collection of data makes it ideal for implementing AI, many are concerned about data privacy.

Importantly, May’s proposal would once again allow commercial firms to access NHS data for profit.

In April 2018, a £1bn AI sector deal between UK Government and industry was announced, including £300million towards AI research. AI is lauded as having the potential to help address important health challenges, such as meeting the care needs of an ageing population. 

Major technology companies – including Google, Microsoft, and IBM – are investing in the development of AI for healthcare and research. The number of AI start-up companies has also been steadily increasing. There are several UK based companies, some of which have been set up in collaboration with UK universities and hospitals.

Partnerships have been formed between NHS providers and AI developers such as IBM, DeepMind, Babylon Health, and Ultromics. Such partnerships have attracted controversy and wider concerns about AI have been the focus of several inquiries and initiatives within industry, and medical and policy communities. 

Last year, Sir John Bell, a professor of medicine at Oxford university, led a government-commissioned review. He said that NHS patient records are uniquely suited for driving the development of powerful algorithms that could “transform healthcare” and seed an “entirely new industry” in profitable AI-based diagnostics. 

Bell describes the recent controversy surrounding the Royal Free hospital in London granting Google DeepMind access to 1.6m patient records as the “canary in the coalmine”. “I heard that story and thought ‘Hang on a minute, who’s going to profit from that?’” he said.

Bell gave the hypothetical example of using an anonymised data for chest radiographs to develop an algorithm that eliminated the need for chest x-rays from the ‘analytical pathway’.

“That’s worth a fortune,” he said. “All the value is in the data and the data is owned by the UK taxpayer. There has to be really serious thought about protecting those interests as we go forward.”

However, Bell highlighted a “very urgent” need to review how private companies are given access to NHS data and the ownership of algorithms developed using these records.

Matt Hancock, the recently appointed health secretary, is now planning a “radical” and highly invasive system of “predictive prevention”, in which algorithms will use detailed data on citizens to send targeted “healthy living messages” to those flagged as having “propensities to health problems”, such as taking up smoking or becoming obese. 

Despite promises to safeguard data, the plans have already once again attracted privacy concerns among doctors and campaigners, who say that the project risks backfiring by scaring people or damaging public trust in NHS handling of sensitive information. People’s medical records will be combined with social and smartphone data to predict who will pick up bad habits and stop them getting ill, under radical government proposals. Of course this betrays a fundamnetal assumption of the government: that illness arises because of  bad “lifestyle choices.” 

Hancock said: “So far through history public health has essentially dealt with populations as a whole.

“The anti-smoking campaign on TV is targeted at everybody. But using data, both medical data — appropriately safeguarded, of course, for privacy reasons — and using other demographic data, you can work out that somebody might have a higher propensity to smoke and then you can target interventions much more closely.”

However, the historical evidence of the government “safeguarding” our data effectively isn’t particularly confidence-inspiring.

Public Health England is already looking at using demographic and smartphone health data to personalise messages on healthy living and plans to launch pilot projects next year.

Initially the data will be limited to broad categories, such as age or postcode. Ultimately, however, including detailed information on individual housing, employment and income or people’s internet use has not been ruled out. 

Hancock said: “We are now exploring digital services that will use information people choose to share, based on consent with only the highest standards on data privacy, to offer them precise and targeted health advice.”

Advice from whom? Unum and other private insurance companies? Businesses selling life style products? The pharma industry? Many campaigners are very concerned that the use of their data may lead to them being discriminated against by insurers or in the workplace.

Concerns

Another concern is how intrusive surveilance and data analytics is and how it may dehumanise patients. One NHS suicide prevention app, for example, that is currently in development, will monitor emails, texts and social media for signs that “people might be about to kill themselves.”

“Technology now allows us to offer people predictive prevention; tailored, intelligent advice on how to live longer, healthier lives,” Hancock said. 

“This used to happen within the brains of the GPs in the partnership when they really knew the community and had personal relationships with everyone in the community. As GPs’ practices have come under more pressure, that’s become harder and we can use data really effectively to target people who have propensities to health problems.”

Another danger is the ongoing demedicalisation of illness and the deprofessionalisation of trained doctors. Healthcare professionals may feel that their autonomy and authority is threatened if their expertise is challenged by AI. The ethical obligations of healthcare professionals towards individual patients might be affected by the use of AI decision support systems, given these might be guided by other priorities or interests, such as political ideology regarding cost efficiency or wider public health concerns.

AI systems could also have a negative impact on individual autonomy. For example, if they restrict choices based on calculations about risk or what is in the best interests of the user.

If AI systems are used to make a diagnosis or devise a treatment plan, but the healthcare professional is unable to explain how these were arrived at, this could also be seen as restricting the patient’s right to make free, informed decisions about their health. Applications that aim to imitate a human professional raise the possibility that the user will be unable to judge whether they are communicating with a real person or with technology.  

Although AI applications have the broad potential to reduce human bias and error, they can also reflect and reinforce biases in the data used to train them. Concerns have been raised about the potential of AI to lead to discrimination in ways that may be hidden or which may not align with legally protected characteristics, such as gender, ethnicity, disability, and age. 

The House of Lords Select Committee on AI has cautioned that datasets used to train AI systems are often poorly representative of the wider population and, as a result, could make unfair decisions that reflect wider prejudices in society. The Committee also found that biases can be embedded in the algorithms themselves, reflecting the beliefs and prejudices of AI developers.

Sam Smith, of the privacy group medconfidential, warned that a “ham-fisted” plan might backfire, given the government’s poor record on data-handing. He said: “Predictive intervention has to be done carefully and in the right context and with great empathy and care, as it’s easy to just look creepy and end up with a ‘Mark Zuckerberg problem’ [where a focus on the power of data leads to a neglect of the human problems it is trying to solve].”

Humans have attributes that AI systems might not be able to authentically possess, such as compassion and empathy. Clinical practice often involves very complex judgments and abilities that AI currently is unable to replicate, such as contexual knowledge (such as existing comorbidities) and and the ability to read social cues. There is also debate about whether some human knowledge is tacit and cannot be taught.

AI could also be used for malicious purposes. For example, there are fears that AI could be used for covert surveillance or screening by private companies and others. AI technologies that analyse motor behaviour, (such as the way someone types on a keyboard), and mobility patterns detected by tracking smartphones, could reveal information about a person’s health without their knowledge. 

Today it’s reported that NHS Digital is set to ignore the IT security recommendations of its own chief information officer, Will Smart, citing the estimated cost of between £800 million and £1 billion. It claims that the investment would not be “value for money”.

The recommendations were the result of a review, published in February, that was commissioned by government in response to the WannaCry ransomware attack, which affected one-fifth of all NHS trusts in the UK. The NHS was especially hard hit, not least due to a lack of up-to-date patching on Windows 7 workstations across the monolithic organisation, one of the biggest employers in the world.

The recommendations in Smart’s review had been endorsed by the National Cyber Security Centre (NCSC).

However, documents acquired under Freedom of Information by the Health Service Journal (HSJ), indicate that NHS Digital has opposed adoption of the recommendations on the grounds that they would not “be value for money”. 

NHS Digital’s response comes despite the organisation coming under sustained and continual cyber attacks, including one called Orangeworm that specifically targets sensitive healthcare data. HSJ adds that malicious phishing websites mimicking NHS trusts have also been found, while one NHS organisation was found to have exposed a sensitive database online.

A scan by NHS Digital, it adds, found 227 medical devices connected to the internet with a known vulnerability. And four out of five NHS trusts failed to even respond to a ‘high severity’ cyber alert issued in April.

The review of NHS IT security by CIO Will Smart came four months aftea damning report into the state of NHS IT security produced by the National Audit Office, which indicated that the NHS and Department of Health didn’t know how to respond to the outbreak.

With such a cavalier approach to basic IT security, it’s difficult to imagine how we can possibly trust the ‘business-friendly’ government and NHS with the stewardship of our personal health data. Personal data has become the currency by which society does business, but advances in technology should not mean organisations racing ahead of people’s basic rights. Individuals should be the ones in control and government and private organisations alike must do better to demonstrate their accountability to the public.

The use of AI in surgery

DA-VINCI-ROBOT

The Da Vinci surgicalrobot 

An inquest heard recently heard how a patient who underwent ”pioneering’ robotic heart valve surgery at the Freeman hospital in Newcastle died days later after the procedure went horribly wrong. 

Stephen Pettitt died because of multiple organ failure, yet it was expected that he was 98-99% chance of surviving the relatively low risk surgerical procedure.

Heart surgeon Sukumaran Nair had been offered training on the use of the robot with the hospital’s gynaecology department – but he refused.

He told a colleague later he could have done more “dry-run” training beforehand, the hearing heard.

The operation was planned to repair a mitral valve but damage was caused by the robot to the interatrial septum. The procedure had to be converted to an open heart operation where the chest was opened up to repair the tear.

Pathologist Nigel Cooper said: “By that time the operation had been going on for a considerable period of time. By the end of the surgery the heart was functioning very poorly.”

Medicines and a machine to help the heart function were brought in but Pettitt’s organs began to shut down and he didn’t recover.

The robot was so loud in use that the surgical team were shouting at one another and the same machine knocked a theatre nurse and destroyed the patient’s stitches, the Newcastle Coroner’s Court heard.

A leading heart surgeon, Professor David Anderson, told Newcastle Coroner’s Court the operation conducted by under-trained Sukumaran Nair, using the Da Vinci surgical robot, would not likely have ended that way had the robot not been used.

Anderson, a consultant cardiac surgeon at Guy’s and St Thomas’s Hospital, London, told the Newcastle hearing that Pettitt’s euroSCORE – the risk factor applied to heart surgery patients – was just 1-2% in normal circumstances.

Such was the concern at the completely botched six-hour-long procedure performed on Stephen Pettitt, that Northumbria police have launched a criminal inquiry.

Nair was fired from his job at Newcastle’s Freeman Hospital and their robotics heart programme ended. Newcastle coroner Karen Dilks recorded a narrative verdict into the retired music teacher’s death.

According to the US company behind the botched procedure, Intuitive Surgical Inc, “The surgeon is 100% in control of the da Vinci System at all times.”

However, there can be “serious complications and death” in any surgery, according to the business.

Risks during surgery include inadvertent cuts, tears, punctures, burns or injury to organs.

Don’t those stated risks negate the justification for using robotics to perform surgery – increased, not decreased, precision?

The company add: “It is advised the surgeon switch from minimally invasive surgery to open surgery (through a large incision) or hand-assisted surgery if problems occur.”

Related

Artificial intelligence (AI) in healthcare and research

GPrX – the company that sells NHS data to sales teams for pharma industry can market products and target the prescribers 

 


 

I don’t make any money from my work. I’m disabled through illness and on a very low income. But you can make a donation to help me continue to research and write free, informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

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