Tag: Austerity cuts

Campaigners organise ‘First Do No Harm lobby’, aimed at preventing further social security related deaths

this ESA round

Disabled campaigners, researchers and organisations who have played a key role in exposing the discrimination and harm caused by the government’s social security reforms have been travelling to Westminster to attend round table discussions with five Labour shadow ministers. The meetings are chaired by Shadow Chancellor John McDonnell. I was invited to attend by John McDonnell’s office in September, because of my own ongoing campaign work.

The meetings are also the launch of a series of campaigning efforts and consultation between the Labour party, disabled activists, researchers and allied organisations. Labour MPs also hope to secure support from members of other political parties in the longer term.

We will be continuing to challenge the government’s persistent denial of a ‘causal link’ between their draconian social security policies and the distress, systematic human rights violations, serious harm and deaths of disabled people that have arisen in correlation with those policies.

Unless the government undertakes a cumulative impact assessment of the harm and  injustices that have followed in the wake of their welfare reform acts, they cannot provide evidence to support their own claims and flat denials that their policies are causing hardship, harm and distress. 

Public health experts from the Universities of Liverpool and Oxford have also produced a research report titled First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study. It highlights that the process of reassessing people on incapacity benefit for the new employment and support allowance (ESA) from 2010 to 2013 was “associated with” an extra 590 suicides, 279,000 additional cases of self-reported mental health problems, and the prescribing of a further 725,000 anti-depressants.

Speaking to the Huffington Post last year, the shadow chancellor said that he became furious during a Parliamentary debate when he demanded a comprehensive assessment of the cumulative impact of welfare reforms on disabled people and the government refused. He praised the website Calum’s List, which details the cases of at least 60 deaths linked to welfare cuts.

He added:  “We said to the Government we know now from Calum’s List, listing people from reports in the press and elsewhere of people committing suicide as a result of Government cuts.

We knew the Government were monitoring some coroners’ reports and we wanted them published, but [then DWP minister Esther] McVey wouldn’t and I got really angry.”

“Next week, what we are doing is getting a group of campaigning organisations and a group of experts together to talk about the way in which Work Capability Assessments are still having an impact, to try to get to the bottom in terms of mental health and suicide.”

McDonnell added that Labour’s first Queen’s Speech include legislation “making sure we have a welfare and benefit system that lifts people out of poverty”.

He said that his Hayes and Harlington constituency casework now operates an open-door system four days a week due to demand from people hit by government cuts. 

He added: “Helen who runs my office said the casework now is on a scale and a depth of suffering that we’ve never seen before. And this in a constituency with the [Heathrow] airport, high levels of employment but wages not matching the housing costs and the pressure on people working all hours just to keep a roof over their heads.

“If anything goes wrong they fall out of the system. Last month we were dealing with two families living in cars. We also have the ‘beds in sheds’ phenomenon, families living in a shed or garage rented out to them, it’s staggering really.

“Before this last eight years, those sort of horrendous situations would be infrequent but you wouldn’t have someone so heavily sanctioned. The sanctions often impact on people with mental health conditions hardest.”

The Labour party’s track record of inclusion and democratic consultation with disabled citizens and their communities contrasts starkly with the Conservative’s exclusionary ‘we know better than you’ approach to disability policies. The government have imposed cuts on disabled people, acting upon them as if they are objects of policy rather than being citizens within a democracy.  

Government policies are expressed political intentions regarding how our society is organised and governed. They have calculated social and economic aims and consequences. In democratic societies, citizens’ accounts of the impacts of policies ought to matter.

However, in the UK, the way that welfare policies are justified is being increasingly detached from their aims and consequences, partly because democratic processes and basic human rights are being disassembled or side-stepped, and partly because the government employs the widespread use of linguistic strategies and techniques of persuasion to intentionally divert us from their aims and the consequences of their ideologically (rather than rationally) driven policies. Furthermore, policies have more generally become increasingly detached from public interests and needs.

The Labour party listen to citizens’ accounts, and have always acknowledged our concerns. John McDonnell was involved in the setting up of Disabled People Against the Cuts (DPAC). After a nationwide round of consultations with disabled people about policies which enshrine the Equality and Human Rights acts, led by Debbie Abrahams, the Labour party wrote an additional manifesto, outlining policies for disabled people, called Nothing about you without you, which many of us have contributed to.

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Alex Cunningham, me, Debbie Abrahams and Gail Ward after the Disability Equality Roadshow and consultation in December, 2016.

The First Do No Harm lobby on 13 February aims to expose the continued harm caused to disabled people by government social security reforms, and to seek safeguarding changes to the social security system. It follows many years of growing concerns about the controversial Work Capability Assessment (WCA) and the failure of Department for Work and Pensions (DWP) ministers to make the necessary changes to make the assessment process safe.

Disability rights campaigners and MPs will focus on the repeated failure of the DWP to ensure that the “further medical evidence” needed to demonstrate a disabled person’s eligibility for out-of-work disability benefits is always collected, particularly for claimants with mental health conditions.

The three key asks of the lobby are:

1. To incorporate the principle of “First Do No Harm” into the assessment process for disabled people in the welfare system.
2. To call for the publication of a cumulative impact assessment of social security changes to disabled people.
3. To implement an assessment framework that treats disabled people with dignity and respect.

The lobby has been facilitated by Labour’s Treasury and work and pensions teams, through shadow chancellor John McDonnell and shadow work and pensions secretary Margaret Greenwood. Both Labour MPs and activists hope that MPs from all parties will attend. 

Shadow chancellor, John McDonnell has previously said that he believed the ongoing meetings with disability rights campaigners and allied organisations could herald the start of “a significant movement to expose the brutality of the system” and secure “permanent change”.

He told Disability News Service: “Disabled people have had enough of the continuing austerity, attacks and discrimination.

“The lobby will brief on the plight of disabled people and lobby for reform to protect against this harm.” The aim is to push for the principle of “First Do No Harm” to be included in the benefits assessment process, through a framework that “treats disabled people with dignity and respect”.

The lobby also aims to push the government to acknowledge years of raised concerns by our community to carry out a cumulative assessment of the impact of its social security cuts and reforms on disabled people. 

Campaigners will also call for an end to the government’s punitive sanctions and conditionality regime.

The First Do No Harm lobby is the first organised action arising from the ongoing meetings between disabled activists and allies and Labour shadow ministers, including John McDonnell, Margaret Greenwood and shadow minister for disabled people Marsha de Cordova.

Both Margaret Greenwood and Marsha de Cordova are to speak at the briefing as part of the lobby on 13 February.

A mass lobby is one way of using your right to turn up to the House of Commons and request a meeting with your MP as one of his or her constituents. An MP’s role is to represent a constituent’s interests – even if he or she does not entirely agree with them. As each MP may have up to 90,000 constituents to look after, it is best to be as brief, clear and courteous as possible when you meet your MP.   

Disabled people or allies who want their MP to attend the lobby should write to their MP – you can find MP’s email addresses here: WriteToThem – to inform them you wish to seek an appointment on the day of the lobby. 

The lobby is due to take place on Wednesday 13 February between 1pm and 6pm, with the briefing from 2-3.30pm, in the Palace of Westminster’s committee room 15. The committee room can be used for one-to-one meetings with MPs or further discussions on the issue from 1pm-2pm and then from 3.30pm-6pm 

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The most recent meeting at Portcullis House, Westminster.

 

Related

John McDonnell attacks Tory disability cuts and vows to address suicides linked to welfare reforms

Lobby aims to persuade MPs that DWP must First Do No Harm on assessments

Labour’s Disability Equality Roadshow comes to Newcastle

Nothing about you without you – the Labour party manifesto for disabled people

I very much wanted to attend this very important mass lobby and contacted my MP in respect of this. However, unfortunately I am currently not well enough to travel down to Westminster. I will, however, be working hard promoting the event on social media. 


 

I don’t make any money from my work. But you can make a donation if you wish and help me continue to research and write informative, insightful and independent articles, and to provide support to others going through disability claims, assessments, mandatory reviews and appeals. The smallest amount is much appreciated – thank you.

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Labour challenge government about ‘shocking’ rise in coroner warnings over NHS patient deaths

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Coroners have a statutory duty to make reports to a person, organisation, local authority or government department or agency where the coroner believes that action should be taken to prevent future deaths. 

The Labour Party, who compiled the figures, has said the increase is due to the government’s austerity policies. Shadow health minister Justin Madders responded to the finding, saying: “This shocking rise in austerity-related deaths in the NHS shows yet again the devastating impact of Tory underfunding. Jeremy Hunt has claimed patient safety as his watchword, yet the truth is that more deaths are being blamed on a lack of resources in the NHS.

If the government doesn’t provide the health service with the funding it needs there is a real danger that services just become unsafe for patients. Ministers must take action now and give the NHS the resources it needs to keep patients safe.”

There were 42 ‘prevention of future death’ reports (PFDs) relating to issues such as lack of beds, staff shortages and insufficiently trained agency staff in 2016 compared with 30 in 2013. 

Within the 42 PFDs relating to lack of resources, eight were specifically concerned with resourcing of mental health services, double the number from 2013. Labour said the resourcing of mental health services was of particular concern, with deaths related to issues including the lack of mental health in-patient beds or shortages of trained staff.

In 2017, a damning PFD sent to the Department of Health after the death of Christopher Fairhurst in December 2016 said a shortage of GPs put patients at risk and placed unmanageable workloads upon those GPs who were in post. 

At the inquest into Christopher’s death, the court heard that the GP practice where Christopher was a patient serves 14,000 to 15,000 patients, but has been operating for the past few years with four or five GPs. Coroner Lisa Hamshi recorded a conclusion of misadventure, but Fairhurst’s family claimed he was often ‘twentieth in the queue’ when he tried to book a GP appointment.

The coroner claimed the ‘knock-on effect’ of the NHS funding crisis is seen ‘day in and day out’ in courts like hers. Hamshi said that she was satisfied with the care provided by doctors at Edenfield Road Surgery, but said she was concerned about the strain on surgeries – and a critical shortage of GPs across the country.

A Guardian investigation published in March found that coroners in England and Wales served PFDs relating to 271 mental health patients between 2012 and 2017. The NHS ombudsman also warned that mental health patients are suffering serious harm, and in some cases dying, because of “serious failings” in their treatment. 

In a report analysing more than 200 complaints about NHS mental health care, John  Behrens – the ombudsman – highlighted “failings that have occurred, and continue to occur, in specialist mental health services in England, and the devastating toll this takes on patients and their families”.

His findings came just two weeks after the Guardian revealed that coroners had issued NHS providers of care with legal warning notices over 271 deaths of mental health patients that occurred in England and Wales between 2012 and 2017 following failings in the treatment they had provided.

The report identified five “common failings” by mental health trusts that can lead to patients suffering distress or harm or dying avoidably. They include inadequate assessment of the patient’s risk of suffering harm or committing suicide and poor communication between health professionals and the patient or their family.

The report is a dossier of detailed but anonymous cases which, in some cases, led the ombudsman to conclude that patients were subjected to care so poor that it was “injustice [that was] shocking and tragic”. The failings illustrate how far the NHS has to go if it is to improve care in the dramatic way that ministers and health service bosses have promised in recent years.  

For example, a Ms J died after she had a life-threatening reaction, called neuroleptic malignant syndrome (NMS), to being prescribed an antipsychotic drug for a psychotic episode she was having. Doctors dismissed the physical symptoms of her condition.

“Had doctors identified NMS, it is likely that Ms J would have received the appropriate treatment and survived. As such, we concluded that Ms J’s death was avoidable,” the report said. Her death illustrated “the human cost of service failures”, Behrens said.

In another case, a mental health professional decided that a Mr O was suffering from an episode of psychosis for the first time. However, the worker breached National Institute of Health and Care Excellence guidelines by not assessing the patient for signs of post-traumatic stress disorder. The NHS trust’s risk assessment “was too brief and inadequate”, the report said.

Among the mental health-related deaths attributed to resource issues in 2016 was that of Wendy Telfer, 44, who died after taking an overdose. The PFD to Royal Devon and Exeter NHS foundation trust said: “It is accepted that the problem of psychiatric in-patient beds is a national one, but on this occasion, had a bed been available when needed for Wendy, her death is likely to have been avoided.”

A 2017 PFD sent to the Department of Health after the death of Christopher Fairhurst in December 2016 said a shortage of GPs put patients at risk and placed unmanageable workloads upon those GPs who were in post.

The peak month in 2016 for deaths identified by coroners as being linked to a lack of resources – whether mental health-related or otherwise – was December, with eight. The NHS is always most overstretched in winter, with staff shortages and high bed occupancy rates.

Regular winter crises are a consequence of increased demand for services without a corresponding increase in funding. In four weeks in the run-up to Christmas 2016, 50 of the 152 English trusts were at the highest or second-highest level of pressure, according to a Nuffield Trust analysis commissioned by the BBC.

A Department of Health and Social Care spokesman said every preventable death was a tragedy. He said: “When coroners recommend specific steps to prevent future tragedy we expect NHS bodies to act without delay. 

“As well as making mental health services a personal priority, both the prime minister and the secretary of state have committed to a long-term plan with a sustainable multi-year settlement for the NHS, which will be agreed with NHS leaders, clinicians and health experts.”

That clearly isn’t adequate.

Mental health is an integral and essential component of health. Those groups with high rates of socioeconomic deprivation also tend to have the highest need for mental health care, but the lowest access to it.

People with mental illnesses are also vulnerable to abuse of their human rights. Scarcity of available resources and inequities in their distribution pose major obstacles to better mental health. 

Research by the Royal College of Psychiatrists (RCP) found that the income of mental health trusts across the UK had fallen since 2011, after taking account of inflation.  

In England, 62% of mental health trusts reported a lower income at the end of 2016-17 than they had in 2011-12. Only one trust saw their funding rise in all five financial years, according to official figures.

The RCP reports that the total amount of income that mental health trusts received in 2016-17 was £11.829bn – £105m less than in 2011-12 at today’s prices. 

Parity of esteem – the requirement to treat mental and physical health equally – was enshrined in law in 2012 and became part of the NHS Constitution in 2015. Yet ddespite legislating for parity of esteem, the government has failed to adequately fund it. The lack of resources is exacerbated by the fact that mental health funding is not ring-fenced and can be diverted by the NHS to plug gaps in other areas.

“It is totally unacceptable that when more and more people are coming forward with mental health problems, trusts are receiving less investment than they did, in some cases, seven years ago,” said RCP president Professor Wendy Burn.

It’s totally unacceptable that a government which has contributed to a rise in mental ill health in the first place by designing policies that widen inequalities, implementing cuts to public services that are both avoidable and immoral, continues in failing to recognise the psychological costs of austerity for individuals, communities and wider society.

Careless cuts cost lives.

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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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Vote Labour to uphold the rights of disabled people – our letter to the Guardian

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The following letter was published in the Guardian today, written and signed by a group of academics, professionals, campaigners and grassroots activists who work together cooperatively.

We collaborate to fulfil our mutual aims of achieving a progressive, civilised, just and safe society for all. We hope to do this by ensuring that the society we are a part of is democratic and fully inclusive: we want a civilised society that observes and meets its human rights obligations on behalf of all social groups. This isn’t happening currently. (See: UN’s highly critical report confirms UK government has systematically violated the human rights of disabled people).

As an independent researcher, writer, campaigner, and as a disabled person, I am very proud to be included among them. 

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Many disabled people see Labour’s policies as a lifeline, say the 30 signatories to this letter. 

For chronically ill and disabled people, recent years have been a disaster. The UN recently found “reliable evidence that the threshold of grave or systematic violations of the rights of persons with disabilities has been met” (Report, 8 November 2016).

We have been forced through a work capability assessment that the government’s own expert adviser described as “inhumane”, and which in 2015 was found to be associated with an additional 599 suicides.

Many needing help are now forced through another persecutory assessment – the personal independence payment – designed to reduce the numbers qualifying for help by half a million.

Social care has been so savagely cut that some young disabled must wear incontinence pads for lack of toileting assistance. People can’t take any more of this.

Many disabled people are not party-political, but see Labour’s policies for disabled people as a lifeline – envisioning a society where people are treated as human beings deserving of respect, equality and a decent life. Please, don’t endorse recent human-rights abuses; endorse the human rights of disabled people by registering, and by voting Labour on 8 June.

Paul Atkinson Jungian psychotherapist
Stef Benstead Spartacus Network
Peter Beresford Co-chair, Shaping Our Lives
Gary Bourlet Founder, People First Movement in England
Dr Emma Bridger Research fellow in psychology
Professor Woody Caan Journal of Public Mental Health
Dr Kelly Camilleri Registered clinical psychologist
Merry Cross
Dr David Drew Labour Parliamentary candidate for Stroud
Nick Duffell Psychohistorian
Dr Simon Duffy Centre for Welfare Reform
Dr Dina Glouberman Skyros Holistic Holidays
Catherine Hale Chronic Illness Inclusion Project
AC Howard DWPexamination.org – For The UK’s Disabled Community
Chris Johnstone General practitioner
Sue Jones Psychologists Against Austerity, researcher and writer, campaigner
Jayne Linney Disability activist
Alec McFadden TUC Salford
Helen McGauley Trainee clinical psychologist, Lancaster University
Beatrice Millar Person-centred counsellor/psychotherapist
Rev Paul Nicolson Taxpayers Against Poverty
Gavin Robinson Alliance for Counselling and Psychotherapy
Professor Andrew Samuels University of Essex
Nicola Saunders Psychotherapist
Martyn Sibley Disability blogger
Mike Sivier Vox Political
Professor Ernesto Spinelli
Mo Stewart Independent researcher, disability studies
Gail Ward
Dr Jay Watts Queen Mary, University of London
Dr Claudia GillbergSenior Research Associate in Education; Fellow at Centre for Welfare Reform and Disability Rights Activist

Dr Richard House Alliance for Counselling and Psychotherapy

 

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters


I don’t make any money from my work. I am disabled because of illness and have a very limited income. The budget didn’t do me any favours at all.

But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

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Initial thoughts on the work, health and disability green paper

proper Blond

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

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

The context indicates the general intent

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

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

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

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

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

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

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

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

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

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

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

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

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

Watching the way the wind blows

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

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

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

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

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

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

It’s difficult to see how someone with a serious, chronic and progressive illness, (which most people in the ESA Support Group have) can actually “manage” their illness and “move back into work.” The use of the extremely misinformed, patronising and very misleading term manage implies that very ill people actually have some kind of choice in the matter.

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

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

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

Yet the authors of the report doggedly insist that having a higher rate of weekly benefit for extremely sick and disabled people encourages them “to stay on sickness benefits rather than move into work.” People on sickness benefits don’t move into work because they are sick. Forcing them to work is outrageous. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Semantic thrifts: being Conservative with the truth

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The nitty gritty

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Well, at least until you die.
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Pictures courtesy of Robert Livingstone

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



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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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United Nation’s investigation in the UK concerning the human rights of disabled people- submission deadline

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I reported last year that the UK is to be investigated formally by the United Nations because of allegations of “systematic and grave” violations of disabled people’s human rights.

In August I wrote that officials from the United Nation’s Committee on the Rights of Persons with Disabilities (UNCRPD) are to visit Britain. The inquiry is confidential, and those giving evidence have been asked to sign a confidentiality agreement.

A United Nations team have arrived in the UK and it’s understood they will visit Manchester, London, Bristol, as well as parts of Scotland, Wales and Northern Ireland.

The United Nations team are also expecting to meet with the Equality and Human Rights Commission, members of parliament, individual campaigners and disabled people’s organisations, representatives from local authorities and academics.

The team will be gathering direct evidence from individuals about the impact of government austerity measures, with a focus on benefit cuts and sanctions; cuts to social care; cuts to legal aid; the closure of the Independent Living Fund (ILF); the adverse impact of the Work Capability Assessment (WCA); the shortage of accessible and affordable housing; the impact of the bedroom tax on disabled people, and also, the rise in disability hate crime.

In 2013, Amnesty International condemned the erosion of human rights of disabled people in UK, and the Joint Parliamentary Committee on Human Rights conducted an inquiry into the UK Government’s implementation of Article 19 of the United Nations Convention on the Rights of Persons with Disabilities – the right to live independently and to be included in the community. The inquiry, which began in 2011, has received evidence from over 300 witnesses.

The inquiry highlighted just how little awareness, understanding and employment of the Convention there is by the (then) Tory-led Government. Very few of the witnesses made specific reference to the Convention in their presented evidence, despite the inquiry being conducted by the Parliamentary Human Rights Committee, with the terms of reference clearly framing the inquiry as being about Article 19 of the UN’s committee on the rights of persons with disabilities. (UNCRPD.)

“This finding is of international importance”, said Oliver Lewis, MDAC Executive Director, “Our experience is that some Governments are of the view that the CRPD is nothing more than a policy nicety, rather than a treaty which sets out legal obligations which governments must fulfil.”

The report was particularly critical of the Minister for Disabled People (Maria Miller, at the time) who told the Committee that the CRPD was “soft law”. The Committee criticised this as “indicative of an approach to the treaty which regards the rights it protects as being of less normative force than those contained in other human rights instruments.” (See the full report.) The Committee’s view is that the CRPD is hard law, not soft law. 

In August, I wrote about how the inquiry was triggered by campaigners and groups using the convention’s optional protocol, (which the last Labour government signed us up to, in addition to the convention.) The protocol allows individuals (and groups) who are affected by violations to submit formal complaint to the UNCRPD.

The deadline for evidence submissions to the UNCRPD is thought to be 31 October.

Contact details are here.

Psychologists Against Austerity: mental health experts issue a rallying call against coalition policies.

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I wrote an article in March about the government plans to make the receipt of social security benefits for those with mental illnesses conditional on undergoing “state therapy.” I raised concern about ethical issues – such as consent, the inappropriateness of using behaviour modification as a form of “therapy,” and I criticised the proposed Cognitive Behaviour Therapy (CBT) programme on methodological and theoretical grounds, as well as considering wider social implications.

The 2015 budget included plans to provide online CBT to 40,000 claimants and people on the Fit for Work programme, as well as putting therapists in more than 350 job centres.

Since I wrote, over 400 psychotherapists, counsellors and mental health practitioners have written an open letter, published by the Guardian, about the broader, profoundly disturbing psychological and quality-of-life implications of the coalition government’s austerity cuts and policies. However, the letter was particularly critical of the government’s benefits sanctions scheme, which has been condemned by many of us – human rights advocates across the state – as brutal, unjust, ill-conceived, ineffective and inhumane.

In particular, the letter stated that the government’s proposed policy of linking social security benefits to the receipt of “state therapy” is utterly unacceptable. The measure, casually coined “get to work therapy,” was discussed by Chancellor for the Exchequer George Osborne during his last budget.

The letter’s supporters included psychotherapist and writer Susie Orbach. She called the Conservative proposals “beyond shocking.” Echoing the concerns I raised earlier this year, she said:

“It undermines the fundamental principles of one’s right to physical and mental care – that you have to be able to consent and that the people you go to have to be highly trained and have your best interests and aren’t meeting targets.”

The letter’s signatories, all of whom are experts in the field of mental health, have said such a measure is counter-productive, “anti-therapeutic,” damaging and professionally unethical. The “intimidatory disciplinary regime” facing benefits claimants would be made even worse by further unacceptable proposals outlined in the budget.

Among the groups represented by the signatories were Psychologists Against Austerity, Britain’s Alliance for Counselling and Psychotherapy, Psychotherapists and Counsellors for Social Responsibility, the Journal of Public Mental Health, and a range of academic institutions including Goldsmiths, Birkbeck, the University of London, the University of Amsterdam, Manchester Metropolitan University, the University of Brighton, Disabled People Against the Cuts and others.

More generally, the wider reality of a society thrown completely off-balance by the emotional toxicity of social conservatism combined with economic neoliberalism (which I have argued is manifestly authoritarian) is affecting Britain in profound and complex ways, the distressing effects of which are often most visible in therapist’s consulting rooms.

This letter sounds the starting-bell for a broadly based campaign of organisations and professionals against the damage that neoliberalism is doing to the nation’s mental health.

The letter said that for now, we call on all the parties in this election to make it clear that they will urgently review such regressive, anti-therapeutic practices, and appropriately refashion their commitment to mental health if and when they enter government.

Andrew Samuels, an Essex University professor, and immediate past chair of the UK Council for Psychotherapy, said he believed there was “a bit of a public school ethos” behind the work-capability regime introduced under the conservative-liberal democrat coalition and new conservative plans.

Characterising the government attitude as “Pull yourself together man, for heaven’s sake,” Samuels added: “It is wholly inappropriate. It symbolises a society that has lost all moral compass.”

Absolutely. Public schools are notorious for a culture of bullying. However, it’s one thing to be treated as a privileged and insulated public school boy by a peer from an elite background to “character building” rhetoric, but quite another to adopt that same bullying approach towards the ill and most vulnerable citizens. All to justify an ideological drive to “shrink the state” and remove support from the poorest.

All of this said, public schools are regarded by many as institutions that inflict a particularly British form of child abuse and social control. I also think it has to be said that soul trauma and pain don’t respect social status.

Samuels insisted the open letter was not “pro-Labour” but was aimed at getting a review of measures taken and proposed over the past five years.

He said: “If Labour decides afterwards all this is in order, it will go on. But I don’t think it will.”

The Labour Party does value professional opinion and rational discourse. The Conservatives, on the other hand, are not widely recognised as a party that welcomes democratic, open debate, transparency and accountability. The Tories simply exclude critical professionals and representative organisations that may challenge and disagree from the discourse.

A spokesperson for Labour said mental health “is the biggest unaddressed health challenge of our age.”

“It’s essential that we give mental health the priority it deserves if we are to thrive as a nation and ensure the NHS remains sustainable for the future,” he said.

The Labour Party have pressured the government to “write parity of esteem between physical and mental health into law,” and in the response, Labour have stated that the party is committed to implementing this policy if elected in May.

The spokesman pledged the Labour will bring an end to the “scandal of the neglect of child mental health,” indicating a welcomed return to a comprehensive preventative approach. He said: “It is simply not right that when three-quarters of adult mental illnesses begin in childhood, children’s mental health services get just six per cent of the mental health budget.”

Richard House of the Alliance for Counselling and Psychotherapy, the letter’s main organiser, said there had been a mounting groundswell of concern: “When one hears story after story of dramatic negative health impacts, psychological and physical, after people are subjected to these back-to-work practices, the time has surely come for an ‘emotional audit’ of the impact of what, to many, appear to be heartless, un-thought-through policies that are merely penalising and punishing the already disadvantaged still further.”

Yes, the time has come for a change of government. On May 7, we must ensure that the regressive, oppressive regime of the past five years is replaced by a progressive, inclusive and democratic alternative.

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Mental Health Services in crisis because of Coalition cuts to funding

The Psychology of Austerity

A group of mental health professionals have come together under the banner of Psychologists Against Austerity (PAA) to highlight the psychological impact of austerity.

Now, with only a few weeks to go before the general election, PAA have started a campaign calling for a Parliamentary Inquiry into the psychological damage austerity has wreaked across the UK.

You can read more and sign our petition here: 38degrees/psychological costs of austerity inquiry.


 

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Osborne’s razor: the Tory principle of parsimony is applied only to the poorest

The BBC reports that leaked documents from the Department for Work and Pensions suggest the government is planning a regional benefits cap, reducing child benefit, taxing disability benefits and reducing eligibility for the carers’ allowance. The proposals are aimed at helping to save £12 billion from the welfare budget by 2017/18. The Conservatives have of course insisted that the proposals were “not party policy.” Yet. They dismissed the leaked report as “ill-informed and inaccurate speculation.”

However, the documents were prepared by civil servants and commissioned by Conservative Party officials. These are the key proposals in the report:

  • Industrial Injuries Compensation Scheme – could be replaced by companies providing industrial injury insurance policy for employees. Any that did not would become members of a default national industrial injuries scheme, similar to the programme for asbestos sufferers. DWP predicted saving – £1bn
  • Carer’s Allowance – this could be restricted to those eligible for Universal Credit. Leaked documents suggest about 40% of claimants would lose out. DWP predicted saving – £1bn
  • The contributory element of Employment and Support Allowance and Job Seekers Allowance – currently claimants who have paid enough National Insurance contributions can get the benefits with little means testing; DWP analysis suggests 30% of claimants, over 300,000 families, would lose about £80 per week. DWP predicted saving – £1.3bn in 2018/19
  • Disability benefits – Disability Living Allowance, Personal Independence Payments and Attendance Allowance (for over 65s who have personal care needs) would no longer be paid tax free. Possible saving – £1.5bn per annum (based on IFS Green Budget calculation )
  • Council Tax Support – to be incorporated into Universal Credit. Possible saving – not known
  • Child Benefit – Limiting the benefit to the first two children. Possible saving IFS estimates £1bn saving per annum in the long run but little initially
  • Regional Benefit Caps – The £23,000 limit would vary in different parts of the country, with for instance Londoners receiving the top amount due to the higher cost of living. Possible saving – not known and dependent on where levels were set

Meetings about these options have taken place in recent weeks between the chancellor and Iain Duncan Smith. It is also understood that the permanent secretary, Sir Jeremy Heywood, has been coordinating some of the efforts to find savings.

The government has cut around £20bn from projected welfare spending over the course of the past five years, through a range of measures from freezing payments rates to cutting housing benefit. But Robert Joyce, a senior economist with the IFS, says finding another £12bn over the next two years will not be easy.

The easier benefit cuts are the ones that will have been done first, so what’s left will be harder.

“In addition, the Conservatives want to do this by 2017-18, in the next two years. It means they have to be looking at less palatable options that would involve overnight takeaways from certain families.”

Shadow work and pensions secretary, Rachel Reeves, said the Conservatives now needed to explain how they would achieve the welfare savings they needed to make.

She said: “These plans to hit the disabled and carers were drawn up for Conservative ministers to deliver their extreme cuts plan.” “The Tories now need to come clean about what cuts they plan to make and who will pay the price. If they are ruling out these extreme cuts for the most disabled and carers, then it is clear they will be hitting the tax credits, and support for children, for millions of working families.”

Rosanna Trudgian, policy officer at the charity Mencap, said the proposed changes were unfair. “Disabled people don’t choose to have their disability. They don’t choose to pay for these additional costs related to that disability,” she told BBC News.

“For example, if you have to go to hospital on a regular basis and you are paying for those huge car parking fees. Therefore, it’s just unfair if this is treated as taxable income.”

These cuts would hit the elderly, disabled people, poor people, especially those with large families, and those injured at work – and would devastate many communities.

Earlier this week, the Institute for Fiscal Studies (IFS) has asked Osborne to specify how he will reach targets announced in the budget, given that the poorest had been the hardest hit by draconian benefit cuts already. The IFS say the worst of the UK’s spending cuts are still to come.

I proposed that, as a society, we cannot possibly accommodate a further 12 billion cut from welfare spending. It’s not that Osborne can’t answer the IFS challenge: he won’t. He’s being conservative with the truth – which is that we cannot afford to reduce any more from welfare without ending welfare provision as we know it.

Related

Osborne’s razor, smoke and mirrors

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385294_195107567306966_1850351962_n  Thanks to Robert Livingstone for the memes used in this article