Tag: Maximus

Research finds damaging mental health discrimination ‘built into’ Work Capability Assessment. Again.

Research conducted by academics at Edinburgh’s Heriot-Watt and Napier universities confirms what many of us already knew: that the government’s “fit for work” assessment is causing permanent damage to some people’s mental health, from which they are not recovering. 

The researchers say in their report that the Work Capability Assessment (WCA) experience “for many, caused a deterioration in people’s mental health which individuals did not recover from”.

The study comes at the same time as John Pring, journalist from the Disability News Service (DNS) has exposed private provider Maximus in their use of “brutal and dangerous” questions about suicide intention directed at people with mental health problems during their assessments. 

Dr Jay Watts, a clinical psychologist and academic, told DNS that people should only be asked about suicidal ideation by a trained mental health professional who can offer help, or someone in an “existing trusting relationship with the individual”.

Watts said that WCAs were “degrading and humiliating experiences for most if not all claimants” and were carried out in a space which was “not a trustworthy one”.

She said: “Individuals are required to parade their distress and feel compelled to answer intrusive questions (for the means to live relies on this).”

She went on to say: “To ask about suicide or self-harm in this context brings huge risks.”

She added that such questioning “can be suggestive if the environment is unsafe.”

She said that claimants were “battered with multiple questions about that which is most personal” in disability assessments and questioned about suicide while the assessors are “typing away” on their keyboards.

Watts concluded: “I have no doubt that questions on suicidal ideation, and the degrading manner in which they are asked, are one reason behind the suicide spike associated with the WCA process.”

The tragic case of Michael O’Sullivan, who killed himself after being found fit for work by the government’s disability assessors, has also cast a spotlight on the harmful consequences of the work capability assessment, particularly in relation to people with mental health problems. 

Though O’Sullivan’s suicide is the first to have been judged a direct consequence of being found fit for work, the DWP has conducted 49 internal reviews into benefit-related deaths since 2012, according to data released following freedom of information requests by the Disability News Service.

Of these, no fewer than 40 were conducted following the suicide, or apparent suicide, of a person claiming benefit. This is both profoundly shocking and entirely unsurprising. It is the wholly predictable result of a system designed and operated by people who appear to lack even the most basic understanding of the realities of living with mental illness.

Despite providing reports from three doctors, including his GP, stating that he had long-term depression and agoraphobia, and was unable to work, O’Sullivan was taken off employment support allowance (ESA) and placed on jobseeker’s allowance. The decision to find him fit for work was made after an assessment by a Department for Work and Pensions (DWP) doctor, a former orthopaedic surgeon, who did not factor in the views of any of the three doctors treating O’Sullivan.

Work capability assessments discriminate against people with mental health problems and should be “redesigned entirely”, according to Professor Abigail Marks from Heriot-Watt University’s Centre for Research on Work and Wellbeing. This recent study also established, through dozens of in-depth interviews of people who had been through the tests, that “in the worst cases, the WCA experience led to thoughts of suicide”. Mental health charities said the contents of the interviews “reflect what we hear from people every day”.

The researchers interviewed 30 people with existing mental health conditions who had taken the tests throughout 2016. The majority of subjects suffered from depression or anxiety, whilst a smaller number had more complex issues like bipolar disorder or borderline personality disorder. In addition, the team interviewed individuals from advocacy organisations, Citizens Advice Bureau and a former employee of Ingeus, one of the private Work Programme providers.

Marks said: “It is unacceptable that healthcare professionals who act as assessors for the WCA, for example, physiotherapists, nurses, occupational therapists are not fully qualified or trained to assess mental health conditions, yet they seem to be able to override participants’ own GPs, community psychiatric nurses, and therapists.

The WCA must be entirely redesigned, and focus on the potential barriers to work for both physical and mental health problems.”    

The report also highlighted that WCAs make non-Work Programme work experience, or other voluntary work, almost ‘impossible’ for people with mental health conditions. 

Dr Gavin Maclean, research assistant at Edinburgh Napier University, said: “Many of the participants in the study found the experience of the WCA so damaging that they stopped engaging in work-based activity and did not return to it.

This could further reduce their long-term employability and potentially increase their dependency on benefits.”

Dr Sue Cowan, assistant professor of psychology in the School of Social Sciences, said: “For people with severe and enduring mental health conditions, voluntary work may be as ‘good as it gets’, as one of our participants stated.

This does not mean a failure to obtain more. Rather, it is a recognition that an individual is making a choice, and the current system does not recognise or support that in any way.

The assumption that engaging in voluntary work means an individual is fit for employment should be scrapped; there has to be much greater flexibility about undertaking training while on ESA and much greater value must be placed on voluntary work and work-preparation activity.”

The qualitative study highlights in particular a lack of expertise in mental health problems among WCA assessors and advice from the WCA that was not consistent with what people going through the assessment had been told by their own GPs. In one case recorded in the study, a participant recounted a doctor “actually physically gasping” during an appeal because of the poor quality of evidence recorded by a WCA assessor. 

Some participants reported being in tears or having panic attacks during the tests, and others told the researchers that the assessments were “making me feel worse”.

The researchers said that the extreme stress having to deal with multiple stigmas of being unemployed and having a mental health condition became “self-reinforcing and self-perpetuating”, leading to the deterioration of peoples’ condition.

It says in the report: “Our research has reinforced the fact that people with mental health problems face more stigma and discrimination than those with physical health conditions and that this discrimination is built into the WCA.” 

Professor Marks, the lead author of the study, who is based at Heriot-Watt University, told the Independent that people who worked closely with such cases reported that deterioration in mental health conditions was an “almost universal” response to the tests.

Key causes of extreme stress were said to be a claimant’s fear of losing their lifeline income, the prolonged nature of tests, a lack of specialist mental health training amongst assessors, and the fact the test was “clearly geared towards people with physical disabilities.”

This said, many people with physical disabilities have also stated that the WCA experience has had an adverse effect on their mental health. 

Marks says: “A lot of the people we spoke to were in a position where they are preparing to go back to work before their assessment – they were doing training courses, community initiatives, or volunteering.” 

“They said that after the assessment, because the assessment had caused them so much stress, they were unable to go back and take part in those activities because their mental health had had such a deterioration.

“Talking to the advocacy workers, as well, they said it was almost universal that after people had gone through an assessment there was a significant decrease in their mental health.” 

In October last year the Government announced that it would stop repeat Work Capability Assessments for people with chronic conditions, characterising the repeat assessments it was scrapping as “unnecessary stress and bureaucracy”.

Mental health charity Mind said the WCA was clearly “not fit for purpose” and that its lengthy and costly appeals processes could well make matters worse.

“The findings of this report are concerning but sadly not surprising, as they reflect what we hear from people every day,” Ayaz Manji, the charity’s policy and campaigns officer, said.

“People with mental health problems tell us that the current fit-for-work test causes a great deal of additional anxiety. We know the assessors rarely have sufficient knowledge or expertise in mental health, meaning many people don’t get the right outcome and then have to go through a lengthy and costly appeals process. 

“The current approach is not fit for purpose and needs to be replaced by an open and honest conversation based on each person’s individual needs.”

Debbie Abrahams, the shadow work and pensions minister, said the study was more proof that the WCA “is not only unfit for purpose, but is causing harm to some disabled people”.

She added: “That’s why I have committed Labour to scrapping these assessments completely and replacing them with a holistic, person-centred approach.”

As usual, a Department for Work and Pensions spokesperson dismissed the interviewees’ experiences as not “statistically significant”.

Apparently, qualitative data doesn’t count as “empirical evidence”, or contribute to it. Or put another way, if the government don’t want to count it, it doesn’t count.

The spokesperson said: “Only thirty people were interviewed for this report, which fails to acknowledge any of the significant improvements we have made to our assessments – particularly for people with mental health conditions.” 

“Last year alone at least 35,000 work capability assessments took place in Scotland to help ensure people get the right level of support that they need.”

In fact, 37 interviews were conducted for the study. Furthermore, there is much evidence outside of this study that supports the findings. Qualitative evidence often provides richer, more in-depth, detailed evidence than quantitative studies tend to permit. Yet the government insist that citizens’ own accounts are not important, regularly dismissing them as “anecdotal”.

The government have also failed to conduct a quantitative investigation into the established correlation between WCAs and a deterioration in mental health conditions.

In 2015, the “fit for work” tests, introduced to assess eligibility for disability benefit ESA, were again found to have caused relapses in patients with serious mental health conditions, Dr Jed Boarman, consultant with the Royal College of Psychiatrists, called for an  overhaul of the process.

Boardman, a consultant psychiatrist at the South London and Maudsley NHS trust, also said the WCA discriminates against those with mental health issues. 

Boardman, who treats patients with serious and long-term mental health problems, said: “People with severe long-term problems get very distressed about being assessed, probably because mistakes are made, because the process isn’t perfect, because they don’t feel they are being listened to in their interviews.

“You do see people relapsing as a consequence of getting distressed.”

His comments followed a study, published the previous month, that linked the WCA tests with an additional 590 suicides, increased mental health problems and hundreds of thousands of antidepressant prescriptions.

The study, published by the Journal of Epidemiology and Community Health, showed a correlation between worsening mental health and assessments under the WCA.

The Department for Work and Pensions described the study as “misleading.”

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

Boardman added: “Their primary criticism of our study is that we don’t have data specifically on people going through the WCA and consequent mental health problems,” said Barr, from the University of Liverpool. “They have data on who has died following the WCA and they could facilitate linkage of that data with health causes.”

Thousands of claimants have died after being found fit for work, according to statistics released in August 2015 by the DWP, following a freedom of information request and a determined and successful court appeal by Mike Sivier of Vox Political. Ministers insisted that the figures they have released could not be used to link claimant deaths to welfare reforms, but the government has refused to release figures that would make it possible to assess whether the death rate for people found fit for work is higher than normal.

Boardman and Mark’s concerns are echoed by psychologists and benefit advisers working with claimants, who say they have gathered a lot of qualitative evidence that WCAs cause much additional psychological distress for those with mental health issues.

Related

Maximus ‘admits’ using brutal and dangerous suicide questions – John Pring

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

Doctors bribed with 70-90k salaries to join Maximus and “endorse a political agenda regardless of how it affects patients.”

What you need to know about Atos

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

Dying from inequality: socioeconomic disadvantage and suicidal behaviour – report from Samaritans


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The system is designed to deter successful claims

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

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

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

The revolving door of assessments and psychological distress

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Calls to scrap the WCA

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

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

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

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

 

What you need to know about Atos assessments

 

 

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

Chancellor George Osborne

 

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Source: Hansard

Context

Many of us recognised in 2012, when the welfare “reforms” and other cuts to public services that support the poorest citizens were forced through parliament despite considerable opposition, using only the “financial privilege” of the Commons as a justification, that the Conservatives are on an ideological crusade, which flies in the face of public needs, democracy and sound economics, to shrink the welfare state and privatise our essential services.

In a wealth transfer from the poorest to the very rich, we have witnessed the profits of public services being privatised, but the losses have been socialised – entailing a process of economic enclosure for the wealthiest, whilst the burden of losses have been placed on the poorest social groups and our most vulnerable citizens – largely those who are ill, disabled and elderly. The Conservative’s justification narratives regarding their draconian policies, targeting the poorest social groups, have led to media scapegoating, social outgrouping, persistent political denial of the aims and consequences of policies and reflect a wider process of political disenfranchisement of the poorest citizens, especially sick and disabled people.

That the cuts are ideologically driven, and have nothing whatsoever to do with economic necessity, was demonstrated only too well by the National Audit Office (NAO) report earlier this year. The NAO scrutinises public spending for Parliament and is independent of government. The report indicates how public services are being appropriated for purely private benefit.

The audit report in January concluded that the Department for Work and Pension’s spending on contracts for disability benefit assessments is expected to double in 2016/17 compared with 2014/15. The government’s flagship welfare-cut scheme will be actually spending more money on the assessments conducted by private companies than it is saving in reductions to the benefits bill.

From the report:

£1.6 billion
Estimated cost of contracted-out health and disability assessments over three years, 2015 to 2018

£0.4 billion
Latest expected reduction in annual disability benefit spending.

This summary reflects staggering economic incompetence, a flagrant, politically motivated waste of tax payers money and even worse, the higher spending has not created a competent or ethical assessment framework, nor is it improving the lives of sick and disabled people. Some people are dying after being wrongly assessed as “fit for work” and having their lifeline benefits brutally withdrawn. Maximus is certainly not helping the government to serve even the most basic needs of sick and disabled people.

However, Maximus is serving the private needs of a “small state” doctrinaire neoliberal government, and making lots of private profit whilst it does so. The Conservatives are systematically dismantling the UK’s social security system, not because there is an empirically justifiable reason or economic need to do so, but because the government has purely ideological, anticollectivist, antidemocratic, profoundly uncivilising prescriptions and longstanding prejudices.

Last week I wrote about the £30 a week Employmen Support Allowance (ESA) work related activity group (WRAG) cuts, which the Government have forced through the legislative process, despite meeting with widespread opposition, the government claim that it is their financial privilege to do so. Yesterday I wrote about the brutal cuts that are planned for Personal Independence Payments (PIP) for sick and disabled people, which are aimed at saving money by reducing eligibility for the support. The cut, it is estimated, will affect at least 640,000 disabled people by 2020, who may lose up to £150 a week. This is money that provides essential support for people who need help to prepare food, use the toilet or dress themselves, amongst other things, and to maintain a degree of dignity and independence.

The cuts to ESA and Personal Independent Payments (PIP) take place in the context of a Tory manifesto that included a pledge not to cut disability benefits. In fact in March last year, the Prime Minister signalled that the Conservatives will protect disabled claimants from welfare cuts in the next parliament (this one). Cameron said the Conservatives would not “undermine” PIP, which was introduced under the Coalition to save money by “targeting those most in need.” Now it seems those most in need are not the ones originally defined as such.

At the time he told BBC Breakfast: “We’ve replaced one benefit – Disability Living Allowance – with a new benefit – Personal Independence Payment – it’s working well, it is also going to lead to some savings over time and we haven’t created that benefit in order to undermine it. We want to enhance it and safeguard it.”

Semantic thrifts: being Conservative with the truth

Only a Conservative minister would claim that taking money from sick and disabled people is somehow “fair,” or about “helping”, “supporting” or insultingly, “incentivising” sick and disabled people who have already been deemed unfit for work by their doctors and the state via the work capability assessment to work.

The Tories all too frequently employ such semantic shifts and euphemism – linguistic strategies – as an integral part of a wider range of techniques of neutralisation that are used, for example, to provide linguistic relief from conscience and to suspend moral constraint – to silence both “inner protest” and public objections – to the political violation of social and moral norms; to justify acts that cause harm to others whilst also denying there is any subsequent harm being inflicted; to deny the target’s and casualties’ accounts and experiences of political acts of harm, and to neutralise remorse felt by themselves or other witnesses.

Media discourse has often preempted the Conservative austerity cuts, resulting in the identification, stereotyping and scapegoating of the groups in advance of the targeted, discriminatory policies. Media discourse is being used as a vehicle for the government to push their ideological agenda forward without meeting legitimate criticism, public scrutiny and without due regard for essential democratic processes and safeguards.

The five neutralisation techniques identified by Gresham Sykes and David Matza are: denial of responsibility, denial of injury, denial of victims, appeal to higher loyalties, and condemnation of condemners.

The really critical part of Sykes and Matza’s argument is that rationalisations precede immoral, cruel or controversial acts and are a key factor in making deviant behaviour possible (amongst delinquents, the mafia or Conservative ministers). As such, the rationalisations betray intent.

The cuts of £120 a month to the disability benefit Employment Support Allowance  are also claimed to be “fair.” and “supportive.” Though I have yet to hear a coherent and rational  explanation of how this can possibly be the case. Ministers claimed that people subjected to the ESA Work Related Activity Group cuts could claim PIP if they required support with extra living costs, but now we are told that PIP is to be cut, too.

Osborne’s techniques of neutralisation: calling a cut “increased spending”

The chancellor has defended his decision to use the cuts in disability benefits to fund tax breaks for the wealthy. On the Andrew Marr show yesterday, he was questioned about his decision to cut PIP, currently made to over 640,000 disabled people in a bid to save at least £1.2 billion. Many severely disabled people are facing a cut of up to £150 a week under the new reduced eligibility assessment criteria.

Controversially, the cuts to disability benefits will fund tax cuts for the most affluent – the top 7% of earners. The Chancellor is set to raise the threshold at which people start paying 40p tax, in a move that will probably see  many wealthier people pulled out of the higher rate of income tax, in the coming budget. Mr Osborne says he wants to “accelerate progress” towards the Conservative’s manifesto pledge of raising the threshold for the 40p rate to £50,000 in 2020, it is understood. The average annual income in the UK is around £27,000. 

Andrew Marr said: You’re taking money out of the pockets of some of the most vulnerable people in this country, disabled people. These are the people who can least afford the sacrifice, the people with the weakest shoulders.

And you’re changing the rules to hit them. Is that really your priority?”

Osborne ludicrously claimed that the Conservative government was “increasing spending on disabled people”, he said: “Controlling welfare bills is part of what you need to do if you’re a secure country confronting the problems in the world.”

But as Marr pointed out, the cuts to ESA and PIP show an intended substantial reduction on government spending to essential support for disabled people.

From January 2017, the cut to PIP is likely to hit sick and disabled people who face fundamental barriers to health and essential basic care. The cut, it is estimated, will affect at least 640,000 disabled people by 2020.

Andrew Marr went on to say: “At the same time as you’re raising thresholds to help middle-class tax payers, it’s going to seem a very callous set of priorities.”

However, Mr Osborne maintained that the brutal and uncivilised cuts were “necessary to improve the economic conditions in the UK”. He said: “Yes, times are tough. The fiscal situation is a difficult one. All Western countries are not productive enough.”

You can see the interview here:


Austerity and premature mortality

Since 2011, a year after the government began their austerity programme, mortality rates have increased rapidly. Advisers to Public Health England (PHE) have warned that the 4-year trend may be the worst since World War II.

Data from the Office of National Statistics shows a 5.4% (27,000) increase in deaths in the past year alone, prompting calls for an urgent investigation. The year-on-year rise, to a total of 528,340 deaths, is the highest since 1968.

PHE said the elderly were bearing the worst of Tory austerity cuts, with women suffering disproportionately, though this is partly because they live longer, however, it is also due to a growing crisis in the NHS and cuts to social care. Professor Danny Dorling, from Oxford University, an advisor to PHE on older age life expectancy, said:

“When we look at 2015, we are not just looking at one bad year. We have seen excessive mortality – especially among women – since 2012.”

Figures show that the number of deaths had been falling steadily until 2011, a year after the government began their austerity programme, when deaths rates began to increase rapidly.

Professor Dorling cited Tory austerity as the biggest cause:

“I suspect the largest factor here is cuts to social services – to meals on wheels, to visits to the elderly.”

Empirical research published two years ago demonstrated the high a cost the country paid in terms of health and wellbeing for the Thatcher administration’s economic and social policies. The study, which looked at material from existing research and data from the Office for National Statistics, illustrates that Thatcherism resulted in the unnecessary and unjust premature deaths of British citizens, together with a substantial and continuing burden of suffering and a widespread degradation of wellbeing. Co-author and researcher Professor Clare Bambra from the Wolfson Research Institute of Health and Wellbeing said that deaths from violence and suicide all increased substantially during the Thatcher era in comparison with other countries. Regional inequalities in life expectancy between north and south were also exacerbated, as were health inequalities between the richest and poorest in British society.

Professor Bambra also says that the welfare cuts implemented by Thatcher’s governments led to a rise in poverty rates from 6.7% in 1975 to 12% by 1985; poverty is well known to be one of the major causes of ill health and mortality. Income inequality also increased in the Thatcher period, as the richest 0.01% of society had 28 times the mean national average income in 1978 but 70 times the average by 1990. Other research (The Spirit Level) indicates that income inequality is internationally associated with higher mortality and morbidity.

Welfare reform minister, Lord Freud, refused to monitor the number of people who take their own lives as a result of the £120-a-month cut planned for those people in the work related activity group (WRAG), claiming employment and support allowance from April 2017. Concerns were raised in the House of Lords last week, when Baroness Meacher, amongst others, warned that for the most vulnerable, the cut was “terrifying” and bound to lead to increased debt.

Condemning the truly callous and terrible actions of the Treasury, she urged ministers to monitor the number of suicides in the year after the change comes in, adding: “I am certain there will be people who cannot face the debt and the loss of their home, who will take their lives.”

Many people have died as a consequence of the welfare “reforms.”

Not only have the government failed to carry out an impact assessment regarding the cuts, Lord Freud said that the impact, potential increase in deaths and suicides won’t be monitored, apart from “privately” because individual details can’t be shared and because that isn’t a “useful approach”.

He went on to say “We have recently produced a large analysis on this, which I will send to the noble Baroness. That analysis makes it absolutely clear that you cannot make these causal links between the likelihood of dying – however you die – and the fact that someone is claiming benefit.”

Actually, a political refusal to investigate an established correlation between the welfare “reforms” and an increase in the mortality statistics of those hit the hardest by the cuts – sick and disabled people – is not the same thing as there being no causal link. Often, correlation implies causality and therefore such established links require further investigation. It is not possible to disprove a causal link without further investigation.

Whilst the government continue to deny there is a causal link between their welfare policies, austerity measures and an increase in premature deaths and suicides, they cannot deny there is a clear correlation establised, which warrants further research and political accountability.

Then they came for the ESA Support Group …

Despite the fact that this government face a UN inquiry into grave and systematic abuses of the human rights of disabled people, the blatant attacks on a social group with legally protected characteristics continues and the Conservatives continue to target disabled people for a disproportionately large and unfair burden of austerity cuts.

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 often 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 benefit conditionality and being coerced into work by callously 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 and PIP were announced.

 

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Reverse the ESA disability benefit cut: sign the petition

Extend the PIP consultation & stop cuts to supporting terminally ill & disabled: sign the petition

 

Related

A tale of two suicides and a very undemocratic, inconsistent government

Paternalistic Libertarianism and Freud’s comments in context

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

Conservative governments are bad for your health

Research finds strong correlation between Work Capability Assessment and suicide

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

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Maximus ‘has falsified results of fitness for work tests’, says MP – John Pring

By John Pring

The discredited US outsourcing giant contracted to carry out “fitness for work” tests on behalf of the government has been accused by an MP of “falsifying” the results of assessments.

Labour MP Louise Haigh attacked the track record, ethics and even criminal behaviour of Maximus in delivering public contracts in the US, during a debate on the work capability assessment (WCA).

But she also highlighted what she described as a “disconcerting pattern of behaviour” by Maximus in the UK since taking over the WCA contract from Atos last year.

She said: “There seems to be an alarming trend of cases being rejected based on factual errors or even – I hesitate to say this – falsification.”

Haigh (pictured speaking in the debate), a shadow Cabinet Office minister, also raised concerns that there was no way for the public to check whether targets set for Maximus by the government – such as the number of serious complaints and the payment of travel expenses within nine working days – were being met.

 

You can read the rest of this excellent article here

Related

Doctors bribed with 70-90k salaries to join Maximus and “endorse a political agenda regardless of how it affects patients.”

Conservative welfare “reforms” – the sound of one hand clapping

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“Labour MPs sat perplexed … By cutting housing benefit for the poor, the Government was helping the poor. By causing people to leave their homes, the Government was helping people put a roof over their heads. By appealing the ruling that it discriminated against the vulnerable, the Government was supporting the vulnerable.

Yes, this was a tricky one.” – From an unusually insightful article in the Telegraph about the incoherence of Conservative welfare rhetoric:  How bedroom tax protects the vulnerable.

“Ministers keep using the mantra that their proposals are to protect the most vulnerable when, quite obviously, they are the exact opposite. If implemented their measures would, far from protecting the most vulnerable, directly harm them. Whatever they do in the end, Her Majesty’s Government should stop this 1984 Orwellian-type misuse of language.”  – Lord Bach, discussing the Legal Aid Bill. Source: Hansard, Column 1557, 19 May, 2011.

Conservative policies are incoherent: they don’t fulfil their stated aims and certainly don’t address public needs. Furthermore, Conservative rhetoric has become completely detached from the experiences of most citizens and their everyday realities.

Under the Equality Act, provision was made by the Labour government to ensure that legislations didn’t discriminate against protected social groups, which included disabled people. However, the need for public bodies in England to undertake or publish an equality impact assessment of government policies, practices and decisions was quietly removed by David Cameron in April 2011. The legal requirement in the Equality Act that ensured public bodies attempt to reduce inequalities caused by socio-economic factors was also scrapped by Theresa May in November 2010, who said she favoured a greater focus on “fairness” rather than “equality.”

The Conservatives have since claimed to make welfare provision “fair” by introducing substantial cuts to benefits and introducing severe conditionality requirements regarding eligibility to social security, including the frequent use of extremely punitive benefit sanctions as a means of “changing behaviours,” highlighting plainly that the Conservatives regard unemployment and disability as some kind of personal deficit on the part of those who are, in reality, simply casualties of unfortunate circumstances, bad political decision-making and subsequent politically-constructed socio-economic circumstances.

The word “fair” originally meant “treating people equally without favouritism or discrimination, without cheating or trying to achieve unjust advantage.” Under the Conservatives, we have witnessed a manipulated semantic shift, “fair” has become a Glittering Generality – part of a lexicon of propaganda that simply props up Tory ideology in an endlessly erroneous and self-referential way. Conservative ideology is permeating language, prompting semantic shifts towards bland descriptors which mask power and class relations, coercive state actions and political intentions. One only need to look at the context in which the government use words like “fair”, “support”, “help”, “justice” , “equality” and “reform” to recognise linguistic behaviourism in action. Or if you prefer, Orwellian doublespeak.

The altered semantics clearly signpost an intentionally misleading Conservative narrative, constructed on the basic, offensive idea that people claiming welfare do so because of “faulty” personal characteristics, and that welfare creates problems, rather than it being an essential mechanism aimed at alleviating poverty, extending social and economic support and opportunities – social insurance and security when people need it.

The government claims to be “committed to supporting the most vulnerable” and ensuring “everyone contributes to reducing the deficit, and where those with the most contribute the most.” That is blatantly untrue, as we can see from just a glance at Conservative policies.

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Conservative rhetoric is a masterpiece of stapled together soundbites and meaningless glittering generalities. And intentional mystification. Glittering Generalities are being used to mask political acts of discrimination.

Cameron claims that he is going to address “inequality” and “social problems”, for example, but wouldn’t you think that he would have done so over the past five years, rather than busying himself creating those problems via policies? Under Cameron’s government, we have become the most unequal country in the European Union, even the USA, home of the founding fathers of neoliberalism, is less divided by wealth and income, than the UK.

I’m also wondering how tripling university tuition fees, removing bursaries and maintainance grants for students from poorer backgrounds and reintroducing banding in classrooms can possibly indicate a party genuinely interested in extending “equal opportunities.”

It’s perplexing that a government claiming itself to be “economically competent” can possibly attempt to justify spending more tax payers money on appealing a Supreme Court decision that the bedroom tax policy is discriminatory, when it would actually cost less implementing the legal recommendations of the court. As Owen Smith, Shadow Work and Pensions Secretary, said: “Just the Supreme Court session itself will cost the Government more in legal fees than the £200,000 needed to exempt domestic abuse victims affected.

“If the Tories had an ounce of decency they could have stood by the decision and exempted the two groups.

“Instead they are instructing expensive lawyers to fight in the Supreme Court for the right to drive people further into poverty.”

As a consequence of the highly discriminatory and blatantly class-contingent Tory policies, rampant socio-economic inequality apparently is the new Tory “fair”. There is a clear incongruence between Conservative rhetoric and the impact of their policies. This is further highlighted by the fact that the UK is currently being investigated by the United Nations regarding serious contraventions of the human rights of sick and disabled people, and other marginalised groups, because of the dire impact of Conservative welfare “reforms.”

It’s clear that the austerity cuts which target the poorest are intentional, ideologically-driven decisions, taken within a context of other available choices and humane options.

The rise in the need for food banks in the UK, amongst both the working and non-working poor, over the past five years and the return of absolute poverty, not seen since before the advent of the welfare state in this country, makes a mockery of government claims that it supports the most vulnerable.

Income tax receipts to the Treasury have fallen because those able to pay the most are being steadily exempted from social responsibility, and wages for many of the poorer citizens have fallen, whilst the cost of living has risen significantly over this past five years.

The ideologically motivated transfer of funds from the poorest half of the country to the more affluent has not contributed to deficit reduction. It doesn’t take a genius to work out that the cumulative impact of Tory tax and welfare changes, from out-of-work and in-work benefits to council tax support, to the cut in the top rate of income tax and an increase in tax-free personal allowances, has been extremely regressive and detrimental to the poorest.

The revenue gains from the tax changes and benefit cuts were offset by the cost of tax reductions, particularly the increase in the income tax personal allowance, benefitting the wealthiest.

The Treasury response to this is to single out the poorest yet again for more cuts to “balance the books” – which basically translates as the Conservative “small state” fetish, and deep dislike of the gains we made from the post-war settlement. Yet for a government that claims a non-interventionist stance, it sure does make a lot of interventions. Always on behalf of the privileged class, with policies benefitting only the wealthy minority.

How can Conservatives believe that poor people are motivated to work harder by taking money from them, yet also apparently believe that wealthy people are motivated by giving them more money? This is not “behavioural science,” it’s policy-making founded entirely on traditional Tory prejudices.

The government claim that “Every individual policy change is carefully considered, including looking at the effect on disabled people in line with legal obligations,” but without carrying out a cumulative impact assessment, the effects and impacts of policies can’t possibly be accurately measured. And that is intentional, too.

Despite being a party that claims to support “hard-working families,” the Conservatives have nonetheless made several attempts to undermine the income security of a signifant proportion of that group of citizens recently. Their proposed tax credit cuts, designed to creep through parliament in the form of secondary legislation, which tends to exempt it from meaningful debate and amendment in the Commons, was halted only because the House of Lords have been paying attention to the game.

The use of secondary legislation has risen at an unprecedented rate, reaching an extraordinary level since 2010, and it’s increased use is to ensure that the Government meet with little scrutiny and challenge in the House of Commons when they attempt to push through controversial and unpopular, ideologically-driven legislation.

Conservative cuts are most often applied by stealth, using statutory instruments. This indicates a government that is well aware that its policies are not fit for purpose.

We can’t afford Conservative ideological indulgence.

The National Audit Office (NAO) scrutinises public spending for Parliament and is independent of government. An audit report earlier this month concluded that the Department for Work and Pension’s spending on contracts for disability benefit assessments is expected to double in 2016/17 compared with 2014/15. The government’s flagship welfare-cut scheme will be actually spending more money on the assessments themselves than it is saving in reductions to the benefits bill – as Frances Ryan pointed out in the Guardian, it’s the political equivalent of burning bundles of £50 notes.

The report also states that only half of all the doctors and nurses hired by Maximus – the US outsourcing company brought in by the Department for Work and Pensions to carry out the assessments – had even completed their training.

The NAO report summarises:

5.5
Million assessments completed in five years up to March 2015

65%
Estimated increase in cost per ESA assessment based on published information after transfer of the service in 2015 (from £115 to £190)


84%
Estimated increase in healthcare professionals across contracts from 2,200 in May 2015 to 4,050 November 2016

£1.6bn
Estimated cost of contracted-out health and disability assessments over three years, 2015 to 2018

£0.4 billion
Latest expected reduction in annual disability benefit spending

13%
Proportion of ESA and PIP targets met for assessment report quality meeting contractual standard (September 2014 to August 2015).

This summary reflects staggering and deliberate economic incompetence, a flagrant, politically-motivated waste of tax payers money and even worse, the higher spending has not created a competent or ethical assessment framework, nor is it improving the lives of sick and disabled people.

The government claim they want to “help” sick and disabled people into work, but nearly 14,000 disabled people have lost their mobility vehicle after the changes to Personal Independence Payments (PIP) assessment, which are carried out by private companies. Many more, yet to be reassessed, are also likely to lose their specialised vehicles.

In 2012, Esther McVey revealed that the new PIP  was about cutting costs and that there were targets to reduce the number of successful claims when she told the House of Commons:330,000 of claimants are expected to either lose their benefit altogether or see their payments reduced.How else could she have known that before those people were actually assessed? A recent review led the government to conclude that PIP doesn’t currently fulfil the original policy intent, which was to cut costs and “target” the benefit to “those with the greatest need.”

That basically meant a narrowing of eligibility criteria for people formerly claiming Disability Living Allowance, increasing the number of reassessments required, and limiting the number of successful claims. The government have used the review to attempt to justify further restrictions to PIP eligibility, aimed at cutting support for people who require aids to meet fundamental needs such as preparing food, dressing, basic and essential personal care and managing incontinence. “Greatest need” has become an ever-shrinking category under Conservative austerity measures. 

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The use of political pseudo-psychological “diagnoses” to both stigmatise and “treat” what are generally regarded by the Conservatives as deviant behaviours from cognitively incompetent citizens, infering that the problem lies within the individual rather than in their circumstances, or arise as a consequence of political decision-making and socio-economic models, has become the new normal. We are discussing people here who have been deemed too ill to work by their own doctor AND the state. Not for the first time, the words Arbeit macht frei spring to mind.

Welfare has been redefined: it is preoccupied with assumptions about and modification of the behaviour and character of recipients rather than with the alleviation of poverty and ensuring economic and social wellbeing.

The stigmatisation of people needing benefits is designed purposefully to displace public sympathy for the poor, and to generate moral outrage, which is then used to further justify the steady dismantling of the welfare state.

It is the human costs that are particularly distressing, and in a wealthy, first world liberal democracy, such draconian policies ought to be untenable. Some people are dying after being wrongly assessed as “fit for work” and having their lifeline benefits brutally withdrawn. Maximus is certainly not helping the government to serve even the most basic needs of sick and disabled people.

However, Maximus is serving the needs of a “small state” doctrinaire neoliberal government. The Conservatives are systematically dismantling the UK’s social security system, not because there is an empirically justifiable reason or economic need to do so, but because the government has purely ideological, anticollectivist prescriptions. Those prescriptions are costing the UK in terms of the economy, but MUCH worse, it is costing us in terms of our decent, collective, civilised response to people experiencing difficult circumstances through no fault of their own; it’s costing the most vulnerable citizens their wellbeing and unforgivably, it is also costing precious human lives.

It’s not just that Conservative rhetoric is incoherent and incongruent with the realities created by their policies. Policy-making has become increasingly detached from public needs and instead, it is being directed at “incentivising” and “changing behaviours” of citizens to meet a rigidly ideological state agenda. That turns democracy completely on its head. There is no longer a genuine dialogue between government and citizens, only a diversionary and oppressive state monologue.

And it’s the sound of one hand clapping.

one hand clapping

There are many ways of destroying people’s lives, not all of them are obvious. Taking away people’s means of meeting basic survival needs, such as money for food, fuel and shelter – which are the bare essentials that benefits were originally calculated to cover – invariably increases the likelihood that they will die. The people most adversely and immediately affected are those who have additional needs for support.

The moment that sick and disabled people were defined as a “burden on the state” by the government, we began climbing Allport’s Ladder of Prejudice.

Whilst I am very aware that we need take care not to trivialise the terrible events of  world war 2 and Nazi Germany by making casual comparisons, there are some clear and important parallels on a socio-political level and a psycho-social one, that I feel are crucially important to recognise.

Gordon Allport studied the psychological and social processes that create a society’s progression from prejudice and discrimination to genocide. In his research of how the Holocaust happened, he describes socio-political processes that foster increasing social prejudice and discrimination and he demonstrates how the unthinkable becomes acceptable: it happens incrementally, because of a steady erosion of our moral and rational boundaries, and propaganda-driven changes in our attitudes towards “others” that advances culturally, by almost inscrutable degrees.

The process always begins with the political scapegoating and systematic dehumanisation of a social group and with ideologies that identify that group as an “enemy” or a social “burden” in some way. A history of devaluation of the group that becomes the target, authoritarian culture, and the passivity of internal and external witnesses (bystanders) all contribute to the probability that violence against that group will develop, and ultimately, if the process is allowed to continue evolving, genocide.

If you think this observation is “extreme” then you really haven’t been paying attention. By 2012, hate crime incidents against disabled people had risen to be the highest ever recorded. By 2015, there was a further 41 per cent rise in disability hate crime. This is the so-called “civilised” first world, very wealthy liberal democracy that is the UK.

Most disabled people have worked, contributed to society, paid taxes and national insurance. Those that haven’t genuinely cannot work, and as a decent, civilised society, we should support them. Being ill and disabled is not a “lifestyle choice.” Unfortunately it can happen to anyone. A life-changing accident or illness doesn’t only happen to others: no-one is exempted from such a possibility. That this government thinks it can get away with peddling utter nonsense about the characters, lives and motivations of a marginalised social group, dehumanising them, directing hatred, resentment, prejudice and public derision towards them, demonstrates only too well just how far we have moved away from being a decent, civilised society. 

It seems to be almost weekly that there’s a report in the media about a sick and disabled person dying after being told by the state that they are “fit for work” and their lifeline benefits have been halted, or because the state has sanctioned someone and withdrawn their only support. There are many thousands more suffering in silence, fearful and just about living.

 

Doctors bribed with 70-90k salaries to join Maximus and “endorse a political agenda regardless of how it affects patients.”

maximus-logoYes, but which people?


The National Audit Office (NAO) scrutinises public spending for Parliament and is independent of government. An audit report earlier this month concluded that the Department for Work and Pension’s spending on contracts for disability benefit assessments is expected to double in 2016/17 compared with 2014/15. The government’s flagship welfare-cut scheme will be actually spending more money on the assessments themselves than it is saving in reductions to the benefits bill – as
Frances Ryan pointed out in the Guardian, it’s the political equivalent of burning bundles of £50 notes.

The report also states that only half of all the doctors and nurses hired by Maximus – the US outsourcing company brought in by the Department for Work and Pensions to carry out the assessments – had even completed their training.

The NAO report summarises:

5.5
Million assessments completed in five years up to March 2015

65%
Estimated increase in cost per ESA assessment based on published information after transfer of the service in 2015 (from £115 to £190)


84%
Estimated increase in healthcare professionals across contracts from 2,200 in May 2015 to 4,050 November 2016

£1.6 billion
Estimated cost of contracted-out health and disability assessments over three years, 2015 to 2018

£0.4 billion
Latest expected reduction in annual disability benefit spending

13%
Proportion of ESA and PIP targets met for assessment report quality meeting contractual standard (September 2014 to August 2015).

This summary reflects staggering economic incompetence, a flagrant, politically motivated waste of tax payers money and even worse, the higher spending has not created a competent or ethical assessment framework, nor is it improving the lives of sick and disabled people. Some people are dying after being wrongly assessed as “fit for work” and having their lifeline benefits brutally withdrawn. Maximus is certainly not helping the government to serve even the most basic needs of sick and disabled people.

However, Maximus is serving the needs of a “small state” doctrinaire neoliberal government. The Conservatives are systematically dismantling the UK’s social security system, not because there is an empirically justifiable reason or economic need to do so, but because the government has purely ideological, anticollectivist prescriptions.

This is a government that claims social security is “unsustainable” and a “burden” on the public purse, yet has no problem with an extraordinary profligacy with public funds and dispossessing tax payers when it comes to implementing “cost-cutting” and draconian welfare “reforms.” Conservative anti-welfare dogma and prejudice are costing the UK billions of pounds.

In April 2014, Atos was forced to abandon their contract with the government because of a growing public backlash, but not before they had profited from very large sums of public money. Meanwhile, sick and disabled people have had their support callously slashed to the bone, people have suffered and some have died as a consequence of that. Yet our welfare state is being used as a sporting arena for big business profit-making, eating up public funds that were supposed to help people who have encountered difficulties meeting their basic needs through disability, losing their job or becoming ill.

The selling of our public services and lucrative contracting out of state functions to private companies who exchange public money for a notoriously poor service is a prominent feature of Tory “small state” Britain.

The Department for Work and Pensions uses the controversial work capability assessments to decide if people are eligible for benefits or to force those on long-term sick leave back into work. The assessment is conducted using a computer software package called Logic Integrated Medical Assessment (LiMA) application.

The assessments are heavily weighted towards finding people capable for work, regardless of the medical evidence presented by claimant’s own doctors. Patients with severe brain damage, kidney failure, cancer, multiple sclerosis and Parkinson’s Disease, amongst many others with seriously incapacitating illnesses, have been found fit for work. On 24 April 2013, a woman who was a double heart and lung transplant patient died in hospital only days after she had been told that her Incapacity Benefit was being stopped and that she was fit for work. There are many other instances of grave errors in the decision-making of the Department for Work and Pensions which are based on the work capability assessment.

Between April 2015 and March 2018, the Department for Work and Pensions expects to carry out around 7 million assessments which it estimates will cost a total of £1.6 billion.

The National Audit Office report on contracted-out “health and disability assessments” states that the cost of providing assessments is rising and providers are still struggling to meet expected performance standards, and that providers continue to struggle with hiring and training staff.

From the NAO summary:

“The Department continues, however, to struggle with setting targets and requirements with clear evidence and failed to adequately test bidders’ assumptions, for example about staff training, during the contract tender process. It does not yet have a clear strategy for contracting-out assessments and risks damaging market interest through tight procurement timetables, inflexibility towards critical assumptions and lack of transparency.

…For PIP, both providers have failed to meet targets for the quality of assessment reports since October 2013. The Department is paying more for assessments, caused in part by capacity shortages pushing up salaries.”

In the last month, recruitment website healthjobs.co.uk has added almost 100 job advertisements for “functional assessor” roles with Maximus, the US company contracted by the Department for Work and Pensions to conduct work capability assessments. Applicants are required to have two years post-qualification medical experience and are offered positions with whoppingly “incentivising” salaries that start at £72,000, with some roles attracting salaries of up to £98,000. The salary for a junior doctor working in the National Health Service (NHS) with two years of experience is approximately £30,000.

Junior doctors working within the NHS were forced to take industrial action recently – the first strike action for more than four decades – over the government’s proposed new junior doctor contracts, because of serious concerns about patient safety, the quality of doctor’s working lives and the lack of recognition regarding the strain of working long and unsocial hours.

The British Medical Association said:

“The biggest threat to patient care is the government’s insistence on removing safeguards which prevent junior doctors from being forced to work dangerously long hours without breaks, with patients facing the prospect of being treated by exhausted doctors.

“The government is threatening to impose contracts in which junior doctors have no confidence and which represents the first step in a wholesale attack on all NHS staff at night and over weekends. We want a contract that is safe for patients, fair for juniors and good for the NHS.”

Maximus offer substantially better working conditions and pay for junior doctors, but compromising patient safety is an inevitable consequence of the company drive to provide administrative solutions to improve the cost effectiveness … and efficiency of government-sponsored benefit programs.

One NHS doctor, Karl Norrington, noted on Twitter that despite Maximus’s company motto: “Helping Government Serve the People” – in reality Maximus is: “paying drs to medically endorse a political agenda regardless of how it affects patients.”

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Related

The disturbing truth about disability assessments

Why I blew the whistle on Atos fitness-for-work test

We can reduce the Welfare Budget by billions: simply get rid of Iain Duncan Smith

 

 

Government fitness for work test is making disabled people more sick

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In January, 2012, I wrote an article: The ESA ‘Revolving Door’ Process, and its Correlation with a Significant Increase in Deaths amongst the Disabled and I discussed the distress and harm that the current government work capability assessment is causing disabled people. I said:

Many claimants have described a “revolving door” process of endless assessment, ceased Employment Support Allowance (ESA) claim, (based on an outcome of almost invariably being wrongly “assessed” as fit for work), appeal, successful appeal outcome, benefit reinstated, only to find just 3 months later another assessment is required. The uncertainty and loss of even basic security that this process creates, leading to constant fear and anxiety, is having a damaging, negative impact on the health and well-being of so many.

A significant proportion of those required to have endless assessments have very obviously serious illnesses such as cancer, kidney failure, lung disease, heart disease, severe and life threatening chronic conditions such as multiple sclerosis, lupus, myalgic encephalomyelitis, rheumatoid arthritis, brain tumours, severe heart conditions, and severe mental health illness, for example. To qualify for ESA, the claimant must provide a note from a doctor stating that the person is unfit for work. There can be no justification for subjecting people who are so ill to further endless assessments, and to treating us as if we have done something wrong.

Marginalising and stigmatising sick and disabled people, amongst whom are some of our most vulnerable citizens, via propaganda in the media, using despiteful and malicious terms such as “workshy” and “feckless” is a major part of the Government’s malevolent “justification” to the public for removing the lifeline of support from the sick and disabled. We are climbing Allport’s Ladder

In addition to very justified anxieties regarding the marked increase in disability hate crime that the Tory-led propaganda campaign has resulted in, many sick and disabled people have also stated that they feel harassed and bullied by the Department of Work and Pensions and Atos. Many talk of the dread they feel when they see the brown Atos envelope containing the ESA50 form arrive through the letter box.

The strain of constantly fighting for ESA entitlement and perpetually having to prove that we are a “deserving” and “genuine” sick and disabled person is clearly taking a toll on so many people’s health and well being. Many families of those who have died have said that the constant strain, anxiety and stress of this revolving door process has contributed significantly to their loved ones’ decline in health and subsequent death. The figures from the DWP, and the marked contrast between the ESA and IB death statistics certainly substantiate these claims.

Leonard Cheshire, a charity that works with disabled people, surveyed 350 people who had been through the workplace capability assessment, which is used to establish whether benefit claimants are well enough to return to work.

More than six in 10 (65 per cent) of those who had gone through the process said they had ended up with more pain afterwards. Almost three quarters (72 per cent) said they found the assessment had a negative impact on their mental or physical health, or both. The same number described the face to face appointment as very stressful.

A teacher who was medically retired in 2011 due to progressive rheumatoid arthritis, said she left her appointment “feeling absolutely awful and suffered a lot of pain in the following days”. She went on to suffer a stroke a few weeks later, and believes the experience of undertaking a work fitness assessment was a contributing factor.

Andy Cole, campaigns director for Leonard Cheshire, said:

“This isn’t acceptable and no test should put someone through something that makes their condition worse.

We have known for a long time that this is an important issue. We had anecdotally hear this information but, [getting] it quantified in this way in quite such significant numbers, we were really surprised to see that it was this sort of figures.”

Harm may be caused by assessors because they did not have sufficient information about patients’ conditions. Less than half (42 per cent) said their assessor had evidence of their condition prior to the meeting. Only 21 per cent agreed with the statement:

“The assessor let me explain how my condition [or] disability affects me differently on different days or at different points during the day.”

Two thirds disagreed with the outcome of their assessment.

Mr Cole added:

“Some of the conditions are well documented through medical data going back decades. If that was used better there wouldn’t be a need for a test in the first place. It’s worth remembering that the test was fundamentally supposed to be about a benefit that helped people back into work. There are lots of issues around the test about whether it’s been able to achieve that.”

The research relates to the period during which the private company Atos was responsible for carrying out the assessments. Its work has ended after it pulled out of a government contract to manage disability claims early, and the American company Maximus has taken over delivery of the assessments from 1 March 2015.

The charity is calling on Maximus to take the findings of its survey into account when redesigning the fitness for work assessment process. It wants to see staff trained in specific medical conditions, (as most Atos assessors are non-specialised nurses or occupational therapists,) physical examinations restricted to cases of absolute necessity and for claimants to be aware they can say no to an examination if it will cause them pain.

However, a spokesman for the Department of Work and Pensions said:

“Healthcare professionals always take consent for any physical examination and ask claimants to tell them if any movement is uncomfortable. Examinations are not completed if they cause pain. Sufficient information is usually obtained through discussion, observation and a limited physical examination to assess the effects of disability.”

We know this to be untrue because of the high numbers of people needing to challenge wrong decisions.

One such person is Sharon Majek, 57, from Rugby, who has been unable to work since her mid-thirties after suffering a serious injury at work. She stopped an elderly patient from falling out of bed badly hurting her back. She was diagnosed with osteoarthritis, degenerative disk disease and fibromyalgia, leaving her in constant joint pain and with limited sensation in her hands.

She described her assessment as “traumatic”. She said:

“The doctor never made eye contact with me once, and that made me feel very uncomfortable. I was awaiting a knee replacement. He asked me to bend my knees. When I said I couldn’t he pushed it back. I was sweating with the pain. It swelled up later that day.”

Ms Majek was found fit for work so she asked to see a copy of her report, which she and her husband described as unrecognisable from the meeting they had attended. The decision was overturned at appeal. This is a very common and unacceptable experience amongst people claiming ESA.

 

Further reading:

What you need to know about Atos assessments.

Black Propaganda

Essential information for ESA claims, assessments and appeals

Clause 99, Catch 22 – State sadism and silencing the vulnerable

 

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Thanks to Robert Livingstone for the memes

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