Tag: Social Market Foundation

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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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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