Saturday, 7 May 2016

Right Wing ThinkTank Proposal to Cut ESA Support - Objection Email Ignored

I wrote an email to the Right Wing ThinkTank Reform in February 2016 and followed it up in March in relation to their proposals and justifications for cutting the ESA Support Group Benefit down to the same level as Jobseekers' Allowance. You can read their full article available on their website at the following link.

Below is my, as yet, unanswered email to Reform (their email is available on their website). My objections to their comments are in bold. Be aware that there have been a couple of changes since their proposals and my emails including the resignation of IDS.

Dear Reform

Re the above article on your website, I and countless other disabled people are under no illusion as to your agenda so we are not at all convinced and have no confidence in your barely concealed agenda in the above mentioned paper. But let's look at some of the statements contained in it:

"In the quarter to May 2015, just 1 per cent of claimants in the ESA Work Related Activity Group (WRAG) – those deemed able to carry out activity to help them move towards work – left the benefit. The employment rate for disabled people in the UK is just 48 per cent, compared to 81 per cent for the rest of the working-age population."

The reason that rates of employment are far lower among disabled people is because - er - they're disabled. The clue is in the name. Surely it's occurred to you that their rates of employment are largely due to the fact they cannot work in the sense you are talking about because of their disabilities and conditions, which may be physical, mental, both, invisible and/or fluctuating.

You go onto say that "the evidence shows that work is good for people’s health and wellbeing and being out of work is detrimental to it, including for many people with mental and physical disabilities". 

Please cite the evidence and research.  Indeed, research has shown that some work may be good for some disabled people some of the time.  And the evidence shows this needs to be good work, well-paid work and that people need to have control in their working environment. There is evidence to show that poorly paid, menial and inappropriate work is actually detrimental to health.  I will speak from my own experience here. I need to be at home most of the time (due to mental health and phobias as well as mental and physical fatigue and other physical disabilities).  If you really cared about supporting disabled people, why are there to be swingeing cuts to self-employment under Universal Credit?  Many disabled people, by virtue of the fact they are unable to put in the hours, will never be able to earn a living.  This is something the government and their think-tanks never address. You come out with soundbites such as 'be aspirational' and 'supporting the creative industries'. So where's the financial support for our disabled artists and writers and musicians?  The arts are precarious. Disability is precarious. The disabled artist is doubly clobbered. This is why disabled people rely on ESA. They need the finances just to exist and you must be fully aware of this.  There is no more wiggle room; disability incomes have been slashed to the bone. You mention the 21st Century constantly while still relying on a very outdated 20th century model of people going out of their houses to work and doing a 35 hour week.  That isn't 21st century thinking at all.  Oh...and there's always been Permitted Work for those disabled people who wish to work.

You state: "Nonetheless, international evidence does show that the rate at which sickness benefits are set can have behavioural effects – particularly on claim duration. The Government should therefore set a single rate for out-of-work benefit."

Where is the evidence for this?  This panders to the ludicrous and false idea that sick and disabled people aren't 'really' disabled and that if their already meagre income is cut 'they will soon get a job'. This is a very dangerous argument because this government haven't even collected follow up data regarding long term outcomes for disabled people who are no longer claiming disability benefits.  Governments can manipulate the figures all they like to demonstrate that lower numbers on disability benefits equate with successful job outcomes but until robust longitudinal follow up studies have been done to prove this your argument doesn't stand up. What evidence certainly does show is that the proposed cuts will disproportionately affect disabled people, widen inequalities and undermine the UK’s human rights obligations. (The Equalities and Human Rights Commission). A scathing letter by the head of the EHCR warns that official assessments of the cuts impact on disabled people “contain very little in the way of evidence” and “limited analysis” of the consequences for claimants.

You argue: "The current WCA combines an assessment  of eligibility for benefits with an assessment of a claimant’s capacity for work. This much criticised model inadvertently encourages claimants to focus on demonstrating how sick they are, rather than engaging in an open conversation about what they might do with support."

The WCA is already a very stringent unfair benefit and extremely difficult to 'pass'.  It was the last Coalition government who made it the monster that it is and 'unfit for purpose'.  But it was originally introduced to focus on what a disabled person could do, rather than what they couldn't do.  Now that the number of disabled people on this benefit doesn't suit your agenda, you suddenly decide the WCA isn't fit for purpose after all (although not for the same reasons that disabled people have been telling this government and the previous one all along). Forgive me, but when has this government or its overpaid health assessors from overpaid private companies ever 'engaged in an open conversation about what (a disabled person) might do with support'? This requires trust and faith in the system and the assessors. But faith and trust is at an all time low, this is why Atos had to be replaced with Maximus to carry out these assessments.  But faith and trust in Atos' replacement hasn't increased among disabled people because the system is rotten. Your think-tank and this government will never gain the trust of disabled people by just delivering more of the same.  You don't consult us. When disabled people have produced their own reports this government has ridden roughshod over them eg the Spartacus Report. 

You state: "The Government should implement a single online application for the benefit, including a ‘Proximity to the Labour Market Diagnostic’ to determine a claimant’s distance from work and a health questionnaire."

Forgive me, but 'proximity to the Labour Market Diagnostic' sounds like a lot of gobbledegook or a euphemism for the people you want to target to force into work and sanction with benefit cuts if they don't comply.  What on earth does 'proximity to the Labour Market Diagnostic' mean anyway?  I am agoraphobic which literally means 'fear of the market place' so I will always be far from it. For people like myself with phobias it is utterly terrifying to think that some very superficially trained clerk could possibly understand the terror of being trapped and controlled on a daily basis.  Surely you want something more humane and compassionate?  It is fear that incapacitates, fear that holds people back, it is fear that prevents people like me from taking risks.  You don't eradicate fear by bullying and coercing people, or by cutting their already meagre income. It is your own actions that will move people like me 'further from the market place' as you like to call it. If on the other hand you took a wide view of work, to include education, voluntary work, the arts, caring, parenting etc with carrots rather than sticks, you would see a very real change. 

You state that: 'Unlike the ‘pass/fail’ WCA model, the assessment should take a broad view of a claimant’s multiple health-related barriers to work, including ‘biopsychosocial’ factors.'

I would like to think by this you are meaning a more humane compassionate test but there has been absolutely nothing since the Coalition government in 2010 that has given disabled people confidence in the government's motives towards disabled people.  I can list just a few of the countless changes that have gone in the opposite direction: closure of the ILF, cuts to housing benefit in the form of the bedroom tax, cuts to DLA, sanctions introduced for people on ESA, closing of Remploy factories, cuts to Access To Work, cuts to Legal Aid and access to justice and now slashing 33% of the income of some of the poorest people in society - those in the ESA WRAG.  The latest proposals to change the qualifying criteria for PIP are just the latest in a long line.*

We are also under no illusion about the use 'biopsychosocial factors' which hides a chilling reality.  Here are just a couple of the comments taken from the following blog but they are typical of a much wider rejection of this approach of the BPS model for the reasons listed below:

#1 "The Bio-Pscyho-Social model was ... introduced by the American psychiatrist George Engel in the 1970s as a holistic and patient-centred alternative to the reductionist medical model. It has its roots in Parsons’ Sick Role theory, which in turn was influenced by the Freudian notion of ‘secondary gains’ of illness.

Unfortunately the BPS model has provided a handy excuse for medical professionals, academics, private insurance companies and government welfare departments to deny the reality of illness or disability.

For instance, some psychiatrists have proposed a BPS explanatory model for Chronic Fatigue Syndrome, Fibromyalgia, and other so-called ‘Functional Somatic Syndromes’, which they believe have no physical basis but are perpetuated by irrational illness beliefs.

The Government’s benefit policy has indeed been shaped by research carried out at the UnumProvident Centre at Cardiff University. The researchers have, among other things, advised the DWP to adopt a BPS model of disability assessment. Apparently, the old system, which was based on the outdated medical model, ignored the psychosocial nature of many chronic conditions, hence encouraged ‘illness behaviour’, trapping people into benefit dependency."

#2 "...The bio-psycho-social model is a very crude way of trying to apply the social model to chronic illnesses without changing society and making it more accommodating. 

Rather, it's trying to marry the social model with a medical model with a resulting ideological monster, a social mess and a re-emerging culture of patronising disabled people. 

In my mind, its a very cynical and disingenuous attempt to acknowledge the social model while twisting it to a political agenda of disability benefit cuts. This model also fits into the ideas of Lawrence Mead and his "new paternalism."

The end result is that the DWP can look as if they are doing what disabled people want including recognising their wish to work and be seen to be equal, but then saying, if that is the case, then you are fit to work and be treated "normally" like all other unemployed people. 

Moreover, the use of the bio-psycho-social model is able to then go on to blame the individual if they reject this notion of being fit to work. If the disabled person rejects this recognition of being equal and wanting to work, then they therefore they must be workshy - and they are viewing themselves as incapable. They therefore need help with their way of thinking...

This model goes back to making disability a psychological and individual issue, while acknowledging ideas of disability rights. Its clever, but can only be argued if you ignore swathes of academic evidence and argument, and ignore the person's condition. 

Changes to the working environment are completely ignored, and prejudice and a failure of employers to accommodate people's needs untackled. "

You state that "those with mild or moderate health conditions that, with support, could be managed should be expected to take reasonable rehabilitative steps – some level of conditionality should therefore be applied".

So what actually are 'mild to moderate conditions'?  All people who have passed the WCA which - as you very well know is one of the most stringent and difficult to pass in the world - have all got serious and/or chronic health conditions otherwise they would have failed the WCA. In fact, so stringent is the WCA that even those with serous conditions do fail it, because the bar has been set so high. That is the problem when you set the bar too high: you then get too many 'true negatives' rather than 'false positives'. But figures show that over half of appeals against ESA “fit to work” decisions are successful – and that thousands of people who are deemed “fit to work” are actually ill. But you seem quite prepared to risk hounding more and more sick and disabled people.  I really would like to know what health conditions you have in mind because the policy makers never ceased stressing how 'it wasn't the condition itself but the way it affects a person'.  But now you seek to class some conditions into one or other category.  

Are you seriously trying to suggest that people with serious and chronic conditions don't already do what they can to make their health as good as possible? 

I also think you will find you are on very dangerous ground with trying to make financial payments 'conditional' on medical treatment.  There are many examples but let me just give you a couple:  many people with anxiety may have tried  'talking treatments' in the past but to no avail and find what has helped them most is antidepressants.  However, the antidepressants themselves may have side effects such as fatigue or aggression.  The converse may also be true, a person with depression may have tried antidepressants but had to come off them because the side effects made them worse. It would be wrong and frankly dangerous for anybody other than a GP to prescribe treatment. 

In fact, former GP Sarah Wollaston and now Tory MP for Totnes and chairman of the health select committee, claimed  in The Telegraph in 2014 that stripping benefit claimants of their allowances if they refuse to undergo treatment for depression would be "unethical and completely ridiculous". She said that forcing people into counselling would present "profound ethical issues". She said: Consent is a very important principle and to link some kind of compulsion to that treatment would be grossly unethical. There would be a serious risk of a doctor being challenged and taken to the GMC. "You would get people going to GPs having a prescription so they could demonstrate they have got treatment. Enormously wasteful of time. Far better to get on with parity of esteem. "This kind of thing is enormously damaging for the Conservatives. No 10 urgently need to squash this. Do they think this is ethical? Do they think there is any evidence this will work? I have long supported the principle of offering individual placement and support to help get people into work, but this needs to be immediately clarified."

I don't suppose you will listen to me, I am just one of thousands of disabled people after all (though one of thousands who think the same as me).  Ignore me, and others like me, if you so choose, but you may find it will all come crashing about you sooner than you know in spectacular style.  I'll leave you with this thought. The culture and the system in the 1960s and 70s was very much against children who were being sexually abused at that time.  Years later and society can't believe they were ignored or not taken seriously. Now the same is happening with disabled people.  Policy, with the help of a long-serving campaign to undermine out-of-work disabled people in the media, is very much against the disabled person at the moment: a paternalistic, punitive and 'we-know-best' approach.  But you don't know best.  And the tide will surely turn.

Yours sincerely

* Since I wrote this email there have been retractions to the proposed changes to PIP after the Budget fiasco, causing the resignation of Iain Duncan Smith.

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