Archive | May 2013

The Telegraph, ESA and WCA

I wrote this post for Hardest Hit, and have simply cross-posted here.


Hardest Hit was pleased to see Isabel Hardman’s piece in the Telegraph on ESA. Ms Hardman wrote to explain that, “Disability testing isn’t working as it should – and Conservatives must have the courage to admit it.” This is an encouraging stance from a right-leaning newspaper and could become the start of increased accuracy in the debate around welfare.

When one knows most of the facts around an issue, it is easy to pick out the misleading from the less misleading newspaper articles. Newspapers don’t routinely cite the sources of their data, which can make fact-checking difficult. If one already knows the facts, this stage is automatically much easier. Knowing ESA as I do, it is refreshing to read an article that is not misleading in either direction.

The Work Capability Assessment for ESA has come under a lot of criticism. As we know, and Ms Hardman points out, 42% of appeals against ESA are successful.[1] Other information exists supporting the claim that the ESA assessment process is inaccurate. The Citizen’s Advice Bureau has reported high levels of inaccuracy in reports made by Atos assessors.[2] Tribunals report that most appeals are overturned due to new oral evidence presented to the tribunal – that is, evidence that would have been available to the Atos assessor had he or she asked the right question(s).[3] The independent Review, headed by Professor Harrington, has said that Decision Makers’ decisions vary in quality and consistency.[4]

The National Audit Office said that there are “serious questions about the quality of the overall decision-making process.”[5] A court judgement on Wednesday ruled that the current system is unreasonable to people with mental health conditions.

There are many reasons to believe that the ESA assessment process does not work; these are just some of the outcome data that suggest flaws in the decision-making process. As Ms Hardman says, the method of assessment is also unreliable. “It fails to assess, beyond someone’s ability to move a cardboard box in the test room, whether they are capable of doing a real job. The activities in the test are removed from workplace realities. … There are some simple changes that could improve the test, although they are unlikely to remedy the inherent flaw: the fact that it doesn’t realistically assess a person’s ability to do a day-to-day job.” Unfortunately, a real-world test – realistically assessing a person’s ability to do a day-to-day job – was the one thing that then Minister for Employment Chris Grayling was “absolutely unreservedly and implacably opposed to.”[6] Incorporating a real-world test has since been rejected on the grounds that there is a lack of “clear, evidence based advice” for what such a test might look like.[7] This “inherent flaw,” which most disabled organisations agree to be a flaw, appears set to remain.

Despite this, there are possibilities for improvement to the ESA assessment process. There could be more time for both the claimant and Atos to request and receive medical evidence; the questions asked of the claimant could be more relevant to the ability to work; the claimant could be provided with more space and time to fully explain the impact their condition(s) has. Other small, or less small, improvements could be made without first radically over-hauling ESA to include a real-world test.

There doesn’t have to be a public collapse of faith in these tests. Although Hardest Hit amongst others may feel that the collapse of faith should already have occurred, the fact that it hasn’t means there is still time for the Coalition government to get ESA right. It is vitally important: it is not just that this “distresses people who deserve better,” but that it drives into poverty and worsened health people who deserve full support. A catastrophe in the welfare reform may well “be enough to prevent any government looking at welfare reform for another generation,” so the Coalition must get this right.

There is potential for great harm, but there is also potential for great good. It is for us to ensure that everyone knows both what is wrong and what can be done right, to ensure justice for all the sick and disabled of this country.

[2] Right First Time, 2012, Citizen’s Advice Bureau

[3] Social Security and Child Support Tribunal hearings: Early analysis of appeals allowed from pilot data, Nov 2012, DWP

[4] Professor Harrington, An Independent Review of the Work Capability Assessment – year two, Nov 2011

[5] 23rd Report; Contract management of contract services, Feb 2013, National Audit Office

[6] Work and Pensions Committee hears from Chris Grayling on migration to employment and support allowance, June 2011

[7] Professor Harrington, An Independent Review of the Work Capability Assessment – year two, Nov 2011


The Reality of Welfare Reform

When I first started on disability research, I just saw the numbers. I saw that 40% of ESA claimants told they are fit to work then appeal that decision, and most of them win. I saw that nurses under-award points for people with physical health conditions, and physiotherapists under-award points for people with mental health conditions. I saw that most assessments are carried out by either nurses or physiotherapists. I saw that decision makers are not consistent in the accuracy or quality of the decisions they make.

In all of this I saw the fear and the stress for ill people going through an assessment process that they knew to be inaccurate. I saw people calling for, and suggesting, improvements to the assessment process that could make it more accurate. I saw the government say that it accepts recommendations from the independent review, and then either not carry them out or carry them out so poorly that they brought little, if any, improvement.

With my head concentrating on figures I started to become numb to the reality. I forgot how shocking the statistics – the real ones – and the stories are. I told a friend that fraud in the disability benefits is less than half of a per cent, and was amazed at how surprised she was.

So then I started to read some stories. I read about people who cannot afford to put glass back into their broken windows and whose houses are falling into disrepair. I read about people being evicted from their homes. I read about people having cooked meals once every other day, eating bread in between. I read about people skipping medicine because it had to be taken with food and they didn’t any. I read about people having to fund-raise for equipment they need that their local authority won’t provide.

It made me think. I’m middle class so I haven’t seen much of the grinding effects of poverty before. I’ve spoken with people who think benefits are adequate and there isn’t a problem. But I’m seeing the problem now; I know people who are struggling; I’m seeing what happens when there isn’t enough money and there isn’t enough health. I’m seeing the despair.

I’m seeing the effects of the government deciding that people who may return to work from sickness benefits should receive benefit for only one year, even though the majority are still too ill to work at that point. I’m seeing the effects of the government deciding that people under 35 can live in shared accommodation, and thus reducing the housing benefit, without considering the health needs of these people. I’m seeing the effects of the government deciding that people should be charged for under-occupying, even though the under-occupation is this and past government’s fault for not building enough social housing.

And there are so many more cuts and changes. Benefits aren’t being uprated in line with inflation, wages, food or fuel. The Independent Living Fund has been closed. Council Tax Benefit is being reduced. Disability Living Allowance is being replaced with a benefit that ministers knew in advance would cut 20% off the money going to disabled people.

People have ended their lives. People are going without food and medicine. People are becoming homeless.

And this is because of the changes this government is making.

We need to realise what is going on. We need to get angry about what is being done, and let the government know this is not what we want. We need to start protecting those who are sick from extra poverty and stress, and stop listening to the unfounded scrounger rhetoric.

Don’t let the government get away with this. There is still time to make changes that will work, but the government needs to know that we want them. We can stop people dying of despair, losing their homes or becoming even more ill. But we need to let the government know.

Valuing everyone, or just the workers?

Disabled children should be euthanised, according to Cllr Colin Brewer. According to Baroness Warnock, disabled adults should be euthanised.

In both cases this is based on the cost to society.

Cllr Brewer suggested in an interview with the Disabled News Service that some disabled babies should be euthanised to save the costs of their high support needs.[1] Disabled babies were compared by Cllr Brewer to misshapen lambs. According to the DNS, Cllr Brewer said, ‘“If they have a misshapen lamb, they get rid of it. They get rid of it. Bang!” He added: “He’s certainly got a point. We are just animals. He’s obviously got a point… You can’t have lambs running around with five legs and two heads.”’

Cllr Brewer also spoke about the costs and the burden of disabled people. “When you are talking about having to close toilets, facilities for everyone, and perhaps the coastal footpath for everyone, then I have got to question individual budgets to individual people… If you are talking about giving services to the community or services to the individual, the balance has got to be struck. ” He voiced concerns about what happends to disabled people when their parents die, saying “Who shoulders the burden after they [the parents] have looked after them for so many years?”

Asked repeatedly about whether there “might be a good argument for killing a disabled child with high support needs, because it would free up more resources for the wider community,” Cllr Brewer said he would not make that judgement, but that there may be a case as “it is a dilemma and it is going to get increasingly a problem with budget cuts.” He then said agreed that there might be a good argument, saying, ““Yes. That is why I keep as far away from health in the council as I can.”

According to the Telegraph, back in 2008, Baroness Warnock said in an interview with Life and Work, “If you’re demented, you’re wasting people’s lives – your family’s lives – and you’re wasting the resources of the National Health Service. … I feel there’s a wider argument that if somebody absolutely, desperately wants to die because they’re a burden to their family, or the state, then I think they too should be allowed to die.”[2]

Both Baroness Warnock and Cllr Brewer suggest that disabled people or their parents should consider euthanasia to relieve the cost and burden on families and on the state. Both situations would create pressure on individuals. Both suggest that it is sensible to consider a person’s life almost solely in terms of the financial contribution they make.

Both are symptomatic of a wider view in society: that a person is valued by what they contribute economically. We’re valued not because of who we are but because of what we can produce. We’re valued only as long as we can produce; as soon as that ability is gone, we’re worthless. We’re not names or people, we’re numbers, and those numbers are what we cost or contribute – financially – to society.

This view is seen in other areas. The drive to get the sick and disabled off benefits and into work suggests the only contribution we can make is through work. Encouraging both parents, or lone parents, to work suggests that bringing up children is not a worthy contribution. Talking about workers versus shirkers implies anyone not in work is a shirker.

It means the concern is not just that there are advocates for euthanasia of the disabled. The concern is that we live in a society where only financial contributions are valued. In this society it becomes possible to label people as worthy or worthless; strivers or scroungers; to be supported or to be euthanised.

This is not a society I want to live in. I want to be a person, not a number.

If we lived in a society where people were valued simply because they’re people, and where contribution is not measured in pounds, then this sort of view wouldn’t be tolerated. There would be no question of terminating a life simply because a person is disabled. There would be no suggestion that individuals should terminate their own lives. There would be no suggestion that I and my grandparents and people like us should think of ourselves burdens, drains on our family and society, a negative value.

Thing is I know I’m a drain on my parents. I know I am a financial cost and an emotional cost and a time cost and an energy cost. I know that my grandparents bring the same costs, and whereas I make a possible if non-financial contribution through my welfare work, my grandparents do not. But, fundamentally, we are all people. That brings rights and value, just because we’re people. We have a right to live, and we have a value, and our value will always be greater than any cost we are deemed to bring.