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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

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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.

New Website

My blog has now moved to my website, www.aidaaleksia.com. New posts and updates on my book can be found there.

My book is now available for sale.  Why We’re Not Benefit Scroungers can be bought as a pdf for £1 from my website.  Purchasers who buy the book before 15th December, when the print version comes out, can get £1 off the price of the print version.

If you can tweet you can work, and other such lies

Guest post from Latent Existence,

http://www.latentexistence.me.uk/if-you-can-tweet-you-can-work-and-other-such-lies/

Picture the scene: I am lying in bed on my front, with my head turned to the side. My right arm is flat on the bed, a phone propped up by my hand. The only part of me moving is my thumb, pressing the on screen keyboard. Pain is tearing through my body, what I feel in my arms, my legs and my hands is agonising. I don’t have the strength to lift any part of my body from the bed. And yet, I have one, tiny connection to the world  – I can send messages out through twitter, and I can receive replies, 140 characters at a time. This is my often my only interaction with anyone else at this point. Through twitter, I can talk to friends, take my mind off my pain and discuss something – anything else. When the pain is too much, I’ve got a support group of fellow sick people and we can commiserate about the pain.

Fortunately, I am not this incapacitated all of the time. No, much of the last few weeks I have been so energetic that I have been able lie back on a pile of pillows and type on a full keyboard for as much as a few minutes before the searing pain in my hands sets in. Sometimes, gasp, I can even make it to a different room in the house for a while.

And yet, according to Nadine Dorries MP, my usage of twitter means that I can work. I can’t get out of bed most of the time, but apparently I am a scrounger who is defrauding the benefit system.

Last September Dorries made a request on her blog for people to look out for people tweeting too much and report them to her. She also asked people to report anyone who tweeted a lot while on benefits to the Department of Work and Pensions. She went on to pick on someone who was waiting for surgery for arthritis on both feet for their prolific use of twitter.

It gets worse. There are now rumours that ATOS (The company paid to assess people, who have been known to declare people fit for work just before they die from their illness) will be checking twitter and other social networks for activity that indicates ability to use a computer for any length of time. Because, you know, that makes you fit for work. Now this may just be rumours, but it shows a huge problem with public and government attitude to the sick and disabled.

I want to work, I really do. I own a business that my father and I have built up over the last 17 months into something that has the potential to go somewhere. I started my business as a last resort, since both of us are disabled, to try and provide part time work for myself that could be done when I have the strength to do it, not strictly between 9am and 5pm. I have been trying to build up more web hosting and design work, and I even tried to carry on working from my bed when this relapse started nearly three months ago. Unfortunately I have reached the point where brain fog has killed my concentration, and pain and fatigue won’t let me keep going to long enough to finish any work related tasks.

I can write, but I couldn’t tell you when or how much I could write. I can tweet, but that’s because tweets are short, and (mostly) fit in between bouts of brain fog which stops me completing my thoughts. I can set up a website without leaving my bed, but who is going to hire me to do that when it might happen now or it might take me weeks because of my health? I could be brought a customers computer to remove viruses from, but then not have the strength or concentration to do it for days.

The fact is, I can’t work. I am not employable. If I had ANY chance at all of working, I would be desperately trying to save my business into which we have sunk time and money and worked so hard for the last year and a half. I have hurt myself trying to run my business and have had to give up and apply for ESA because I have no other choice. And yet, because I have a variable, invisible disease, I am highly likely to be deemed “Fit for work” by the Work Capability Assessment. I won’t have the strength to appeal against that and I won’t have a Citizens Advice Bureau to help me because they are all being shut down.

So I am going to carry on tweeting and blogging. I have precious little other contact with the world and I will lose my friends and my support group if I don’t. Someone looking at my online activity and judging me on it cannot see how long each blog post took me, or the pain that I have to endure to even communicate with others online. The portrayal by government and by media of all sick and disabled people as scroungers and cheats is disgusting and yet good people that should know better are taken in by it. If you think I should just lie here and be miserable while I wait to be denied my ESA, then screw you. You are the problem.

More on the despicable behaviour of Nadine Dorries

BMJ: Well enough to work? A report on ATOS by a GP.

Guardian: Frequent tweeting doesn’t make one a benefit cheat, Nadine Dorries

Lord Freud and Universal Credit – again

 

Lord Freud has written another piece about Universal Credit.  So I’ve written another response, and here it is.

 

Yes, Universal Credit should be simpler to work out withdrawal rates because there is just one withdrawal rate.  But then there are different disregard levels, so an individual may still struggle or need a computer to help them work it out – much like the benefits calculator that currently exists to allow a person to work out the effects of different situations.

Someone will still have to calculate the different components and how much a person or household is entitled to for each component, but that may be the DWP’s job.  And because tax-credits are removed, there is no need to apply to the HMRC.  So from the claimant’s view, applying is also simpler.

Online processing is supposed to give a more streamlined process.  I don’t know if this will be the case or not.  Certainly when I applied over the phone the form that was filled in for me was full of mistakes.  Filling in online meant no mistakes (or fewer mistakes) were made, because I had all the information I needed in front of me.  However I still needed support, partly because health-related benefits can be distressing to apply for.  For people competent with computers, I suspect using an online form is easier.  But for those who are not competent with computers; those who have other difficulties such as learning difficulties, dyslexia or illiteracy; those without computers or without internet; those with chaotic lifestyles or are living in hostels; for these and for others the emphasis on online submission will be detrimental.

I would have assumed that those who find online forms easier, such as because it avoids a trip to the Jobcentre, already submit online.  And those who find this too difficult will already go to the Jobcentre or use a telephone.  So why the need to change?  Should this not be about the customer’s best interest?

Furthermore, an application for Jobseeker’s necessitates repeated trips to the Jobcentre anyway.  So what’s wrong with one at the beginning of the application process?  If you have alternative plans for those who cannot manage online applications, why have them in the first place?

Comments about whether or not work is worthwhile, or more worthwhile, under Universal Credit deserve fuller attention so I shan’t address them here.

The line about ‘most people at work are paid monthly’ gets a little tiring.  The argument against is not about what most people get.  It is about what people at the bottom of the income ladder get; it is about what it is reasonable to expect of people who often already face numerous challenges that may include poor arithmetic skills; and it is about what is best for the people concerned.

If you have alternative plans for those who cannot manage on monthly pay-packets, why have them in the first place?

I’m confused by the ‘new’ conditions on working part-time and claiming benefit.  As far as I was aware, a person could only work up to 16 hours whilst retaining benefit; this was to encourage people to seek some work whilst continuing to have the requirement of looking for full-time work.  Anyone who had caring duties could claim Income Support to top-up part-time work.  I don’t know what ‘new’ conditions have been brought in, unless part-time work is to be discouraged.  Which would be unfortunate given the difficulty of finding full-time work in the current climate, and would keep people away from the labour market for longer.

Lord Freud seems to have hinted at a partial benefit for those who are ill.  Other countries have partial benefit schemes whereby those who are deemed too ill for full-time work but capable of part-time work are given partial benefits.  Some countries also top this up with an unemployment benefit if the person concerned cannot find part-time work.  But as far as I am aware, there has been no suggestion of this by the government.  I am therefore unsure what Lord Freud means when he says, “If someone can’t work full-time because of an illness or caring responsibilities or simply because a full-time job isn’t available, then we will not place additional expectations on them.”  People who cannot work full-time because of an illness do have expectations placed on them – it is called the Work-Related Activity Group.

I also imagine it could be very difficult to determine who is not working full-time “because a full-time job isn’t available,” as opposed to lack of trying.  This would also be a new policy I have not heard of before.

I can’t say whether “speculation” that the IT system will fail is true or not.  I can point out that such large schemes generally do have problems.  But concern about failure, when the concern is based on many past failures and difficulties, is not defeatist.  It is a pragmatic request that things are done properly the first time, taking the time necessary to do so.  It isn’t that “people believe we shouldn’t changes the system because it is hard.”  Rather, it is that given we are changing the system, we should do it properly.

Lord Freud correctly says that, assuming full take up under both the current system and the new one, Universal Credit will involve an extra £2 billion in spending.  Which leaves the unsettling question that if UC brings higher payments and pensioners are not being touched at all, where are the savings coming from?  In large part, the savings are coming from the fact that rises in benefits will no longer be inline with the Retail Price Index, and will instead rise with the Consumer Price Index.  This means that benefits will rise at a lower level, thus giving the savings.  This also counteracts the government’s anti-poverty measures.

This is Lord Freud’s article in the Guardian:

http://www.guardian.co.uk/commentisfree/2012/nov/01/universal-credit-debunking-myths

(Why We’re Not) Benefit Scroungers: Extract 2

The one thing I am absolutely unreservedly and implacably opposed to in all of this is a real world test.” – Chris Grayling, Minister of State, Department for Work and Pensions, 2011.

But the current, not-real-world test isn’t working.

It is not uncommon for a claimant to be signed off work by a GP, and yet be refused benefits.[1]  Nor is it unknown for an employer to consider an employee to be too ill to return to work, yet the employee is refused ESA.[2]  The DWP argue that this is because the ESA assessment considers the ability to carry out any job, not just the one the claimant was in before becoming ill.  However this still conflicts with the GP’s judgement, and the questions asked are so poor that it is often unclear what job the DWP has in mind when assessing a person as fit for work. …

When a system works well, appeals against decisions occur in marginal cases.  In terms of the WCA, the only people appealing should be those who received just under the required points.  After all, most people know whether or not they can walk 200m, dress themselves, prepare a meal, remember to take all their medicine etc.  They won’t appeal if they can appreciate that the decision was fair (n.b. fraud in DLA costs a mere 0.5% of DLA payments, less than the cost of official error.  Fraud in Incapacity Benefit is even lower at 0.3%.  ESA will not be assessed until 2013).  Yet up to February 2010, 60% of appeals overturned in favour of the claimant were for cases that had originally been awarded zero points.  A further 23% had been awarded between 3 and 6 points (there are no 1 or 2 point descriptors), leaving just 17% who had been awarded between 7 and 14 points.[3]  This is unacceptable.  A high percentage of claimants are failing to even come close to having a proper assessment of their health made. …

There is high variability between decision makers [who are non-medical staff at the Department of Work and Pensions].   Professor Harrington, the head of the independent reviews into the ESA assessment, said that “consistency and quality of decision making appear to be key issues.”  This is particularly the case now that Harrington’s previous recommendations have led to an increased importance of the decision maker’s role, relative to the ATOS assessment. …

Professor Paul Gregg, before the WCA was rolled out nationally, reported that, “the test so far has caused a huge amount of anguish to the people who have gone through it. We need to have something that is working accurately before we apply it nationally. We shouldn’t roll this out until we have something that is working.”[4]  Gregg was involved in the design of the new system (ESA and WCA)and  has been described as “one of the most rigorous and high-impact social policy academics in the UK.”[5]


[1] Dryburgh, Unfit for Purpose, 2010, Citizen’s Advice Scotland. http://www.cas.org.uk/publications/unfit-purpose

[2] Dryburgh and Lancashire,The Work Capability Assessment, 2010, Citizen’s Advice Scotland http://www.cas.org.uk/publications/work-capability-assessment

[3] HC Deb, 28 June 2011, c662W

[4] New disability test “is a complete mess,” says expert. 22nd Feb 2011, The Guardian. http://www.guardian.co.uk/politics/2011/feb/22/new-disability-test-is-a-complete-mess

[5]Baumberg, September 27th 2012, Paul Gregg: new ideas for disability, employment and welfare reform. Inequalities. http://inequalitiesblog.wordpress.com/2012/09/27/paul-gregg-disability-employment-speech/

(Why We’re Not) Benefit Scroungers: About

Yesterday I published a post with extracts from my book that is coming out in December.  Today I realised I had put very little information about my book on this blog, and I should probably let my readers know what my book is about.

It’s called “Why We’re Not Benefit Scroungers,” and has the subtitle “Living with disability and chronic illness in modern Britain.”

The first of its two parts is about the current welfare system and the changes the government is making.  This part is fact-based, relying on data and publications from bodies such as the Joseph Rowntree Foundation, Citizen’s Advice Bureau and Department for Work and Pensions.  One chapter deals with Employment and Support Allowance and the facts surrounding its unpopular assessment process.  Another looks at Disability Living Allowance, how assessment for this currently works and what is happening with the changes to Personal Independence Payments.  Other chapters discuss common media misrepresentations – and sometimes government misrepresentations – and some of the costs associated with disability and chronic illness.

The second part features stories about people with different disabilities and illnesses.  These are written as memoirs, giving the experiences of these people as they recall them.  For some, ill-health and disability has interrupted or hindered education.  For others, illness came later in life and has forced a withdrawal from work.  Some disabilities or illnesses can be worked around with understanding from the employer; others require the purchase of aids and adaptations.

All these stories show the obstacles that face the chronically sick and disabled in this country.  From inaccessible public transport to incomprehensible instructions, this society is not prepared for the needs of some of its most needy people.  These stories show some of the realities of living with disability or chronic illness in this country today.

I will be publishing some extracts from the book on my blog over the next week so that you can get more of an idea of what it is about.  I haven’t got a planned publication date yet, partly because I’ve lacked the health to get on with it, but I intend to have it out at the beginning of December.  If I can sort out how to work my website, I will be making the book available to pre-order.  Keep watching or follow me on Twitter (@AidaAleksia) to find out more.