Tag Archive | welfare reform

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.

Welfare Reform: It could have been good

It’s such a shame. There was a wonderful opportunity to make something that worked. To get rid of what was failing and bring in new things that improved on the original. To end the mess and confusion. To repair the holes.

Instead we have more holes. Bigger holes. Holes in places that used to work.

Like Housing Benefit. For those in social housing, Housing Benefit used to go straight to the landlord. The tenant never saw it. Now, Housing Benefit is going to go to the social tenants for them to pass on to the landlord. In a pilot study, arrears increased from 2% to 11%. Landlords faced increased costs as many tenants were reluctant to pay by direct debit due to the financial penalties incurred if a debit payment bounces.

Only 37% of social landlords think direct payment will still be in place in 2017.

Occupants of social housing now also have to contend with reduced housing benefit if they have spare bedrooms. Whilst in theory it sounds sensible to not pay for under-occupation, it depends on a vital assumption that is not met. The assumption is that there are smaller houses for these tenants to move in to. The reality is that there are not. In Falkirk, there are 2547 one-bedroom properties of which 2507 are occupied. That leaves 40 for the 2645 tenants with one spare bedroom, and nothing for those with two or more spare bedrooms. The DWP admits that there is a surplus of three-bed and lack of one-bed accommodation. The DWP suggests that tenants move to a different area – but when all areas lack one-beds, where exactly are these tenants supposed to move to?

Then there’s Disability Living Allowance. This benefit exists to assist with the extra costs brought about by disability. The government is changing this to Personal Independence Payments, a benefit that they predict – and indeed predicted even before it had been designed – to cut 20% off the DLA bill. That’s 20% taken from disabled people. At least 500 000 people are expected to lose disability benefit.

Housing Benefit wasn’t broken. So why break it? DLA could have been improved; instead it was made worse.

But the biggest shame is Universal Credit.

The idea is great. Different benefits shouldn’t be tapered at different rates, as that does cause confusion. So to combine them into one payment with one tapering rate is a good idea.

But the good idea stops there.

The benefit is made up of different components, depending on one’s situation. There is a child element and a disabled element and a carer’s element. But why are these needed when there is already Child Benefit and Disability Living Allowance (soon to become Personal Independence Payments) and Carer’s Allowance?

There are different levels of personal allowance – the amount kept before tapering starts – that will change as one’s situation changes.

There is a cap to the total that can be received, but not everyone is included. Nor is every benefit included.

Council Tax Benefit isn’t included and has been devolved to local councils. This will create a postcode lottery, meaning if you move your income could change. The lack-of-inclusion means that another taper is added to that of UC.

All these things aren’t necessary. Either have a separate Child Benefit, DLA and Carer’s Allowance, or fully include them in UC.  Either have a cap or don’t. Don’t keep changing things as people’s circumstances change – if you do this, you might as well not have bothered with the whole idea of UC.

And then the real problem: all this has been brought in so quickly, that the flaws in the system remain. Councils lack the information they need about how UC will work, so they can’t adapt to it. The IT needed to support it isn’t ready. There have been four directors of this project in 6 months. The pilot scheme is being carries out manually using spreadsheets.

But it isn’t behind schedule. Oh, no. That the pilot is being carried out only in Tameside, and not Wigan, Oldham or Warrington, is not because of delays and problems. That only 300 people – 0.5% of potential claimants – are expected to join in the first month is not because of delays or problems. That those in the trial must be single, have no children, have been recently employed, not be ill or on disability benefits, not be caring for another person, not be homeless, not be in temporary accommodation, have a valid bank account and have a national insurance number is not because of delays or problems. That families will not be included in the October national roll-out – with no fixed date for when they will join – is not because of delays or problems.

It’s such a shame. The benefits system could have been improved. The holes could have been sewn up. The net could have been raised so that people didn’t hit the ground anyway when they fell in. It could have been raised so that people could climb out again.

Instead we have a mess. A universal benefit that isn’t ready; a disability benefit that excludes too many people; a housing benefit that doesn’t meet the cost of housing.

The government could have done something good.



Latest information to Universal Credit from The Guardian:


You will NEVER take away my shoes

Guest post again (saves me so much effort!), this time from the amazing lady Sue Marsh. Her blog is
We all know it who have posted here. We all know that by writing too well, or too often or too scathingly, we put ourselves at risk. Some of us will be or are being “investigated”. Some of us will simply lose our sickness or disability benefits, which could mean losing our independence or even our homes.
Despite this culture of fear we are living in, just look at these stories! Could you honestly read through them all without feeling astonished at the state of our care of and attitudes towards the sick and disabled?
If you are one of the mercenaries hired by the ATOS monopoly to prove we’ve all been cheating all along, you can watch me if you like. Take your pictures, twitch the curtain, send me forms and summon me to assessments. Doubt me, judge me, even try to take away my dignity, but you will NEVER take away my shoes.
If I have to use a wheelchair, then surely it’s time for the 8 inch hooker heels? (Electric-blue satin with never ending chrome spike heels. If I can’t walk anyway…) If I feel like wearing fake-fur and ripped leggings I will. I will wear red lipstick and paint my nails gold. If I want to go to dinner with friends and sip cocktails and nibble tapas and pretend, just for once, that I won’t pay for it dearly later, then I will. I don’t do hair shirts and self-denial.
If I have a rare good day, amongst the searing pain and endless vomiting and I want to dance, then I will dance. Joyously, because I know that joy is fleeting. If it puts me on the floor, I will still dance, because I am free. You can’t tell me never to dance.
If you follow me walking my kids home from school one day you might see me chase them, giggling until we fall in the crunchy piles of autumn leaves. Will you see the wince I try to hide as we carry on home? Will you notice my six year old take my arm because he’s already learnt what giggle-chases cost me? But I vow to chase my kids whenever it might not kill me.
If I see your hypocrisy clearly, I will write about it with scorching fire.  I will tweet from a hospital bed, with my drips and my bleeps and my needles and tubes. Read it if you like, you might learn something. Writing is all I have then – did it ever occur to you I can dictate?
At weddings, I will wear a hat. An enormous, wide brimmed, floppy hat, with freesias stitched into the brim. I will hold my head high, push my shoulders back, paint on a dazzling smile and sip champagne. Life and soul for the hour or two life and soul is required. But will you see me when the mask slips? When my soul can’t cover for my life any longer?
I can transform, butterfly-like with expensive skincare and will-power. The grey, clammy, puffy little face you know will emerge, glowing and radiant, my eyes sparkling, my hair shiny. Like Cinderella, the sheen will fade by midnight, but you might not notice, busy as you are marvelling at “how well I look.”
One warm, summer afternoon, when the breeze feels like silk, I will take a motorbike ride with my husband, racing through hazel lined lanes across the rolling South Downs. I will gulp in pleasure and live a year in those few, adrenaline-fuelled hours. I will pull off my crash helmet, shaking my hair and laughing at life. I wonder if you’ll remember how little my life normally gives me to laugh at?
So, whatever money, or security or comfort you try to take from me, all those other things are mine. Chronic illness takes away almost everything you ever took for granted – ambition, spontaneity, careless energy, dreams, independence – sometimes even love. When any of those things come fleetingly within my grasp, I will grab them.

Wearing an Elvis print mini-dress with pink polka dot Jimmy Choos.

**Once again, please share/link/tweet – I don’t care where, the more people read these One Month Before Heartbreak posts, the better. Yes, you can copy and paste it into emails, yes you can send it to your MP. In particular, perhaps I can ask you to send this to high profile women via Twitter and Facebook? On Twitter with the hashtag #ombh. We need friends in high places who are prepared to support us.

Saving the welfare state from misguided opinion

The folowing is a quick response to an article by Max Wind-Cowie entitled “Iain Duncan Smith: Saving the Welfare State From Misguided ‘Kindness.'” I wrote this very quickly, am now very tired and my hands hurt from typing.  So apologies for any inappropriate statements, I generally try to stay evidence-based but sometimes my emotion gets away with me, especially when I’m too tired to regulate it.  And apologies for any typing mistakes.


“Anyone who genuinely, seriously wants to protect our welfare state should be full-square behind Iain Duncan Smith’s latest ideas for reform.”

That’s a huge conclusion to reach.  No arguments are made to support this conclusion.  Off the top of my head, I can think of several against it:

  • Universal credit is not simplifying the benefits system; monthly payments will make life harder for many; online management will  be difficult for many
  • DLA is being replaced with a harsher benefit that is planned to cut 20% from working-age recipients.
  • ESA has a heavily criticised assessment process
  • More and harsher sanctions are being introduced, with no evidence to their effectiveness
  • Out-of-work benefits are amongst the lowest in the developed world and do not meet subsistence levels of income


“A Daily Mail article has trailed the idea of using smart-cards to restrict what certain individuals spend their benefits on.”

It was Iain Duncan Smith who trailed the idea, and he has asked his department to come up in one month with a solution to the impacts of drug addiction and poverty on children.


“Apparently there’s some moral principle that demands taxpayers fork out money to help addicts fuel their alcoholism.”

Taxpayers are required to provide a form of social insurance because it would be hugely costly and inefficient for individuals to take out private insurance against all possible dangers.  Because it is a form of insurance, welfare payments are not a form of charity.  For this reason there is no more dictation on how the money is spent than a private insurer would place restrictions on the money it pays out.

Dividing people into ‘taxpayers’ and ‘non-taxpayers’ is rarely possible, except for those who are still in or have only just left full-time education.  The majority of adults have paid tax; whether this covers what they receive in benefits at a later date is a separate issue.  Most adults receiving out-of-work benefits have paid tax in the past.  They are therefore, for at least some period of time, buying alcohol and tobacco out of their own taxes.

Mothers who stay at home whilst the father works yet still claim child benefit may not have ‘paid’ their ‘tax’ to ‘deserve’ this benefit.  Pensioners who have worked little (particularly current pensioners, for whom it was more common that the mother/wife did not work) or only on minimum wage but then live for several decades may get more in pension, and other benefits such as housing benefit, winter fuel allowance, TV licence, free bus pass, Disability Living Allowance/Attendance Allowance, Carer’s Allowance, than they paid in tax/National Insurance.  Given all the benefits we all receive from the government – education, health, transport networks, defence – it becomes very difficult to say who has the right to what.

The risks that National Insurance provide against include the possibility of addiction to nicotine and alcohol.  Such addictions may start in childhood through peer pressure and difficult home lives; when carried on into adulthood these people need extensive support not enforcement into further poverty, stress and chaos.  Or the addictions may have started as a response to stress in the adult life; 3-5% of professionals are alcoholic, with another 25% at risk of becoming alcohol dependent.[1]

As a slight aside, taxpayers currently subsidise the MP’s bar.


“I want there to be a safety-net for folk who fall on hard times. The good news is – as the British Social Attitudes survey and a flurry of recent polling shows – so, in principle does almost everyone else. But, in common with my compatriots, my support for a welfare system does not equal support for this welfare system. We need social security in this country – not social dependency.”

I think most people agree that we want a safety net and social security.  The difference is, Wind-Cowie implies that the current system promotes dependency (and presumably also a safety net and security, otherwise there would be nothing to become dependent on), whilst the new system will provide safety and security only.  Wind-Cowie provides no evidence for dependence; indeed there is very little.  There is, however, a large body of evidence published by reputable organistations such as the Citizen’s Advice Bureau and Joseph Rowntree Foundation that the current system is not a safety net and does not provide social security.  Unfortunately the changes that the government is bringing, and Wind-Cowie is advocating, are changes that work to make the system harsher.  The aim is to stop welfare dependency; but if there is little dependency then the result will be an even hole-ier net.


“Last week, Demos released the findings of a poll, conducted on our behalf by Populus, looking at attitudes to how people spend their benefits. Coming on the back of the BSAS (which, while showing in-principle support for welfare also found high and growing levels of concern about how our benefits system works – or fails to work) this polling highlights the need for further and more radical reform.”

Unfortunately, the public aren’t necessarily making informed decisions.  With a wealth  of media and government output using pejorative language and discussing fraud, dependency and ‘problem families’ as though these are widespread issues, it is unsurprising that many believe there is a culture of welfare dependency that needs to be addressed.  But important decisions need to be based on fact, not on opinion that has been formed from biased and all-too-often sensationalised media reports.


“The fact that government currently exercises little to no control over how benefits are spent – while the vast majority of us wish that it would – should bring home the growing gulf between our expectations of what is reasonable in relation to welfare and the policy responses on offer.”

It also brings home the growing gulf between the reality of welfare and poverty, and what many of the rest of the public thinks is the case.


“In my view, there are two possible justifications for limiting what benefits can be spent on. The first is in the case of alcohol and drug dependent claimants – whose addictions are ruining their lives and often the lives of those around them. These are people whose illness is all-too-often being enabled by the payment of cash-benefits, which allow them to fuel a destructive habit and makes recovery all the more difficult. By giving this group smart-cards, that could only be used to buy groceries and essentials, and by targeting treatment, we could do a lot of good with minimal harm. This is not about punishing the sick – it’s about enabling their recovery.”

There are many reasons to argue why smart-cards is not going to get addicted people off drugs and aid recovery with minimal harm.  The biggest one is that lack of money has rarely, if ever, been a reason why someone ended a long-term addiction.  On the other hand, it will restrict choice as market-stalls and small shops may be unable to take the cards; it may encourage a black market as people trade items to get desired drugs; it provides no help or support to people who are already suffering the effects of poverty and addiction; it may serve only to force these people into greater poverty and more chaotic lives.


“The second group we should look at are the non-disabled, non-contributors. People who’ve never had meaningful work and have never made a meaningful contribution – through NI – to the safety-net the rest of us pay for. There are too many in our society who walked out of the school-gates and onto the dole queue without so much as a glance at the workplace.”

This is a very small group of people.  Or at least it was, until a recession hit and many graduates were unable to get a job – over-qualified and under-experienced being the story of many graduates attempts to find work – whilst many school-leavers struggle to find training or apprenticeships that pay a livable wage, or even one that adequately reimburses the cost of commuting and time spent in training.


“We’re a civilised country, we don’t let people starve to death in the streets. But the lack of recognition for contributors – who, on the whole, will get pretty much the same out of the state as those who’ve put nothing in – is a damaging and corrosive theme of our welfarism. We can’t afford to give contributors substantially more. But we could give them more freedom and flexibility over how to spend their benefits than those who’ve added little to the pot. After all, for those who have worked and paid-in their welfare is a right and an insurance policy they should expect to enjoy when times are hard. For those who have failed to pay-in, welfare is the privilege of being born to our generous and caring society. It’s right, proper and – if the attitudinal evidence is to be believed – necessary to start making that distinction. Smart-cards for those who could have contributed but have not done so would be a step in the right direction.”

Somewhat sadly, the first link I found when I searched ‘people starve on streets UK’ was this one: http://mikesivier.wordpress.com/2012/10/05/uk-policy-on-refugees-let-them-starve/

Another story explained the existence of starvation and malnourishment in our capital city:


Other pages explained the role of food banks, a charitable provision and not a government policy of aid.  I’m delighted to live in a country where the citizen’s care, but the government should care too.

Wind-Covie’s lack of data on who pays what in and gets what out undermines his argument about what freedom people should have in spending benefits.  The government, as I have said, pays for many things for the citizens of this country.  A rough calculation I made some time ago suggests that anyone who does not earn an average salary of £41 500 a year for fifty years will receive more from the government than is paid in tax.  Separating into National Insurance contributions vs any other form of tax becomes nonsensical when the welfare bill is well above NI receipts.  Unless the government is going to make other restrictions, it is inconsistent to restrict alcohol and tobacco purchases by people on certain benefits.

It is not right, proper or necessary to make the distinction between those who ‘have’ and ‘haven’t’ paid in. The very concept of ‘paying in’ is rife with problems.  Age is one big factor in what has been paid in.  Caring duties are another.  ‘Paying in’ can also occur through voluntary work, or simply the presence of a friend or relative helping a healthy adult to stay on top of things in an often stressful world.

Then there’s the question of what the government has paid out.  State schools vary in quality.  Healthcare varies in quality.  Public transport varies in quality.  Maybe these ‘problem families’ or people with addictions have these problems at least in part because of inadequate or improper provision on the part of the state in the first place.  So maybe what should actually be happening is that the state should invest more in helping these people, not simply restrict their freedom in the hope that this will somehow sort out all the struggles they are having in their life.  And the state should do this because it failed to help these people in the first place, before the use of alcohol and tobacco became an addiction.


“What’s more, it would add more nuance to the ‘conditionality’ framework. At the moment, the only real penalty we have for folk who refuse to play by the rules is to remove their benefits for a short time. So if you refuse to apply for a job we can stop payments – but only for a little while because, as I say, we’re a civilised country. Under a smart-card regime we could use flexibility as a reward and greater control as a punishment. That gives us a better range of tools to use in the battle to get people back to work.”

By short time, Wind-Covie means complete cessation of benefits for a minimum of four weeks (only for the first failure at a low or intermediate level) up to 156 weeks, that is 3 years.[2]  Not a short time for anyone trying to live on nothing.  By better range of tools, Wind-Covie appears to mean an increase in punishments.  Flexibility isn’t a reward when it’s what most people have, it’s simply the status quo with loss of freedom as a punishment.   It shouldn’t be a battle to get people back into work, and if it is then it may be more helpful to look at the state of the job market and what can be done to improve that.


“I want a welfare state that accords with the moral intuitions of British people. To continue with what we’ve got would be to dangerously derange benefits from the beliefs, attitudes and opinions of those who pay for them. We need to listen to those who pay the bills, not denounce them. Exercising more control over how benefits are spent – to differentiate between contributors and non-contributors and to enable the recovery of addicts – would be a kindness both to individuals and to our welfare system itself.”

I want a welfare system that works and is based on evidence: evidence of what the problems are; evidence of what is needed; evidence of what is successful.  I’m not interested in intuition when people’s lives are affected.  To separate between contributors and non-contributors, those who pay and those who don’t, is complex to the point of impossibility.  In some ways we all contribute and pay; in many ways we all take.  The ones with the money aren’t necessarily the ones who know what is best to do with it.  And the recovery of addicts has never yet occurred on a large and permanent scale by forcibly removing access to cash.

[2] http://www.dwp.gov.uk/adviser/updates/jsa-sanction-changes/ These are the sanctions for Jobseeker’s Allowance.  As many other benefits such as Housing Benefit are passported from JSA, a loss of JSA frequently means a loss of all benefits and therefore may be loss of all income.

WCA and the fear it brings

With greatest respect and sorrow for everyone who has attempted or completed suicide.

“84% of GPs say they have patients who have presented with mental health problems such as stress, anxiety or depression as a result of undergoing, or fear of undergoing, the Work Capability Assessment.  21% of GPs say they have patients who have had suicidal thoughts as a result of undergoing, or fear of undergoing, the Work Capability Assessment.”[1]  As Stephen Lloyd, MP, said, Atos is “feared and loathed probably in equal terms.”  Many find the WCA both stressful and upsetting, and Citizens’ Advice Scotland concluded, “It is fair to say that claimants always feel the process is making every condition worse.”[2]

Patients do not only experience suicidal feelings, brought on or exacerbated by the ESA assessment process; they also act on them.  14% of GPs have patients who have self-harmed as a consequence of the distress brought by the ESA assessment, and 6% have patients who have attempted, and in some cases completed, suicide.  This is something that is scaring people so much that they take it out on their body.  It is scaring them so much that sometimes they literally cannot live through it.

As Rethink Mental Illness concluded, WCAs are pushing vulnerable and unwell people “to the edge.”[3]  And sometimes over it.


This is not acceptable.  This is supposed to be a test that assesses people’s ability to work, not one that makes their health worse.  It is supposed to separate the unwell from the very unwell, not drive the unwell into the very unwell category.  Of course when I say unwell, I am talking largely about people who are ill enough to have been out of work for 28 weeks; otherwise they would still have been on Statutory Sick Pay or gone back to work before their SSP ran out.  So it’s not like these are people who are just a bit peaky, to quote Rod Liddle’s definition of ME and Fibromyalgia. (The Sun, 27/1/12)

Genuinely sick people are terrified that they won’t get the support they need.  They know they are too ill to work, but also know they are likely to be found fit for work.  Their fears are not based on rumours.  ESA has been in place for four years, so the people living in fear now have been through the system and know what it is like for themselves.  In that time, appeals have led to 38% of initial refusals being overturned, 60% of which were originally assigned 0 points; if a representative such as a CAB volunteer is present, then appeal overturn rates can reach 100%.  Report after report has highlighted the errors, inaccuracies and falsehoods that are leading to very ill people being found fit for work.  Labour has called for a review; the British medical Association has called for the WCA to be scrapped immediately.

These people are not basing their fear on hearsay.  It’s based on fact and personal experience.  These people are scared because they know the system, they know it doesn’t work, and they know their money is being stolen.  They have a right to it legally – appeals are judged according to the law – but their payments are being stopped.


The government and the public need to know this is happening.  They need to know that there are people so ill that, when they are found fit for work, death is a more viable option than an attempt to go on Jobseeker’s Allowance with its attendant interviews.  They need to know that people who weren’t mentally ill are becoming so; people who were mentally ill are becoming suicidal.

“These figures demonstrate how urgent it is that the Government overhauls the test. It is putting a strain on individuals, families and the NHS. The human and economic costs are too great for the Government to continue with it. We urge the Government to halt the system now – it could be the difference between life and death for some of the most vulnerable people in our society.”[4]

As Tom Greatrex, MP, said, “There is clearly a problem when an assessment that is designed to help people back into work ends up having the opposite effect.”

[1] Rethink Mental Illness: New GP survey shows Government welfare test is pushing vulnerable people to the brink. http://www.rethink.org/how_we_can_help/news_and_media/national_press_releases/new_gp_survey_shows.html

[2] Dryburgh, K. and Lancashire, M., September 2010 The WCA: A response from Citizens’ Advice Scotland. CAS

[3] Rethink Mental Illness

[4] Rethink Mental Illness

Disability’s Not Working

The government has plans to further sanction long-term sick or disabled people if they deem these people to not be working hard enough.  There are already sanctions if these people do not attend all of their ‘work focussed interviews’ or fail to satisfy ‘work-related activity’ requirements.  The government is extending this ‘work-related activity’ to include work experience; it is now legal for officials to mandate people in WRAG to carry out work experience,[1] although plans for unpaid work experience have not yet been finalised.[2]

“Ministers strongly feel there is a link-up to support those moving close to the labour market, and the individual’s responsibility to engage with the support.  Ministers feel sanctions are an incentive for people to comply with their responsibility.”

I find this sort of statement deeply frustrating.  I’m not interested in what Ministers feel.  I’m interested in facts.  What exactly does it mean for a long-term sick or disabled person to ‘engage with the support’?  Who decides what is engagement and what is not, and does the decision maker understand what it means to be long-term ill or disabled?  In what way will sanctions successfully incentivise people to comply with their ‘responsibility’?  What is their responsibility, given that they are long-term sick and thereby have reduced capabilities?

Work-related activity as defined in the Welfare Reform Act 2007 is that which “makes it more likely that the person will obtain or remain in work or be able to do so.”  The 2012 extension is that this work “includes work experience or a work placement.”  Work-related requirements for those found to have limited capability of work (i.e. in WRAG) is limited to ‘work preparation’:

Section 16 of Welfare Reform Act 2012

(1)In this Part a “work preparation requirement” is a requirement that a claimant take particular action specified by the Secretary of State for the purpose of making it more likely in the opinion of the Secretary of State that the claimant will obtain paid work (or more paid work or better-paid work).

(2)The Secretary of State may under subsection (1) specify the time to be devoted to any particular action.

(3)Action which may be specified under subsection (1) includes in particular—

(a) attending a skills assessment;

(b) improving personal presentation;

(c) participating in training;

(d) participating in an employment programme;

(e) undertaking work experience or a work placement;

(f) developing a business plan;

(g) any action prescribed for the purpose in subsection (1).

(4)In the case of a person with limited capability for work, the action which may be specified under subsection (1) includes taking part in a work-focused health-related assessment.

(5)In subsection (4) “work-focused health-related assessment” means an assessment by a health care professional approved by the Secretary of State which is carried out for the purpose of assessing—

(a) the extent to which the person’s capability for work may be improved by taking steps in relation to their physical or mental condition, and

(b) such other matters relating to their physical or mental condition and the likelihood of their obtaining or remaining in work or being able to do so as may be prescribed.

(6)In subsection (5) “health care professional” means—

(a) a registered medical practitioner,

(b) a registered nurse,

(c) an occupational therapist or physiotherapist registered with a regulatory body established by an Order in Council under section 60 of the Health Act 1999, or

(d) a member of such other profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002 as may be prescribed.

The plan is that those considered capable of ‘work-related activity’ may be mandated to carry out voluntary work for charities, public bodies and high-street retailers.  There is no plan for a time limit for such work, despite the existence of time-limits for people on JSA.  There is also no evidence that this will be at all effective; it may even be detrimental.  The government’s paper on work and health, published in 2006, concluded that there is no data on the impact of work on people with chronic health-problems, and that there is a significant minority for whom work has negative effects.[3]  Whilst it is to be hoped that this significant minority would be placed in the Support Group, there is no confidence amongst disabled and long-term sick people that this is the case.

There is a real risk that this requirement will cause deteriorations in people’s health.  These people have been found unfit for work; some of the reasons they are unable to work will also apply to their ability to carry out mandatory unpaid work.  If a person would find paid work exhausting or painful, or would be unable to regularly attend due to fluctuations in health, surely this will also be the case for mandatory unpaid work?  Advisers lack medical knowledge that would enable them to assess a patient’s ability to carry out work, whether paid or not, or understand why health issues can make such work impossible.  There is then the possibility that advisers will require people to carry out work that is beyond their capabilities, and then sanction them when they are unable to carry on.

Added to this, the government is making sanctions are even harsher.  It is as if they have forgotten that they themselves assessed these people as unable to work due to health problems.  Current sanctions have a maximum of £28.15 a week, but from 3rd December this will change to £71 a week, which is 70% of the weekly payment.[4] As Paul Farmer, chief executive of Mind, said, “Whatever an individual’s health problems, slashing their benefit is only going to exacerbate the strain they are already under. The additional stress and anxiety incurred by the sanction – worries about paying for bills, rent and even food – risks devastating their mental health.”

It is essential that the government starts listening to disabled people and what they need, not what the government wants.