Tag Archive | welfare

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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Does the Work Programme Work?

Back on wordpress because I can’t get my website to work…

Today (27th november) the government released data on the first year of its work programme.  This programme is open to people on ESA and JSA.  People are mandated to this programme when they have been on JSA or ESA for a set number of months; the number of months depends on the category into which a person falls.  For people moved on to JSA from Incapacity Benefit, this is three months.  People placed in WRAG can be referred to the work programme at any time, in general when they are considered to be within three months of recovering enough to return to work.  Jobseeker’s are given six months before referral if they are 18-24, and 12 if they are over 25.

The Work Programme was started in June 2011.  Since then, there have been 878 000 referrals to the Programme and 837 000 attachments.  Of these, 91% were from JSA and 9%, 79 000 people, were from ESA.  Most ESA referrals are from new ESA claims who are mandated to the programme from WRAG; these form 52 100 people or 66%.  The next biggest is voluntary referrals at 22% (17k), and the smallest is ESA claimants who were previously on IB, at 12% (9.4k).

Out of all referrals, 200 000 people started jobs.  However most left within six months: only 31 000 people have been in work long enough for the Work Programme Providers (WPPs) to get job outcome payments.  Of these 31 000, only 1 000 are people from ESA.

To get an idea of how well the WPP are performing, ideally we would need to know how long it took people to find a job and have data for 2 years, the amount of time WPP are given to find people a job.  Because the WP has only been going for 14 months, the best we can do is to use the first three months to work out what percentage of people are found a job in 12 months.  We also can’t easily compare it to Jobcentre data, as Jobcentre data will include people who are able to find jobs more quickly.  There is also little data on how will the WP performs compared with previous schems, although Alex Hurn does a good comparison here. (basically, WP is not very, if at all, effective, and the Future Job Fund was effective)

For ESA groups, this gives the data in Table 1 for how many and what percentage found work within one year of referral to the WP.  Note that the September 2011 cohort is just under one year, as figures for August 2012 are not available yet.  Over all ESA groups, 475 people found jobs within one year of joining the Work Programme out of 11 488 referred from June-Aug 2011.  That’s a success rate of 4.1%.  This is much lower than the figure for all people on the WP, which has an 8.3% success rate over the first two months of the programme.

Note that there is some incorrect use of statistics.  For all WP participants, 31 000 of 878 000 referrals got jobs: this is 3.5%, the figure that is being most quoted.  However, this includes people referred who weren’t attached (don’t ask, I don’t know what that means, unless it is that people voluntarily left the benefit) and therefore understates the percentage.  It also includes people who have joined the programme very recently and therefore can’t be expected to have yet found work.

This graph shows the percentage that have a job outcome (i.e. stay in work for 6 mths) for each month after joining, up to ten months.  It is not cumulative.  The big jump between 6 and 7 months suggests that most people are likely to take at least 6 mths to be found a job.  Therefore, to include people who joined the WP in the last 6 mths (i.e. Feb to Jul 2012) will inappropriately raise the caseload relative to job outcome rate.

This is why the government uses the figure of 8.1% and 8.6%.  These are the percentages who found work within one year of joining, for June and July 2011 cohorts respectively.  These graph use 10 months, to allow more cohorts to be included.

The use of the figure 3.5% is inappropriate.  To know whether the WP is successful, we need to have an agreement on how long we think it should take a WPP to find a job for a person.   If we think it should be 6 months, then the figure is 1.2%; at 9 months it is 4.6% and at 12 (not shown on these graphs) it is 8.35%.

It is worth bearing in mind that for people mandated from JSA, another 6 months has to be added to the time out of work, and for ESA it is another three.  So if the total amount of time acceptable for a person to be out of work, including time before joining the WP, is 12 months, only 1.2% get a job in this time.

ESA ex-IB ESA New IB/IS voluntary ESA voluntary JSA ex-IB
% referred no. jobs % referred no. jobs % referred no. jobs % referred no. jobs % referred no. jobs
Jun-11 0 90 0 3.9 1800 70 6 170 10 7 300 21 5.6 150 8
Jul-11 8.3 120 10 3.2 3400 109 7 290 20 6 500 30 8.1 370 30
Aug-11 0 130 0 3.3 3290 109 5 210 11 7 460 32 7.1 208 15
Sep-11 0 180 0 3.7 3550 131 4.3 230 10 6.3 480 30 8.3 240 20
Jun-Aug 2.9 340 10 3.4 8490 288 6.1 670 41 6.6 1260 83 7.3 728 53

Job outcome rate varies by group.  In particular, people who are on ESA and have been mandated to the Work Programme are unlikely to find work, at 3.4% across both groups.  However, people moved on to JSA from Incapacity Benefit or who volunteer for the programme from IB or ESA are twice as likely to find work, at 6.7% across all three groups.  It may be that this occurs because those who are mandated to the WP are less healthy than those found fit for work (although bear in mind these people are not necessarily either well or fit for work) or those who self-select for the WP.  People who self-select for the WP may feel that their health condition or disability need not be a barrier to work, if appropriate work and support can be found.

The key issue however is whether or not these people stay in work.  And the results say that they do not.   1000 people from ESA found work.  But only 2000 sustainment payments occurred for people on ESA.  Sustainment payments are lump sums given to WPP for every four weeks an ESA claimant spends in employment above the first three months.  Given how long the work programme has been running, and the number of people reaching a job outcome (3months in work) there was potential for 3000 payments to be made.  Such a small sum means very few people stayed in work for more than 3 months.  Because the number of job outcomes per month has been increasing, most of the potential sustainment payments occur for people who reached job outcomes in Feb-Jun 2012.  This skew also means that the average person who got a job kept it for only 6 months (3 months to job outcome, plus 3 months of sustainment payments).

The data suggest two things.

First is that small numbers of people are being helped into long-term employment.

Second is that a large percentage of people who reach 3 months employment don’t stay in that employment.  They may not leave right away, but the data suggests the average person does not get past 6 months.

The numbers can be cooked in different ways.  You can consider how many got a job out of all who have been referred to the WP, but this makes it look worse than it is – it includes people who only recently joined.  You can consider how many got a job within a year of being on the WP, but this makes it look better than it is – it forgets that people have already been unemployed for three or six months, and ignores that the majority do not stay in employment for six months.  You can also find inappropriate data to compare it with: bearing in mind that these are people who have been unemployed for six months (three for ESA), it is not correct to compare this with all jobseekers who find employment, because some will find employment within six months of signing on.

But however the numbers are cooked, one thing is clear: the Work Programme is not working well.

Key Figures:

All:

837 000 people joined the Work Programme

200 000 people started a job

8.3% of people got a job within a year of being on the WP.[1]

1.2% of people got a job within a year of being on JSA, or 9 mths of being on ESA

31 000 people kept a job for six months (three for ESA recipients)

20 000 people kept a job for more than six months (three for ESA recipients)

£58 000 was spent as sustainment payments for the 20 000 people in work for more than six months (three for ESA recipients)

ESA:

1 000 people had a job for three months

4.1% of people got a job within a year

Most of these people did not stay in employment for more than six months


[1] This data is only available for people who started the WP in June or July 2011

The People’s Review of the WCA: a summary

Yesterday a report was released about the Work Capability Assessment for Employment and Support Allowance.  It contains many stories of poor assessments and inappropriate decisions that a person is fit for work.  Here I have made a summary of some of the problems that the WCA faces.  The full report is well worth reading and can be found at http://wearespartacus.org.uk/wca-peoples-review/

 

The ESA is surrounded by secrecy:

  • Atos Health Care Professionals (HCPs) have to sign the Official Secrets Act
  • The DWP has refused to release details of the contract between the DWP and Atos
  • Details of the Independent Tier that monitors Atos have not been released
  • Data on Quality Assurance checks are not available to the public
  • The report on improved Mental Health descriptors developed by Professor Harrington with Mind, Mencap and the National Autistic Society has not been released to the public
  • recordings of assessments are ‘only provided for the customer’s own personal use’ and will not be routinely used in appeals or as evidence of inaccuracy in the WCA
  • Data on the use of free text boxes during the WCA are not released to the public

 

Evidence suggests the ESA is not working well:

  • 41% of people found fit for work appeal this decision
  • Of this 41%, 38% win the appeal.  This rises to 70% if the claimant has a representative; some representatives claim a 100% appeal success rate
  • 72% of claimants found fit for work are still out of work 12-18 months later[1]
  • anecdotal reports from Jobcentre staff show multiple people are sent to look for work who are demonstrably too ill to work
  • appeals cost £60 million a year; the Atos contract is worth £100 million a year[2]
  • A large backlog of appeals means that the tribunal service has had to:[3]
    • recruit more judges and medical panel members
    • increase administrative resources
    • secure additional estate
    •  increase the number of cases listed in each session
    • run double shifts in its largest processing centre
    • run Saturday sittings in some of the busiest venues
    • set up a customer contact centre to deal with telephone inquiries

 

Atos HCPs are not well trained:

  • reports on training vary, but appear to be measured in days or a small number of weeks[4]
  • HCPs are not required to have a Diploma in Disability Assessment Medicine[5]
  • any training received by Atos HCPs is not recognised by the European Qualifications Regulations 2007[6]
  • The Royal College of Nurses has refused to accredit the training of Atos Nurse assessors[7]

 

WCAs are not well checked for accuracy and quality:

  • Checks are internal and are not open to the public
  • The checks are run by a company chosen and paid for by Atos
  • Professor Harrington recommended unannounced visits to assessment centres, but this has not occurred
  • the National Audit Office said that, “The current target of no more than 5 per cent of reports being graded as ‘unsatisfactory’ is not sufficiently challenging and allows the contractor to deliver a significant number of assessments before financial penalties become due.”[8]

 

WCAs have been criticised by multiple bodies and experts:

  • GPs called for an end to the WCA with immediate effect
  • The British Medical Association called for an end to the WCA with immediate effect[9]
  • The RCN has refused to accredit Atos nurses[10]
  • The Liberal Democrat Party voted unanimously for a Motion calling for the WCA to be changed
  • The High Court has granted a Judicial Review against the Secretary of State for Work and Pensions, on the basis that medical evidence for claimants with mental health issues should be obtained early in the assessment process
  • the National Audit Office criticised the DWP for not seeking financial redress for delays
  • The NAO noted “uncertainty of roles and responsibilities, poor record-keeping and irregular sitting of the Executive Management Board.”

 

Recording of WCAs is variable:

  • no information about the right to have WCA recorded, or how to request this, is provided on either the DWP or the Atos website
  • the Jobcentre said that, “There is no real need for customers to request and use the recording of their assessment.  The recording is only provided for the customer’s own personal use and must not be put into the public domain… If the customer is insistent on the recording being taken into account as evidence, these will be handled on an individual basis and the customer will need to provide consent for Atos Healthcare to share this information with Jobcentre Plus.”

 

Professor Harrington’s recommendations have not all been implemented:

  • work with Mind, Mencap and the National Autistic Society to develop better mental health descriptors has not been used by the DWP
  • Professor Harrington recommended unannounced visits to assessment centres, but this has not occurred[11]
  • there is no requirement for a claimant’s doctors to submit medical evidence
  • there is strong opposition to incorporating a real world test into the ESA assessment process
  • Atos is not required to provide data on the use of free text boxes during the WCA[12]

 

There is risk of breaching human rights:

  • a judge ruled that not requesting data from a claimant’s doctors may breach the Equality Act requirement for reasonable adjustment for claimants with mental health problems
  • the Welfare Reform Bill was not accompanied by a human rights memorandum, and there has not been any detailed analysis of the compatibility of the Bill with human rights obligations
  • conditionality and sanctions could lead to destitution, which would be inhumane or degrading treatment This is particularly problematic where disabled people are judged capable of work when in practice they cannot work; they may therefore struggle to comply with the requirements put on them.
  • The decision to time-limit contribution based ESA to 12 months has not been taken on the basis of any evidence that twelve months is a reasonable time frame in which to expect chronically ill or disabled people to have recovered and/or found work

 

Customer satisfaction with WCAs is low.  Problems include:

  • poor format of the assessment process:
    • irrelevant questions
    • lateral questions
    • lack of consideration from the claimant’s doctors
    • tick-box approach
    • increase in severity and prevalence of mental health problems as a result of the assessment[13]
    • doctors have noted that suicidal tendencies and self-harm are occurring in patients where the WCA is cited as a contributing factor
    • nearly 1000 complaints have been made against Atos so far this year
    • Citizen’s Advice Scotland has received 24 000 complaints about Atos and the WCA[14]
    • investigations have been started into 35 Atos HCPs

 

 


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.

(Why We’re Not) Benefit Scroungers: Extract 1

This is an extract from my book, “Why We’re Not Benefit Scroungers”, coming out in early December.

 

“General saving is really important to us,” he says. “We are a nation that doesn’t save … We drifted into a culture where consumption was all, and you borrowed to spend … So we change the culture so that you save, you invest and you prepare for the worst. Like we insure our cars, this is basically insuring our lives.”[1]

Iain Duncan Smith, MP for Chingford and Wooding Green, and Secretary of State for Work and Pensions.

Which sounds great.  Insure your life, then if (when) bad times come, the insurance will pay out to keep you safe.  This is what National Insurance was introduced for.  It is what private health or life insurance contributes towards.  But life, unlike owning and insuring a vehicle, is not a luxury.  If you are poor, you can choose not to own a car (although this reduces job access, further contributing to your poverty).   But few people consider that the alternative to life insurance for the poor should be for them to choose not to live.

Most people don’t spend time reflecting on how they will manage if they fall ill.  Is the mortgage on the house affordable if you develop lupus and can no longer work?  Can you raise two children if you lose your sight?  Will you be able to care for your ageing parents if you have a stroke and become hemiplegic?  Should you avoid all holidays abroad, in order to save up money to ensure you can tide yourself and your family over when the tide goes out on your health?  Do you live in the smallest house you can fit your family into, live in the cheapest area you can, own the most economical car, deny yourself all luxuries – so that on the day when the stroke strikes, the heart attack attacks or your memory walks out and forgets to return, you have enough savings that you do not ever need to ask for support from a charity, friend or government? …

Living with disability or chronic illness is costly.  That is why support is needed.  Whether in work or not, disability brings additional costs to life that the disabled person may not be able to meet.  Disability and chronic illness can hinder education, employment and access, as well as bringing medical costs. …

Disabled people often want to work and aspire to work as much as any non-disabled person.  But their health, combined with lack of accessibility in society, effectively discriminates against them…

The Greater London Authority recognises disablism as a form of oppression.  “Medical and associated interventions should in no way be seen as substituting for ongoing work to challenge and deal with barriers faced by disabled people in mainstream society… ‘Equal opportunities’ does not mean that all people are treated the same, but rather that their diversity is recognised and accommodated to enable them to access services and opportunities.”[2]

The Joseph Rowntree Foundation said: “Much could be achieved if society was properly attuned to the needs of disabled people and effectively enhanced services could do much to reduce the costs carried by individuals. At the same time, additional resources directly for individuals are also required in order to facilitate the ‘level playing field’ that disabled people seek.[3]


[1] Iain Duncan Smith, MP for Chingford and Wooding Green, and Secretary of State for Work and Pensions.  In The Telegraph, Iain Duncan Smith: I’m not afraid to light the fuse on disability reform, 13th May 2012, Robert Winnett;

http://www.telegraph.co.uk/news/politics/9263502/Iain-Duncan-Smith-Im-not-scared-to-light-the-fuse-on-disability-reform.html

[2] Barer, Davies and Fitzpatrick. Review of the London Health Strategy high-level indicators, Section 3, 2003, London Health Authority http://www.london.gov.uk/lhc/publications/healthinlondon/

[3] Disabled People’s Costs of Living, 2004, JRF