The ‘get tough’ approach to sick and disabled welfare claimants promoted by the big party players in the run up to this General Election, and in recent media rhetoric, is not just morally cheap, it is reflective of a profoundly inadequate policy approach which ends up scapegoating those we should be supporting most.
It also puts into sharp perspective some of the realities behind the rhetoric about 'family' and 'community' which politicians (and some Christian pressure groups) like to indulge in.
Where we need to start, is with the real life situations people face, and what they tell us about the 'issues'.
Dying of cancer can be deeply difficult, both for the sufferer and his or her family and friends. Even non-fatal forms of this disease, and conditions such as Parkinson’s and multiple sclerosis, can have a devastating effect. The last thing that people in such situations need is additional stress and the risk of being left destitute.
Yet a Londoner in his 50s who became so ill with heart disease that he needed a triple bypass, then found that he had incurable stomach and liver cancer, and who suffered constant pain, struggling to walk and even breathe, was ordered to start looking for a job. A work capability assessment had found him capable of work. Likewise a Wiltshire man with Parkinson’s disease who could no longer stand for more than 10 minutes, tended to fall over, slurred his words, had severe memory loss and mental health problems was also declared capable of work.
Fortunately, in each case, the Citizens’ Advice Bureau was able to assist. Yet in many areas, advisers and advocates are overwhelmed by the level of need, as sizeable numbers of sick and disabled people are threatened with reduction or withdrawal of benefits. So far, it is new claimants who have been targeted, but in time, the scheme will be rolled out more widely.
In March 2010 a CAB report, Not Working, summed up some of the hardship caused by the introduction of an “Employment Support Allowance” (ESA) for those not in paid work because of a long-term illness or disability. ESA was introduced in October 2008 to replace incapacity benefit for new claimants. The supposed aim was to give more help to those who might, with support, be able to undertake paid work.
It had long been recognised that some disabled people who wanted to enter into employment were not given enough support or working conditions did not adequately address their access needs.
In addition, more rehabilitative support and flexibility by employers could enable some people with illness or injury to get back to work, even if the tasks they could do were limited, and this could be financially beneficial and good for their health.
There were also some people who exaggerated the extent of their incapacity – though there were fairly rigorous tests, and unnecessary claims were counterbalanced by those who fail to claim benefits to which they were entitled.
However, a more reasoned approach was overtaken by a contest between the Labour government and Conservative opposition as to who could get tougher on those who, at best, imagined they were less capable than they were and at worst, were “scroungers” or “cheats”.
Investment banker David Freud was appointed as a government advisor, though in his own words he “didn't know anything about welfare at all”, and set out a bold programme to end the UK’s “dependency culture”.
The system was to be largely privatised, offering private and third sector companies lucrative opportunities, and ambitious targets set to get people back into work, or at least, off benefits.
Both parties argued as to which would be more radical in reforming welfare. While some positive measures were introduced, the new system was largely based on achieving ideological goals, whatever the human cost.
A year after the reforms were introduced, they had outwardly been successful – a high proportion of people had been declared fit for work or dropped out of the process of claiming, either because they found work or could not cope with the hassle of making a claim.
But the human cost had become very apparent, as sometimes, even people who should have been exempt, were caught up in the drive to get large numbers into, or back to, work.
A report by Macmillan Cancer Support and Citizens Advice, based on large numbers of cases, found that cancer patients were often being poorly served. Terminally ill patients were not always fast-tracked into the ESA support group as they should have been, and instead were asked to undergo the work capability assessment (WCA) or attend work-focused interviews.
Cancer patients receiving chemotherapy were likewise asked to attend a WCA or work-focused interviews, while the WCA is not sensitive to the problems faced by people with cancer, including the sometimes drastic effects of treatment.
Examples were given, including that of Patricia Watson from London, who discovered that she had terminal bowel cancer. Though the Department for Work and Pensions (DWP) was informed, “I was shocked when I received a letter requesting that I attend an assessment centre to review my ability to work during my third cycle of chemotherapy. I was told that if I didn’t attend the interview I wouldn’t receive any benefits.”
The Parkinson's Disease Society announced in October 2009 that two-thirds of people under 65 with Parkinson's who responded to a survey, had been wrongly forced into job-seeking, despite being physically unable.
UK-wide research for the National Autistic Society found that one-third were without a job or benefits. Medical assessors often seemed to lack understanding of autism, and those who felt they were capable of employment did not always get the support they needed.
Many reported that Jobcentre Plus staff and professionals from Atos Healthcare – a private firm contracted by the Department for Work and Pensions to carry out the WCA – had little understanding of autism: as one carer put it, “it’s like these people haven’t got a clue what the circumstances are.”
A woman with Asperger’s, Paula, described her experience of being assessed by an Atos doctor. Despite a seven-page psychiatrist’s report about her diagnosis, he rushed through her assessment in a quarter of an hour and recorded that he saw no evidence of communication difficulties: “It was like he thought I could just ‘get over it’ or something.” On appeal, her ESA was restored.
Competing to victimise claimants and their families
Such inhumane treatment of some of the most vulnerable people in society and their families, undermines other aspects of public policy. For instance, many politicians are gushing in their praise for unpaid carers, yet the latest welfare reforms are stressful and potentially financially ruinous for many carers, who may be required to support claimants left distressed and possibly destitute.
In addition, some disabled people are also carers. Some sick or injured people who might have been able to cope in the community may end up in hospital or institutional care, which can be hugely expensive.
There are also measures which might help people back to work without causing distress, such as ensuring quick access to high quality physiotherapy for stroke patients across the country, and greater flexibility so that claimants who volunteer, and through this, gradually increase their fitness and self-confidence, need not be afraid that they will be pushed into employment before they are ready.
More affordable childcare and better access to social care services too could help – those with limited energy may be too exhausted after a day’s work to do much in the way of domestic tasks.
Yet the Labour government shows no sign of retreating on its current policy and the Conservatives, if elected, plan to go further, while introducing even more harsh cuts in public spending, which is already overstretched.
"Let’s cut benefits for those who refuse to work" declares a poster campaign. Though party leader David Cameron has claimed, “To people who cannot work, to people who are disabled, to people who are looking for work: we will always help you, we will always stand by you”, he too is committed to reassessing all current incapacity benefit claimants for supposed fitness to work.
He has threatened that “within six months of taking office, we will set out a new welfare contract that says the first time you refuse a job that you could do you lose a month's benefit, the second time, three months' benefit, and then you lose benefit for three years.”
In practice, then, if a building worker who had been traumatised and suffered ongoing dizziness and balance problems after a near-fatal accident were ordered back to work on a similar job, if he were too frightened to take it, he would be left to starve.
As the DWP’s research shows, benefit claimants are largely manual workers from lower-grade occupations with a track record of continuous employment who stopped paid work due to illness, injury or disability. In contrast to the state’s generosity to rich bankers whose recklessness has imperilled the economy, and MPs making dubious expenses claims, sick and disabled people are finding that even the slightest assistance is begrudged them.
Yet these policies have a certain appeal. Some people in paid work who are able-bodied and in good health have difficulty empathising with those in a different situation, especially if they appear healthy (and those with fluctuating conditions or mental illness may indeed look perfectly fit much of the time).
The inner turmoil faced by someone who has found that she has early-onset Alzheimer’s or a brain tumour is not immediately visible, and to a neighbour she may just seem like a workshy scrounger. Indeed claimants themselves may understate their needs, refusing to admit to problems which may make them seem weak or affect their self-image.
Some employees may make considerable effort to keep their jobs and feel that others too, should pull their weight. Perhaps most significantly, especially at times of social turmoil, there is a tendency to victimise minorities, who can serve as scapegoats for society’s ills and thus help restore a sense of unity. Welfare claimants and immigrants are tempting targets.
There may also be a degree of denial about people’s bodily realities in this society: in particular, the fact that we are all prone to get sick or injured, and will eventually die. Insisting that most sick and disabled claimants can “pull themselves together” and “snap out of it” if they make the effort, may perhaps help to ward off the fear of being vulnerable and mortal oneself.
Acting to defend the rights of claimants
Many people, even if not personally targeted, find politicians’ treatment of the sick and disabled affronts their sense of decency and compassion.
Article 25 of the Universal Declaration of Human Rights states that “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
Many people of faith also believe that injustice to the vulnerable is not only cruel but also spiritually destructive to those who are involved, and societies built on such shaky foundations may topple. In the words of Isaiah 10:
Woe to those who make unjust laws,
to those who issue oppressive decrees,
to deprive the poor of their rights
and withhold justice from the oppressed of my people,
making widows their prey
and robbing the fatherless.
What will you do on the day of reckoning,
when disaster comes from afar?
Sooner or later, the population as a whole is likely to reject these policies, especially as growing numbers of voters find that they, their families or friends are personally affected. In the meantime, however, much damage is being done.
Alliances of those concerned about the harsh treatment of sick and disabled people, from disability and carers’ organisations, to trade unions, faith and humanist groups and human rights activists, could effectively challenge the crack-down on claimants.
(c) Savitri Hensman was born in Sri Lanka. She works in voluntary sector in health and social care and equalities in the UK, and is also a respected writer on Christianity and social justice. Savi is an Ekklesia associate.
See also 'Care and control at life's end', by Savi Hensman - http://www.ekklesia.co.uk/node/10334