Benefits and targets: Sickness and disability are not the same

The shiny pink elephant in the room of policy makers and certain sectors of the disability lobby is the complete exclusion of sick people from this group. Sickness and disability are not the same issue, but for benefits purposes we are all lumped in together and labelled as ‘disabled’ regardless of condition.

Whilst it’s important that young people growing up with disabilties be educated, skilled, prepared for a competitive labour market, and taught that they are just as valuable as any other employee, it’s also equally important to recognise the vast difference between those needs and those of someone in their early 50’s, who has worked all their adult life, and now become too ill to work with conditions as diverse as breast cancer, Parkinsons, or Huntington’s Chorea.

Chris Grayling would like to know, “is it really the case that these people can’t return to any work?”. The answer is a shameful yeah but no but yeah but no.

Of course it is not the case that young, skilled disabled people can’t do any work – it may be impossible to acheive full-time work, it may require large amounts of support from the NHS, social services, an accessible transport system, the correct equipment, employers and access to work, but work is often possible and desperately desired if those essential factors are all in place.

In fact, we had an impressive example of such a situation in the Remploy factories. Remploy urgently needed modernisation and the removal of its entire managment structure, which bled most of its funding into huge salaries, but could, with the correct will, have been reshaped into a modern system of disabled led co-operatives providing a supportive employment environment for those who need it and support towards mainstream employment for others.

However, Remploy is set to all but disappear, with 1600+ severely disabled people being made redundant. Promises of support into mainstream employment for those people ring hollow in a time of recession and austerity, particularly as 90% of those previously made redundant from Remploy in better economic times are still without work.

But now ask yourself the same question about a 50 year old woman with Huntingtons Chorea, a rapidly progressing neurological disease, who’s been medically retired from work having watched her mother die horrifically of the same disease and knows she will be lucky to have a few years left before losing all her faculties and eventually facing a terrible death choking on her own saliva.

This scenario does not fit into the inflexible welfare system which demands that NHS doctors declare that someone has less than 6 months left to live before they can be considered as terminal. Even if everyone knows they will be beyond terminal in two years that is not terminal in terms of eligibility to benefits.

It’s a graphic description, but these are exactly the people Chris Grayling thinks could go back to the workplace, failing to make any real distinction between the different needs of people, some of whom could work with the right support and some of whom are simply too ill to do so.

These issues and more were finally exposed last night by Dispatches undercover investigation into Atos, the company contracted to carry out the Work Capability Assessment for Employment Support Allowance, and followed by Panorama taking a wider look at the WCA system, and in particular the increased cost burden already being felt by NHS GP’s and mental health services who are having to see people previously stable in the community who are becoming ill and needing additional health support as a result of the WCA process.

This was accurately described by one reviewer as a “howl of despair”, this one hour of proper investigative journalism is the culmination of four years of fear, desperation and terror amongst sick and disabled people.

As a community we were concerned but hopeful when ESA was initially introduced, some naive enough to believe the promises that this was intended to be a system to enable people to work, others still hopeful that would be the case but wondering how that would happen against a background of already reducing social care, access to equipment or support services to even live the most basic of independent lives.

The programmes gave case studies which will come as no surprise to campaigners or those familiar with the inflexible nature of the WCA, but will appear extremely shocking to the wider public who still believe that people they perceive as sick and disabled are deserving of and entitled to social security.

The key to ESA and the WCA is simple; a brutal and ruthless desire to reduce the numbers claiming benefits.

This desire was always political, originating from a three week report commissioned by Labour’s James Purnell to be carried out by the investment banker, the now enobled Lord Freud.

At that time David Freud was an investment banker who freely admitted he had no knowledge of welfare, sickness or disability, but in a mere three weeks concluded that he could reduce the numbers of people claiming incapacity benefits by as much as two thirds, or almost two million.

There has been huge contention about whether Atos or HCP’s are incentivised to remove people from benefits.

Whilst no evidence was presented that there are financial incentives, it was clear that HCP’s work under huge pressure to see a miniumum of eight claimants a day, regardless of the complexity of their needs and that should an HCP deviate from an ‘average’ number of people put into the support group, described in a training session as as low as 11 or 12%, they will be immediately audited.

It was not mentioned whether HCP’s are audited for finding too many people fit for work, or for their treatment of claimants, but it would seem likely that if that does occur the targets that aren’t targets but averages are applied using a vastly different percentage level.

Also, vitally the averages that aren’t targets but are called norms are applied in exactly the same manner to those initially claiming ESA as they are to those transferring from the old Incapacity Benefit.

As approximately two thirds of people claiming IB are also entitled to Disability Living Allowance, which has much tighter standards of eligibility than IB, it is reasonable to suggest the IB transfer group already have a very different level of sickness and disability than the ‘normal’ population who are going straight to ESA with a more balanced mix of people. Some have short term conditions and need support for a period of time before returning to the work place.

It seems utterly nonsensical to apply such tight norms with no variation to these two disparate groups.

It is also utterly facile to repeatedly claim that there are no targets, when it is abundantly clear that by using a system of statistical norms the only two possibilities are that these norms are imposed as a de facto target by the Department of Work and Pensions upon Atos, or those tasked with setting up the system of norms were as equally ignorant of welfare, sickness and disability as David Freud, and additionally their own areas of expertise, not realising that norms based upon ‘forecasts’ will create a system of targets.

Put simply it’s conspiracy or cock up; either Ministers and Atos are quite happy to justify to themselves that it is not a lie to repeatedly deny the existences of targets because they really aren’t targets, they are norms based on forecasts which definitely aren’t targets, or they are so spectacularly stupid that they can’t work out for themselves that targets that aren’t targets because they are norms based on forecasts create targets whether you intend them to or not.

Neither scenario is inspiring of confidence in our politicians or Atos.

Tagged in: Atos, benefits, Chris Grayling, david freud, disability, dispatches, ESA, james purnell, nhs, panorama,Remploy, scope, WCA, welfare