Mo Stewart Research
Fellow and Research Lead, Preventable Harm Project, Centre for Welfare Reform
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Phone: XXXXX XXXXXX Text: XXXXXXXXXXX EmaiL: XXXXXXXXXXXXXXXXXX Date: 10th November, 2022
The Rt Hon Steve Barclay MP
Private & Confidential
Secretary of State for Health and Social Care
Department of Health and Social Care
9th Floor, 39 Victoria Street via email:
London, SW1H 0EU
Dear Secretary of State,
Re: The public health crisis created by UK social policy reforms
Justice, Power and Resistance1
Many congratulations on your reappointment as the Secretary of State for Health and Social Care.
Further to the recent very detailed letter to the Minister for Health,2 which provided a significant amount of references demonstrating the public health crisis directly linked to social policy reforms, it remains cause for serious concern that an identified public health crisis1,3 is it seems totally disregarded by the Department of Health and Social Care (DHSC) who are duty bound to protect the public. Published research identified that the adoption of psycho-coercion by the Department for Work and Pensions (DWP) has negatively impacted on the health, the wellbeing and also the survival of many chronically ill and disabled benefit claimants by adopting the ‘politics of fear,’3 which seems destined to be increased by the DHSC after your predecessor adopted increased powers.4
Having established that this identified public health crisis is directly linked to the ‘institutional violence’ generated by the DWP,5 whose assessments of the disabled community disregard clinical need, clearly a public health crisis was inevitable. The human consequences1,3,5 of this identified DWP generated public health crisis means a much greater demand on the National Health Service (NHS) and on General Practice, which struggle to cope.
1 The public health crisis created by UK social policy reforms: Justice, Power and Resistance
2 Letter to Minister of State, DHSC
3 The Adoption of Psycho-Coercion to Manipulate the UK Disabled Community: Centre for Welfare Reform
4 The Health Foundation – Briefing for Peers: Health and Care Bill, Report stage
5 Violent bureaucracy: A critical analysis of the British public employment service: Critical Social Policy
“A growing body of research has found that benefit claiming processes became a more
physically and psychologically injurious experience for out-of-work populations under
social security austerity… Between 2010-2014, statistics show that over 9,000 benefit claimants died and an additional 725,000 anti-depressant prescriptions were administered after they were declared ‘fit-to-work’ or their benefit was made conditional on participation in work-preparation groups…
Grover (2019) conceptualises post-2010 social security changes as a form of ‘violent proletarianisation’. He concludes that reforms led to a range of avoidable harms and fatalities, primarily by forcing claimant groups off benefit and/or into precarious wage labour in ways that ‘socially murdered’ some of Britain’s most vulnerable individuals through penury and suicide. Relatedly, Wright et al., (2020) view this as a form of ‘social abuse’…
While the DWP explicitly denied the existance of sanctioning targets, it was conveyed how mounting expectations to administer sanctions from above, translated into the formation and execution of local target regimes on the ground: ‘certain staff would come [into the canteen] and say ‘”well, I’ve got my [sanctions] targets for the week.”’
It became clear that sanctioning and off-flow target regimes had a ‘dehumanising’ effect.” 5
Having established the creation of a public health crisis, as generated by the continued use of a fatally flawed assessment model by the DWP to limit access to disability benefit,6 it is cause for increasing concern to learn of the planned use of NHS files to identify patients being treated for anxiety or depression, who are to be given a work coach at a cost of £122 million.7
“Therese Coffey, the Health Secretary, said “The good health and well-being of the nation is also good for the economic health of the nation. Offering employment support to people under the care of NHS mental health services will help them start, stay and succeed in work, improving their well-being and resilience as well as growing our economy.”7
This is another example of health and social policies being adopted using a fiscal priority whilst
disregarding health and wellbeing,8 which risks negatively impacting on many thousands of lives as the previous sanctity of NHS files is now compromised, without any plan to evaluate the human consequences of expecting mentally ill patients to be ‘incentivised’ by a work coach to find employment.7 This is also another disturbing example of the ‘one size fits all’ mentality as demonstrated by various social policies with often fatal consequences which, to date, have been disregarded by the DWP and may be unknown to the DHSC.3,5,6,8
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3 The Adoption of Psycho-Coercion to Manipulate the UK Disabled Community: Centre for Welfare Reform
5 Violent bureaucracy: A critical analysis of the British public employment service Critical Social Policy, 2021
6 Preventable harm: creating a mental health crisis – Journal of Public Mental Health, 2019
7 Ministers launch back to work drive for people signed off with mental health problems. The Telegraph
Secretary of State, please be advised that as the research lead for the Preventable Harm Project9 that I led for ten years (2009-2019), it is disturbing to note that the catalogue of published, peer-reviewed research papers demonstrating the public health crisis generated by the ongoing use of the fatally flawed Work Capability Assessment (WCA), as used by the DWP to limit access to the Employment and Support Allowance (ESA) and Universal Credit is either unknown to the DHSC or is disregarded by the DHSC. This cannot simply be dismissed as being a DWP problem. The research used to justify the adoption of the WCA failed all academic scrutiny, and the use of the WCA is guaranteed to cause more preventable harm.9
The question remains as to who is to be held to account for this identified, ongoing and relentless government generated public health crisis,1,3,9,10 as used to conduct social re-engineering and to successfully remove the past psychological security of the welfare state whilst disregarding the inevitable and often fatal human consequences.11
“…considering that a 2016 NHS report identified that almost 50 per cent of ESA claimants had attempted suicide at some point, how much longer will this DWP tyranny prevail? With DWP reports advising that almost 90 people per month die after being found ‘fit for work’ following a WCA, and the DWP still resisting claims for a cumulative impact assessment of all the disability benefit cuts, when will someone actually be held to account for what is government enforced death, despair and preventable harm introduced for political gain? When will the British government stop killing people who are too ill to work?”11 (author’s emphasis)
The various ‘prevention of future deaths’ Coroners reports identified the risk to public health created by the fatally flawed WCA, and the use of sanctions which removes all income leading to death by starvation of chronically ill benefit claimants. This is shameful and should be challenged by the DHSC, and the WCA should surely be abolished to prevent future deaths.
I look forward to hearing from you and I thank you for your time.
Yours sincerely,
Mo Stewart
Fellow, Centre for Welfare Reform
Research Lead, Preventable Harm Project
Copied to: Wes Streeting MP, Shadow Secretary of State for Health and Social Care
Dr Jenny Harries OBE, Chief Executive UK Health Security Agency
1 The public health crisis created by UK social policy reforms: Justice, Power and Resistance
3 The Adoption of Psycho-Coercion to Manipulate the UK Disabled Community: Centre for Welfare Reform
9 The Preventable Harm Project
10 Psychological tyranny prescribed by the DWP: preventable harm is government policy. BJGP
11 Killed By The State: Social Policy Abused. Centre for Welfare Reform
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