Man leaves coroner letter as he fears Work Capability Assessment will kill him

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The government have persistently denied any “causal relationship” between their welfare reforms and an increase in premature deaths and suicides, despite an existing correlation. Ministers have also denied a link between disability assessments and an increase in mental distress and ill health.

Figures released last year show that between December 2011 to February 2014, 4,010 people died after being told they were fit for work, following a Work Capability Assessment (WCA). 40,680 died within a year of undergoing the WCA, making a bleak mockery of any claim that the WCA is a real and valid “health assessment” of any kind. Or that our welfare system is “supportive” to those in most need, in any real or meaningful sense. Those people were clearly not at all “fit for work.” The figures were only released after the Information Commission overruled a Government decision to block the statistics from the public.

Research last year from Leonard Cheshire, a charity that works with disabled people, also showed that the assessments are making people who are ill more sick. Almost three quarters (72 per cent) said they found the assessment had a negative impact on their mental or physical health, or both. The same number described the face to face appointment as very stressful.

David Sugg would agree with those research findings. David suffered a life threatening subarachnoid haemorrhage (bleeding in the brain) because of an aneurysm (a swollen and very weakened point in a blood vessel) in 2013, and faces more life saving surgery because he has developed two more aneurysms that threatens to rupture, putting him at risk of another catastrophic brain haemorrhage. Whilst he waits for his operation, he has been told that if his blood pressure goes up, he is likely to die.

He had a Work Capability Assessment with Maximus this week. He was so afraid of the adverse health impacts that the strain of the WCA may have on him that he left a letter for the local coroner, to be opened in the event of his sudden death.

The letter said: “You may be looking into the reason for my death. I am hoping I can save you some time. This uncaring and spiteful Tory government killed me.”  

He told me: “My neuro-surgeon says I mustn’t get stressed, but I have been called by the Department for Work and Pensions for an assessment even though I’ve told them about my situation. 

If I don’t go for an assessment my benefits will be stopped. But I fear it may cost me my life.”

Although David survived his appointment, he has been suffering with a violent headache since, and hasn’t been able to eat for a week.

 “That appointment might still kill me. If my blood pressure goes up I could be dead before I hit the floor. I asked the assessor why she was putting my life at risk, but she said it wasn’t her decision,” he said.

Aneurisms are quite often caused by an increase in blood pressure. The majority of people don’t survive a subarachnoid haemorrhage, and those who do are remarkably lucky if they escape without serious disability. Most people don’t survive if they have a second one.

David added that he felt the situation he is in has “Orwellian” parallels. It’s a terrible choice to have to make: he either risks his life and complies with the assessment or loses his lifeline support – his benefit is the only income he has.

David explained to me that like many people needing to claim Employment Support Allowance – which is a very misleading name for a sickness benefit –  he had worked all of his life before becoming ill. He worked in IT and security until a couple of years ago. He became unemployed at that time, and was struggling to find work.

 “I’d paid tax and national insurance all my life – since I was 15,” he said.

“The battle to get Job Seekers Allowance was so stressful I actually think that led me to having the aneurysm in the first place. Then I had to battle to get support. The first work capability assessment I had was just six months after I’d had seven-hour brain surgery.”

He told me that his assessor recognised how inappropriate the appointment was, telling him “you shouldn’t actually be here.”

Despite the fact that David was awaiting life saving surgery, the Department for Work and Pensions (DWP) demanded that he was assessed again. He returned the form, explaining that he was awaiting life saving surgery and must avoid stress, but to his horror, was forced to attend nonetheless.

He said “It’s brutal bullying by the DWP. No wonder people are committing suicide, pushed over the edge. You either die because of your condition or from suicide. All I would have to do is stop taking my pills for a couple of days and I would die.”

Debbie Abrahams, the shadow Work and Pensions Secretary, said that David’s case is far from unique.

She said: “This WCA process, revised by this Government, is not only not fit for purpose, there is growing evidence of the harm it is doing. These assessments need to be completely overhauled. Labour want to see a holistic, person-centred approach, not the dehumanising, harmful, inefficient process we have now.”

David wrote to his own MP, Stephen Metcalfe, outlining his extremely distressing circumstances, and was told that Stephen would contact the Department for Work and Pensions, but did not yet receive a response.

The system is designed to deter successful claims

I co-run a support group on Facebook for sick and disabled people claiming disability benefits. I know from the accounts and everyday experience of many others just how stressful the assessment process is. It’s a terrible state of affairs when people who are already struggling with severe health problems are made even more vulnerable because of callous cost-cutting government policies.

The assessment is not always an end to the stress, either. Quite often, people are forced to challenge wrong decisions, because the WCA is designed to find ways of passing people off as “fit for work” regardless of whether they actually are, cutting their benefit. It’s worth remembering that people needing sickness benefits have already been assessed as unfit for work by their own doctors.

If people need to appeal a wrong decision, they first have to go through a mandatory review  – where the DWP “reconsider” the decision. Sickness benefit is stopped at this stage, leaving people who are often very ill without any lifeline income. Most can’t claim jobseekers allowance because they are too ill to work and so cannot meet the harsh and rigid conditionality requirements of that benefit. There is no set time limit for how long the DWP have to undertake the mandatory review. No-one may appeal until after their review is completed. The appeal process is also very stressful and intimidating, it usually entails another wait of months. 

The revolving door of assessments and psychological distress

David is not the only person to contact me this week.

George Vranjkovic has been extremely anxious and distressed about his Work Capability Assessment, too. He is very afraid at the thought that he may lose his lifeline support.

He told me: “I took 5 days filling out the assessment form by hand and I sent it in 12 days before my deadline. But 5 days before the deadline I got a letter saying it had still not been received, so I rang them, and I got some bloke who chuckled. He said it probably got lost and was there anything else he could do.

I blew my top I’m afraid and said he could effing apologise for losing my form!!! He said he deserved to be treated with respect. I was so upset I shouted not if you sit there laughing at desperate people you don’t . Anyway, I ended up filling in the form on line, printing it off and sending one version by fax, and one version by special delivery, which is what I was instructed to do by them… £22.00 that cost me.”

The form showed up, according to another advisor that George spoke to the next day, but by then he had already paid out for the fax and special delivery and was told the likelihood of getting the £22.00 back was pretty remote. This is someone relying on just a lifeline benefit, calculated to meet only basic living costs – essentials: food, fuel and shelter.

Previously, George has been left without any money to live on by the DWP, without them providing any reason. That’s absolutely unacceptable.

“For 6 months when they cut my money off completely,  I was made to feel like a criminal. I was spoken to so badly on the phone. I wasn’t being sanctioned. They just weren’t paying me.

 This is all just another example of the abject cruelty we, as honest people, are put through,” he said.

Like many other disabled people, George has also worked previously, co-running a photographic service.

George talked to me over a period of 24 hours before his assessment yesterday. He hasn’t slept for weeks. He really needed someone to support him emotionally. He was extremely anxious, agitated and afraid. He knows that the WCA is designed to try and cut costs and take lifeline support from sick and disabled people.

He told me that he is someone who usually copes, and doesn’t like to make a fuss. He said “I try not to fall to pieces in public.” He was in a state of sheer panic, however, when he contacted me.

When he arrived for his appointment, George said that the assessor tried to reschedule the assessment. His distress was so great by this time that he absolutely refused to leave until the assessment was carried out. He simply couldn’t face going through the strain of waiting again.

“He asked me how the rescheduling of the test made me feel.  He told me that it wasn’t the first time today he’d heard that forms had got lost or went missing, he asked me if I’d ever thought about committing suicide. Which I have, the last time being a year and a half ago when the DWP cut off my money for 6 months,” he said.

Like many others, George has had several assessments. It’s fairly common experience to have to go through an appeal, only to get another appointment within three months of a successful outcome.

A study published by the Journal of Epidemiology and Community Health last year, showed a correlation between worsening mental health and assessments under the WCA. The study linked the WCA tests with an additional 590 suicides, increased mental health problems and hundreds of thousands of antidepressant prescriptions

In a letter to the Guardian, the study’s main author, Benjamin Barr, said it was crucial the DWP takes seriously concerns that WCAs are “severely damaging” mental health. He called on the department to release data it holds to researchers to allow further analysis of the health impact of the controversial test.

Calls to scrap the WCA

Earlier this year, a report for the Social Market Foundation thinktank recommended that the government entirely scrap the work capability assessment. The report also said the government should introduce a properly funded system – making use of trial projects and extensive consultation with benefit claimants – which would identify those disabled people closest to being able to get a job, while those too ill or disabled to work should have a “level of benefit provided … sufficient to allow them to live comfortably and engage fully in society.”

It also recommended that the government abandon the failing benefit sanction system for people with chronic illness or a disability – instead putting an emphasis on support meetings and financial incentives through a “steps to work wage” on top of their unemployment benefit.

Remarkably, the report was written by Matthew Oakley – a former Treasury adviser who until 2013 was head of economics at the right-of-centre Policy Exchange thinktank. He was also on Iain Duncan Smith’s own social security advisory committee.

The WCA is not only unfit for purpose, arbitrary and cruel, but it is also one of the most shocking political betrayals of those most in need that has ever been allowed to go unchecked.

 

What you need to know about Atos assessments

 

 

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Reframing frames – ideology, George Lakoff and a call for your views

Wall Street Protestors Rally Against Police Brutality

An excellent example of using a slogan to reframe debate about neoliberalism and inequality from the Occupy movement

 

Left wing progressives hope that we can win elections by citing facts, rational debate and by offering policy programmes that serve the majority of voters’ interests. When we lose, we either conclude that we need to move farther to the right, where the voters are; where the Overton window opens, or that we need to move further to the left, to present a genuine alternative to the status quo. That dilemma has rigidly polarised the Labour party, undermining our unity and turning what was once a “broad church” appeal into an either/or basic dichotomy of alliances and reflected interests. The problem is how do we know which of these responses to the dilemmas of being a party in opposition will engage the public? And what if it is neither?

Yet, how can the left possibly lose a debate about the economy and social policy, when our current steeply hierarchical socioeconomic organisation serves the interests of so very few citizens? In fact those policies are seriously harming some social groups, especially those traditionally afforded social protections by previous Labour policies. 

Margaret Thatcher once made the absurd claim that the “problem” with socialism is that it “runs out of other people’s money to spend.” However, the New Right became experts on spending our public funds on extending the wealth of a few privileged millionaires, taking money from those who have the very least and handing it out to those who have the very most.

That really is “spending other peoples’ money.” As a consequence, the UK is now the most unequal country in the world, and that includes the US, where the Chicago boys – the founding fathers of neoliberalism – operationalised their experiment in hierarchical and authoritarian modes of neoliberal socioeconomic organisation.

Things ain’t what they ought to be

I’ve pointed out before that it’s easy to mistake the patterns and social circumstances of our era for “natural laws”. We really do need to revisit the is/ought distinction  (the naturalistic fallacy: we cannot use descriptive statements – what “is” – to make or justify prescriptive ones – what “ought” to be). So many people assume the Conservative world view of competition, mysterious “market forces” and the “invisible hand”, survival of the wealthiest, and Randian self interest is simply how things are: that these qualities are all fundamental to our “human nature”. They are not.

They are the qualities required of us – what “ought” to be the case – in order to prop up a hierarchical society, preserving a privileged elite and the material inequality and power relations of neoliberalism. Social Darwinism, which is like a comic strip version of Darwinism, was debunked last century, but here we are with policies that are directed by an ideology founded on social Darwinist principles once again. It’s become  a “common sense” assumption that we are naturally inclined to be competitive, and as a society, hierarchically ranked, on the basis of power and worth. Yet the matter of what “human nature” actually is has never been resolved over the centuries, let alone accounts of how that “nature” translates into the kind of society we have. Or ought to have, for that matter.

How can the Tories be right in their cynical miserablism, regarding our competitive social Darwinist tendencies?  If we are so fundamentally selfish and self-interested, with a generally Hobbesian temperament, moulded a little more by Burke’s profound anti-intellectualism, how, then, did we end up with a trade union and labour movement, working class enfranchisement, the welfare state, the NHS, legal aid, social housing, human rights and to generally progress to develop an altruistic, collectivist, cooperative approach for our post war settlement?  

“Human nature” is far more complex and much less static and defined than the Conservatives would have us believe. The kind of society that we live in, with its prevailing beliefs, attitudes and organisation, also contributes significantly to the kind of people we are, and importantly, to how we see ourselves and others.

Façade democracy

George Lakoff, a linguist and cognitive scientist, says that Conservatives exalt “obedience to authority,” insulate leaders from accountability, oppose checks and balances against leaders and rely on fear. All of this is true.

Lakoff says the right wins and keeps power by framing issues and “controlling minds”. This explains why Conservatives win elections. They manipulate us more effectively than the Progressives. They’ve been “preparing the seedbed of our brains with their high-level general principles” so that when the “low tax/low welfare society” idea, for example,  was planted in its various guises, repeatedly, “their framing could take root and sprout.” And “as a result, progressive messages don’t take root.”

Tories successfully reframe social issues, re-set defaults and normalise their prejudices and values. They become “common sense.” As dominant narratives do. In doing so, the Conservatives shape how the public see themselves and others.

Lakoff proposes that the left present frames instead of raw facts, in order to “train” the public to think less about neoliberal competition and self-interest and more about serving others. It’s not the platform that needs to be changed. It’s the voters. 

Lakoff says that we need to beat Conservatives at their own game. “Democracy is too important to leave the shaping of the brains of the public to authoritarians.” 

I like a lot of Lakoff’s work, but cannot get behind the idea of using techniques of persuasion to win support and (re)grow a movement. But then, the use of such techniques has been effective for the Conservatives, and that level of manipulation creates a problem for democracy. Lakoff is proposing we address the problem of a managed democracy by attempting to manage it too.

Is it possible to propose we manipulate voters and then still claim to be a democrat? 

He is right in that the rational approach doesn’t always work, but perhaps it’s more a question of how we present our alternative. I can get behind a shorthand and punchier general messages, just as long as it isn’t a strung together lexicon of glittering generalities with nothing meaningful referenced below the surface level. Integrity matters. The new world order is maintained partly by a precarious new word order. But it rests only on the very surface of our mind. It exists, not because it is rational or serves our best interests, but because it appears to be “normal.”

It’s probably true that many voters don’t pay much attention to the details and implications of policies. We have a tendency towards cognitive miserliness – the Principle of Least Effort; we frequently rely on simple and time efficient strategies when evaluating information and making decisions. But this can lead to prejudices. We formulate stereotypes, for example, which are simplistic ways of categorising others. Heuristics are mental shortcuts we often use in order to lessen the cognitive load that decision making requires. We often rely on habitual, superficial explorations and generalisations because we are caught up in our lives, and so to some degree, its a strategy of necessity and efficiency. 

However, this tendency towards cognitive miserliness is also manipulated. We often assign new information to categories that are easy to process mentally. These categories arise from prior information, including schemas, scripts and other knowledge structures, that has been stored in memory and so storage of new information does not require much cognitive energy. Cognitive miserliness means we tend not to stray far from our established beliefs when considering new information. That’s partly why repetition and slogans work so well as propaganda techniques. 

My own view is that we should try multiple approaches to messaging the public, but none of it should be simply about changing a vote for the sake of it. We also need to engage citizens in active participation in democracy. That is something the authoritarian Conservatives will never do: they have a policy agenda informed by private companies and millionaires, not ordinary citizens, and that won’t change.

Public needs have been privatised and pushed into the “market place” of competition and invisible capitalist hands. Increasingly, private companies are operating our essential public services, as the Conservatives claim that this is “efficient.” It isn’t, because it’s costing us billions to support unaccountable private businesses whose only motivation is to make profit.(See for example: Doctors bribed with 70-90k salaries to join Maximus and “endorse a political agenda regardless of how it affects patients.” )

Meanwhile, the privatisation of public need means that individuals shoulder the responsibility for them, rather than the state, who are still taking money from the public to fund those public “services.” Making individuals responsible for the consequences of political decision-making and arising socioeconomic problems like unemployment and poverty then justifies an authoritarian state intrusion in the form of “therapy.” For example, the rise of nudging, which is about the political directives to “change behaviours” because people make “the wrong choices” and so it turns democracy on its head.

This is because nudge is used without public consent, and it is solely aimed at “changing behaviours” of citizens to meet the states’ idealised and narrow neoliberal outcomes, rather than it being about actually recognising and meeting social needs and democratic inclusion.

The left tend to have a rather more optimistic, expansive and generous view of human nature. We believe in the human potential for learning, development and progress. However, that optimism is also tempered with an acknowledgement of our darker side, too. Policies which protect social groups that are prone to being exploited, scapegoated and other socially constructed vulnerabilities have largely been Labour party ones.

However, the problem is that the Conservatives hold up a darkly distorting looking-glass to the public, showing only what they want people to see of themselves. In that mirror, we are rendered ugly – always prone to being stupid, selfish, greedy, impulsive savages that need to to be ruled and controlled. Our self perceptions are shaped by significant others. There arises a subsequent social self-fulfilling prophecy. We project and scapegoat: it is always others that are savage and selfish, not us. This is facilitated by the Conservative tendency to marginalise poor people, creating folk devil stereotypes and social outgroups. 

We’re capable of changing minds. But we have good SOCIAL reasons to do so. That, for me is the key – there’s a difference between propaganda and reasoning; public interest and simply maintaining the public’s interest. The answer probably lies somewhere in a compromise – using both a rational and evidenced approach and the reductive pop politics soundbites to capture public interests AND public interest.

Tory cuts cost lives was a soundbite of mine from 2015. I wanted to reference war, and highlight the enemy in a longstanding and ongoing class conflict. It’s got integrity as a slogan because I’ve spent a few years writing about and presenting evidence of how  Conservative austerity is harming and sometimes killing people. 

But I don’t have all the answers. To come up with effective solutions requires our willingness for collaboration and cooperation.   

I’m particularly interested in what others think about this issue. If you have any thoughts on this, please leave me a comment, and I will revisit them in due course. We can do what the left always do very well: hold a democratic discussion and problem-solve collectively.

 

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Disabled woman and survivor of abuse to be subjected to grossly intrusive council surveillance to justify care costs

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 Cuts Kill, No More Benefit Deaths protest, Westminster Road block, 7 September 2016: part of Disabled People Against the Cuts’ Rights Not Games week of action.

Photo courtesy of Paula Peters, DPAC.


John Pring from Disability News Service
reports:

“A disabled woman has told how her local council is threatening to spend several days watching her every move as she eats, showers and uses the toilet, in order to check if planned cuts to her care package will meet her needs.

The woman, Jane*, a survivor of serious sexual, physical and emotional abuse, and a former Independent Living Fund (ILF) recipient, spoke about the council’s “violation” at a parliamentary campaign meeting this week.

The meeting was held to launch Inclusion London’s report on the impact of last year’s ILF closure, as part of the Rights Not Games week of action organised by Disabled People Against Cuts (DPAC)**.

The report, One Year On: Evaluating The Impact Of The Closure Of The Independent Living Fund, includes information from all 33 London local authorities, and concludes that there has been a “dramatic postcode lottery” in the support provided to former ILF recipients since the fund closed.”

*Not her real name

**DPAC has set up a legal fund to help former ILF recipients like Jane challenge cuts to their support packages.

I recommend that you read the full article: Council wants to watch abuse survivor shower and toilet to check post-ILF needs.

The council have suggested that Jane may survive on microwave meals – which she has said would both damage her health and be unaffordable – and that she can use incontinence pads for up to 12 hours a day, instead of being helped to use the toilet.

Over the summer, council officials told Jane that once the cuts to her care package were in place (from 12 hours of support a day to 38 hours a week), they wanted to send a “team of people” to observe (for up to two weeks) the impact of the reduction in care on how she manages to use the toilet, take a shower, gets in and out of her wheelchair and her bed and feeds herself.

This will require an intrusion on a very intimate level, into aspects of her life where privacy is something that most people would take for granted. For disabled people, the public/private divide no longer exists. The details of our most intimate circumstances have become public property. Jane is not only horrified at this dehumanising move to cut costs, or about the fact that her physical needs, citizen rights and dignity are being so casually disregarded; she also has concerns regarding the potentially very damaging psychological effects of such an intrusion, from the state, who have the sole aim of callously cutting her essential support.

The Independent Living Fund (ILF) was set up in 1988 to fund support for disabled people with high support needs in the United Kingdom, enabling them to live in the community independently, rather than move into residential care.

The ILF was designed to combat social exclusion on the grounds of disability. The money is generally used to enable disabled people to live in their own homes and to pay for care, and in particular to employ personal care assistants. Many of the beneficiaries would otherwise have to move to residential care homes.

In December 2010 the Government announced the closure of the Fund to new applicants, and in December 2012, following a consultation on the future of the Fund, it was announced that the Fund would be closed permanently from April 2015. The Government claimed that Local Authorities could meet the same outcomes as the ILF and proposed transfer for existing ILF recipients to their Local Authorities.

The Government initially decided to close the fund by March 2015 but this was delayed until June 2015 after five disabled people challenged the Government’s decision in the High Court.

In a very significant decision on 6 November 2013 following the Judicial Review, which highlighted the effects of the Equality Act 2010 on public authorities and their decision-making, the Court of Appeal found that the Department of Work and Pensions’ (DWP) decision to close the ILF was not lawful, overturning the High Courts’ decision of April 2013. The Government had indicated that it would not be appealing this judgement and the ILF would remain intact for the time being. 

The Court of Appeal unanimously quashed the decision to close the fund and devolve the money, on the basis that the minister had not specifically considered duties under the Equality Act, such as the need to promote equality of opportunity for disabled people and, in particular, the need to encourage their participation in public life. The court emphasised that these considerations were not optional in times of austerity.

On March 6, 2014, the Government made the authoritarian announcement that it would go ahead with the closure of the ILF fund on 30th June 2015, saying that a new equalities analysis had been carried out by the DWP. The government has shown a complete disregard for disabled people and the Court of Appeal decision. 

Highlighting that government had failed to comply with the equality duty had been a rare victory, entirely due to disabled people fighting back. The government responded to this by simply ignoring the court ruling.

The ILF provided additional income to nearly 19,000 disabled people who have high level support needs. The government devolved the responsibility to already cash-strapped local authorities in England, which meant that it would cease to be ring-fenced and would be subject to constraints and cuts within a local authority budget in June 2015. The funding, however, was not ring-fenced. Because of budget cuts, local authorities have had limited capacity to support individuals unless their needs are very severe and so the ILF had previously served to supplement this provision. Local Authorities are already struggling to fund statutory provision and services, as it is. 

Local Authorities had already said that they will not be able to offer the current level of financial support provided by ILF, potentially forcing many disabled people to move out of their homes and into residential care homes.

The Inclusion report aims at gathering evidence of the impact of the closure of the ILF with a focus on the situation in London. It brings together statistical analysis from Freedom Of Information (FOI) requests sent to all 33 London boroughs with findings from a survey sent out to London Deaf and Disabled People’s Organisations (DDPOs) as well as qualitative evidence provided by former ILF recipients concerning their experiences of transfer to Local Authority (LA) support.

Comparison of evidence gathered through comparison of the Freedom Of Information (FOI) responses, Deaf and Disabled People’s Organisations (DDPO) survey, and examples of lived experience submitted by former ILF recipients has led to a number of themes emerging:

  • Post-code lottery for former ILF recipients across Local Authorities.
  • The detrimental impacts of the ILF closure on former ILF recipients, ranging from distress and anxiety to removal of essential daily support. 9 One Year On: evaluating the impact of the closure of the Independent Living Fund
  • The lack of consistent practice across different Local Authorities regarding referrals for CHC funding.
  • Limitations of the mainstream care and support system and failings in the implementation of the Care Act.
  • The value of the model of support provided by the Independent Living Fund.
  • The importance of Deaf and Disabled People’s Organisations for making Deaf and Disabled people aware of and supported to exercise their rights.

There is an urgent need for a radical rethink of how Disabled people are supported to live independently. Disabled people who use independent living support must be at the forefront of developing ideas and with adequate resources for meaningful engagement.

This also needs to happen quickly, before the memories of what effective independent living support looks like and how much Disabled people can contribute when our support needs are met fade into the distance.

You can read the full report here: One year on: Evaluating the impact of the closure of the Independent Living Fund

Related  

ILF closure cuts report produces instant results from Labour and Greens

Two-way mirrors, hidden observers: welcome to the Department for Work and Pensions laboratory

 

 

Nothing about us without us? Are you bonkers?

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This is an excellent article from The Alliance for Counselling & Psychotherapy. It de-individualises and de-stigmatises mental illness by placing it firmly in the context of neoliberalism, which is a doxa  –  an over-arching political and economic dominant narrative and mode of social organisation. Neoliberalism has a dire impact on increasing numbers of citizens, and on those who are a part of already marginalised social groups in particular.

A doxa is something that comes to be regarded as common sense;  it is taken for granted “knowledge” in society. It is the experience by which “the natural and social world appears as self-evident.” As an over-arching and self referential, self perpetuating idiom of belief, it is difficult to challenge from “within” the idiom. Yet neoliberalism is just one choice of social organisation amongst several alternatives. It isn’t a rational or democratic choice, since it is increasingly detrimental to the majority of ordinary people.

R.D Laing once said that: “Insanity is a perfectly rational adjustment to an insane world.” That has probably never been more true than it is now. How can therapists address these real and pressing issues? One thing is certain, it isn’t by claiming value neutrality and by simply “treating” individuals. Kitty.

Alliance blog

In May this year, I joined members of the Mental Health Resistance Network at an event at the Old Vic. It was a panel debate on the state of mental health provision in the UK, one of their Voices Off events linked to the production of Harold Pinter’s The Caretaker. The original panel was Luciana Berger MP, Shadow Minister for Mental Health; Paul Farmer, CEO of Mind; and Simon Wessely President of the Royal College of Psychiatrists. MHRN members protested that there were no service user speakers, and eventually Peter Beresford and Alice Evans were invited onto the panel.

Inspired by the desperate lack of service user voices, mental health activists rapidly got together a zine to distribute at the meeting – a passionate collection of first-hand experiences of living on the sharp end of mental health disability in the UK. Jay Watts of the Alliance contributed a cartoon…

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Andrew Samuels on Jobcentre Therapy and the Psy-Organisations

Alliance blog

Letter submitted to Therapy Today (the BACP journal) but not published.


I’d like to respond to Catherine Jackson’s interesting article Colocation or collusion? How ethical are the Government’s proposals for closer working between IAPT services and Jobcentre Plus?’ (Therapy Today, April 2016, pp.8-9).

Catherine’s title suggests that the issue is generating heat and, at the end of this letter, I make a suggestion for a dialogical, relational next step.

What Catherine wrote illustrates the usual dilemma that the large professional organisations find themselves in with regard to Government policies – in this case, the many linkages between employment on the one hand and psychological therapies on the other. If bodies such as BACP, UKCP, BPC, BPS and BABCP are too robust in their criticism of Government policies, they will be labelled as ‘the awkward squad’ and ‘the usual suspects’. Doors in Whitehall close, requests for meetings go…

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Man with diabetes had to have his leg amputated because of benefit sanctions

David Boyce had to have his leg amputated when his diabetes spiralled out of control because he couldn’t afford to eat after having his benefits sanctioned
                                                      David Boyce 

Photo courtesy of the Manchester Evening News.

David Boyce has diabetes. He was sanctioned for five months by the Department for Work and Pensions, which meant he had no money whatsoever to meet his basic needs. As a result, he had to sell his belongings, but couldn’t afford to eat properly and subsequently had to have his leg amputated, as his medical condition spiralled out of control. A healthy diet is essential as part of the management and treatment for diabetes.

David was a photographer who used to own a business, but was forced to give up his work because of ill-health. There was a dispute with the Department for Work and Pensions (DWP) about his jobseeker’s agreement and he was sanctioned numerous times.

David said that his benefits were frozen fourteen times because of “issues with paperwork.”

However, it’s clear that the sanctions happened because of a flawed decision-making process on the part of the DWP and he won an appeal which successfully overturned every sanction, with support from Salford’s Unemployed and Community Resource Centre. He was eventually awarded the money that had been wrongfully withheld from him

The government have claimed that benefit sanctions are an “incentive” to “help” people like David into work. However, David has been pushed even further away from the job market, because he’s now been left with a greater degree of disability: horrifically, the sanctions have cost him his leg.

David said that by July, complications from diabetes had already caused irreversible damage. His health deteriorated because he had no money to live on: he couldn’t control his insulin intake and was unable to follow his strict diabetic diet. 

Subsequently he suffered diabetic ulcers and was diagnosed with the flesh-eating infection, necrotizing fasciitis, and doctors were forced to amputate one of his legs.

He told the Manchester Evening News: “I suffered from depression and mental anxiety. I’m not a rich man. I had to sell everything to eat.

You don’t tell anyone, it’s embarrassing, that’s what they prey on.

You go into a depression. You lock yourself away.”

David Boyce’s tragic case was revealed as protesters gathered to demonstrate against the extremely punitive and irrational Jobcentre conditionality rules and welfare sanctions. 

Campaigners gathered at Eccles Job Centre this week to protest against the immoral benefits sanctions. They said that scores of people were being left depressed and on the verge of suicide. 

David’s horrific experience is not an isolated case, sadly. Many campaigners have reasonably demanded an inquiry since the death of former soldier David Clapson, who also had diabetes. David died of ketoacidosis because he couldn’t take his insulin. He was also starving, after being sanctioned for missing a single Job Centre meeting. The coroner said that he hadn’t eaten for at least three days prior to his death. David was unable to afford to maintain an electricity supply to keep his fridge running, where he ordinarily safely stored his life-saving insulin.

The government have been presented with many other cases of extreme hardship and suffering because of sanctions, but they simply deny there is any “causal link” between the negative impacts, distress and deaths and their policies, despite the ever-growing and distressing evidence to the contrary. There is no evidence that there isn’t a “causal link” either. To establish such a link requires an inquiry and further investigation of the already established correlation between the government’s policies and adverse impacts. If the government are so confident that their claim is right, then surely an inquiry would provide a welcomed verification of this.

As it is, the government’s refusal to research and investigate the link is simply oppressive, and their claims fly in the face of established research and longstanding empirical evidence which shows that punishing people who are already experiencing hardship cannot possibly “incentivise” them to look for work, since we know that if someone cannot meet their basic survival needs (such as the physiological necessities of food, fuel and shelter), then they cannot meet higher level psychosocial needs, including looking for work.

Salford Unemployed and Community Resource Centre manager, Alec McFadden, said the DWP had imposed “unachievable” requirements for those in receipt of benefits.

McFadden added: “Illegal benefit sanctions need to be stopped and we will continue to use the law against these dangerous and illegal actions that bringing stress and the threat of suicide to so many people.”

A DWP spokesman said: “Sanctions are an important part of our benefits system and it is right that there is a system in place for tackling those few who do not fulfil their commitment to find work.

They are only used in a very small percentage of cases, and the number of sanctions has fallen substantially in the last year.”

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Abraham Maslow’s hierarchy of human needs.

Related

Two key studies show that punitive benefit sanctions don’t ‘incentivise’ people to work, as claimed by the government

Nudging conformity and benefit sanctions

Welfare sanctions can’t possibly “incentivise” people to work. Here’s why

The Conservative approach to social research – that way madness lies


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The Resolution Foundation’s review of the Conservative’s “Living Wage”

longer_term_living_wage

 

The Conservatives’ summer budget saw a new national minimum wage set. However, it has been  re-branded as a “national living wage” as the Conservatives claim that it should be what people need to live on. Employers will no longer be allowed to pay the £6.70-an-hour rate, but will have to pay the new “national living wage” of £7.20 an hour to people over the age of 25. Call me a cynic, but the psychosemantic re-branding of a minimum wage increase of less than a pound an hour is a diversion because the government intend to stop subsidising low wages through tax credits. 

Increasing the minimum wage is simply not adequate to reduce poverty. Forty per cent of individuals earning between the minimum wage and the actual amount that would be the Living Wage campaigners want, are in households in the top half of the income distribution. They aren’t poor. Tax credits on the other hand are much more highly targeted at those in need of support. Whilst the public understand what the minimum wage was about, renaming this new policy the “National Living Wage” will inevitably create confusion, as many will incorrectly assume that the government are targeting the same rate as that advocated by the Living Wage campaign – a figure based on estimates in line with the cost of living. They aren’t.

The Living Wage Foundation say:

  • The current UK Living Wage ought to be £8.25 an hour
  • The current London Living Wage ought to be £9.40 an hour

However, the Resolution Foundation have issued a press release that says the Prime Minister should allow the in-built flexibility of the “national living wage” to “take its course.”

Conor D’Arcy, Policy Analyst at the Resolution Foundation, said: “Some businesses are unhappy about a higher minimum wage, particularly amid the post-referendum uncertainty. But backsliding on the government commitment is unnecessary given the in-built flexibility of the policy to adjust to changing economic circumstances. It would also be costly for millions of low paid workers, so the Prime Minister should stick to her guns.”

Backsliding on the so-called “National Living Wage” (NLW) could leave some full-time workers up to £1,000 a year worse off by 2020 – with women, the young and older workers most likely to lose out – according to the new analysis published yesterday (Wednesday) by the Resolution Foundation.

Earlier this year, the introduction of the NLW delivered an average 7.5 per cent pay rise to around 4.5 million workers aged 25 and over. Low-paid workers are set for another four years of above average pay rises as it approaches its target ‘bite’ of being worth 60 per cent of typical hourly pay by 2020.

More recently, May has put tackling squeezed living standards at the centre of her new government. However, some business organisations have called on the government to water down its plans following the EU referendum. In a letter to the Business Secretary Greg Clark, 16 trade associations called on government to “exercise caution” in light of “the economic uncertainties the country faces”.

Such calls are understandable given the challenge of a higher wage floor for some businesses. However the Foundation says that the in-built flexibility of the NLW – which automatically adjusts to economic shifts by being pegged to typical hourly pay, rather than the £9 cash figure that many people associate the policy with – means that there is no need to water down the policy.

The Foundation’s analysis, based on the latest summary of independent economic forecasts published by the Treasury, shows that the NLW is currently on track to rise to around £8.70 in 2020. That’s lower than the £9 forecast in the March 2016 Budget, due to expectations of weaker wage growth. The Foundation notes that the projected figure for 2020 is likely to rise and fall in coming years as wage forecasts are updated and the actual impact of implementing Brexit becomes clear.

The Foundation says the Prime Minister should therefore stick to her guns and press on with implementing a policy that will deliver a pay rise for six million workers – and support her vision for an economy that works for everyone, not just the privileged few.‎

Torsten Bell, Director of the Resolution Foundation, said:

“Theresa May is right to stick to her guns on the National Living Wage. Britain has a serious low pay problem and now of all times is not the moment to put off dealing with it.”

The Foundation adds that sticking to the current policy is very different to pursuing a cash target of £9 or higher in the face of weaker overall wage growth. That approach, which some advocate‎, could jeopardise the success of the NLW.

Ahead of a crucial meeting of the Low Pay Commission in October to decide their recommendation for next April’s NLW rate, the analysis shows that should the government scale back its ambition over the next four years – for example by raising the NLW at a similar pace to the recent minimum wage increases applied after the 2008 financial crisis – its value would fall by around 55p per hour in 2020. This would lower the annual pay of a full-time worker on the NLW by around £1,000, relative to current plans. Should the current ‘bite’ of the NLW be maintained, rather than increased to 60 per cent by 2020, the annual pay would be reduced by £1,500.

Around one in five women and one in five workers aged 26-30 would lose out from any backsliding on the National Living Wage, as would over a quarter of workers aged 66 and over.

The Foundation says that the main focus for the government should now be on implementation. To do this, it is calling for the government’s upcoming industrial strategy and productivity plan to include a focus on the often unheralded low-paying sectors of the economy, and not just on areas like digital and high-value manufacturing. This will help employers handle the higher labour costs brought about by the NLW.

The analysis is part of the Foundation’s upcoming report Low Pay Britain 2016, which will be published later this month.

Conor D’Arcy, Policy Analyst at the Resolution Foundation, said:

“The National Living Wage is a hugely popular policy that is set to deliver a pay rise to six million of Britain’s lowest paid workers and play a pivotal role in the Prime Minister’s vision for an economy that works for everyone, not just the privileged few.

“Understandably some businesses are unhappy about a higher minimum wage, particularly amid the post-referendum uncertainty. But backsliding on the government commitment is unnecessary given the in-built flexibility of the policy to adjust to changing economic circumstances. It would also be costly for millions of low paid workers, so the Prime Minister should stick to her guns.

“The government’s attention should instead turn to the huge task of implementation. This should ensuring that its upcoming industrial strategy includes the less glamorous but hugely important sectors like retail and hospitality, which are at the coalface of Britain’s huge low pay challenge.”

Review recommendations

  • While the National Living Wage is a welcome boost to low earners, the Living Wage with its genuine link to an acceptable cost of living, remains as vital as ever.
  • But as we have made clear, improvements are possible in both methods and seeking alignment will inevitably lead to change. We believe the recommendations we have outlined in this review represent a genuine improvement over the current methods. The aligned method should be more representative, more robust and, most importantly, driven to a greater extent by changes in the cost of living.
  • Inevitably, calculating a Living Wage requires judgement calls. Policy changes like the introduction of Universal Credit would always have required judgements on how the new system is phased into the rate. Having a body like the Living Wage Commission to make such decisions when required in future can only be an asset to the Living Wage campaign as it moves forward.
  • The natural question which follows these recommendations is what impact is likely on the rates themselves. However, the next steps are for the Living Wage Commission to consider our recommendations. The options they choose will determine the extent to which the rates vary from their current levels.
  • Broadly speaking however, the aligned method we have recommended is likely to have an upward effect on the London Living Wage. We consider this to be an unavoidable consequence of a Living Wage rooted in an up-to-date basket of goods with a more diverse mix of family types. There is a clear discrepancy in the target income between London and the rest of the UK, and as highlighted by recent analysis on the size of London salary weightings[1] the differential between rates should be larger than at present. The exact size of the increase will depend on the Living Wage Commission and Mayor’s response to our review. They also have a role in setting out a how to implement and transition to the new rates in London and the rest of the UK.
  • The Living Wage Commission is expected to respond to our review in September 2016. With a strong, aligned methodology and an enhanced governance structure, we see no reason why the Living Wage cannot continue to raise the wages of workers across the UK, delivering more families an acceptable standard of living.

Notes 

  • The ‘bite’ of the National Living Wage – its value relative to typical hourly pay – is set to increase by 4.3 percentage points over the next four years. The ‘bite’ of the National Minimum Wage (NMW) increased 1.7 percentage points in the four years following the financial crisis. Should the NLW instead follow this path, rather than the one currently set out, its value in 2020 would fall to £8.17 an hour. That’s 55p an hour less than the latest economic forecasts imply, equivalent to £1,075 to a full-time worker on the NLW.
  • The Resolution Foundation forecasts that by 2020 around 12 per cent of workers will be earning the National Living Wage, including 19 per cent of women, 19 per cent of 26-30 year olds and 26 per cent of workers aged 66+. 

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