Category: Political ideology

The poor state of child health in the UK

uk-child-poverty

Neoliberalism is based on competitive individualism and mythical “market forces”. In such a competitive system, where the majority of people are left to sink or swim, most are pitched against the tide, as it were, since the very design of the economy means that only the wealthiest make significant gains.  It’s therefore inevitable there will be a few “winners” and many “losers”.

That’s what “competition” means. It means no rewards for most people – inequality and poverty for the 99%. It’s not possible to “work hard” to change this. Inequality is built into the very system of our socioeconomic organisation. Therefore it’s hardly fair or appropriate for a government to blame and punish people for the failings of their own imposed dominant ideology – a political and economic mode of organisation – which most ordinary people did not intentionally choose.

A  major report – State of child health – says that child health in the UK is falling behind that of many other European countries. It also confirms a strong link between growing inequality and poverty in the UK and increasing poor health and mortality. This comes at the same time as another key study found that poverty has a significantly damaging impact on the mental health and behaviour of children. 

The report raises particular concerns over rates of mortality, mental health issues and obesity among the young. Children living in the most deprived areas are much more likely to be in poor health, be overweight, suffer from asthma, have poorly managed diabetes, experience mental health problems and die early.

The in-depth report, from the Royal College of Paediatrics and Child Health (RCPCH), has emphasised that poverty is the cause of many child health problems.

UK health ministers claim that money was being invested in services to help tackle health inequalities.

The report looked at 25 health indicators, including asthma, diabetes and epilepsy, as well as obesity, breastfeeding and mortality, to provide a snapshot of children’s health and wellbeing.

It said there had been huge improvements in child health in the UK in the past 100 years, but since the mid-1990s “there has been a slowing of progress”.

This has left the UK falling behind other European nations in a number of league tables. For example, in 2014 the UK had a higher infant mortality rate (of 3.9 per 1,000 live births) than nearly all comparable Western European countries.

Infant mortality ranges from 3.6 in Scotland to 3.9 in England and Wales, and 4.8 in Northern Ireland.

Rates of smoking during pregnancy – an important factor in the health of babies – are also higher in the UK than in many European countries, at 11.4% in England and nearly 15% in Scotland.

Levels of smoking were highest in deprived populations and in mothers under 20, the report found.

Also, more than one in five children starting primary school in England, Wales and Scotland are overweight or obese, and there has been little improvement in these figures over the past 10 years.

Obesity leads to a significantly increased risk of serious life-long health problems, including type 2 diabetes, heart disease and cancer.  

In 2010 a report for the government in England by Sir Michael Marmot set out the social factors governing health and pointed to the role of a child’s early years in determining life chances. Now, leading child health experts are saying that little progress has been made since then and that health inequality is still blighting the lives of young people.

The Royal College of Paediatrics and Child Health has stated that the wide gap between rich and poor is damaging infant health around the UK.

The college president, Professor Neena Modi, argues that a lot more needs to be done to improve child health and that it is “particularly troubling that stark inequalities have widened in the last five years.”

Mortality rate worsens

The report says that the UK ranks high amongst Western European countries on mortality rates for infants under the age of one. Deprivation is strongly correlated with death rates among children.

The report says that many of the causes of infant mortality are preventable and asserts that issues such as fetal growth restriction disproportionately affect the least advantaged families in society. Diet and adequate nutrition, for example, play a key role in healthy birth weight.

Reducing child poverty, with benefits and housing policy playing a part, are crucial for improving infant survival, according to the report.

New mortality data was published in January by the Office for National Statistics, which also underlines the scale of inequalities in the UK.

Modi also said: “Poor health in infancy, childhood, and young adult life will ultimately mean poor adult health, and this in turn will mean a blighted life and poor economic productivity. The UK is one of the richest countries in the world; we can and must do better, for the sake for each individual, and that of the nation as a whole.” 

Sarah Toule, head of health information at World Cancer Research Fund, agrees:“We strongly support RCPCH’s call on the government to close the poverty gap and improve our children’s health and future.”

The report calls for child health to be pushed high up the government’s agenda, as a cross-departmental issue. Each government – Scotland, Wales, Northern Ireland and England – should develop a child health and wellbeing strategy and consider children’s health in all policymaking.

Both type 1 and type 2 diabetes are on the rise

According to the report, there was also evidence that young people in the UK had low wellbeing compared with other comparable countries.

Type 2 diabetes is increasing. However, the report said that the UK could do much better at monitoring and managing type 1 diabetes, which is an increasingly common autoimmune condition amongst children and young people in the UK, though unrelated to “lifestyle choices” or obesity. It can lead to very serious long-term health problems if it isn’t adequately medically monitored and managed.

The report lays out a number of key recommendations for improving the health and wellbeing of the nation’s children.

These include: 

  • Each UK Government to develop a child health and wellbeing strategy, coordinated, implemented and evaluated across the nation 
  • Each UK Government to adopt a ‘child health in all policies’ approach 
  • UK Government to introduce a ban on the advertising of foods high in saturated fat, sugar and salt in all broadcast media before 9pm 
  • Each UK Government to develop cross-departmental support for breastfeeding; this should include a national public health campaign and a sector wide approach that includes employers, to support women to breastfeed  
  • An expansion of national programmes to measure the height and weight of infants and children after birth, before school and during adolescence 
  • A reversal of public health cuts in England, which are disproportionately affecting children’s services 
  • The introduction of minimum unit alcohol pricing in England, Wales, and Northern Ireland, in keeping with actions by the Scottish Government  
  • UK Government to extend the ban on smoking in public places to schools, playgrounds and hospitals 
  • UK Government to prohibit the marketing of electronic cigarettes to children and young people 
  • National public health campaigns that promote good nutrition and exercise before, during and after pregnancy  

The high number of Sure Start centre closures runs counter to the government’s rhetoric on improving children’s life chances across society. Sure Start was an innovative and ambitious Labour government initiative, introduced in 1998, aimed at supporting the most deprived families and safeguarding children. In 2010, Gordon Brown said the Conservatives would cut Sure Start spending by £200m, forcing 20% of all centres to close. Maria Miller, the (then) shadow children’s minister, dismissed this as “scaremongering”, saying the scheme had the Conservative party’s “full commitment”.   However, increasing numbers of the centres have shut under the coalition and Conservative governments, with 12 closing in 2011, 27 in 2012 and 33 in 2013. In 2014 the number increased to 85, and then 156 in 2015. 

Neil Leitch, chief executive of the Pre-school Learning Alliance, said the figures were worrying.

“Children’s centres are a vital source of advice and practical support for families – especially those more disadvantaged families – and so for so many to be disappearing at a time when there is so much government rhetoric on ‘closing the gap’ and improving children’s life chances seems completely contradictory,” he said.

The State of Child Health report said poverty left children from deprived backgrounds with far worse health and wellbeing than children growing up in affluent families.

One in five children in the UK is living in poverty, the report says, though other estimates have been higher.

The report urges the four governments of the UK to reduce the growing health gap between rich and poor children.  

Key messages to governments from the report

  • Poverty is associated with adverse health, developmental, educational and long-term social outcomes.
  • Nearly one in five children in the UK is living in poverty. This is predicted to increase. Therefore strategies are urgently needed to reduce poverty and to mitigate its impact on child health outcomes.
  • Improving the health outcomes of children living in poverty requires provision of good-quality, effective and universal prevention and health care services. 
  • All professionals caring for children should advocate for and support policies that reduce child poverty.

An ‘all-society approach’ is needed

Professor Modi who is the president of the Royal College of Paediatrics and Child Health, said she was disappointed by the findings of the report.

“We know the adverse economic impact of poor child health on a nation and yet we singularly seem to be incapable of doing anything substantive about it.”

Modi said other European countries had much better results than the UK in closing the health gap between rich and poor children.

“Their policies are much more child friendly and child focused,” she said.

“We have a tokenistic recognition of the importance of child health in all policies in this country, but we don’t have that translated into real action.”

She added the UK could transform the health gap with an “all-society approach”.

“As citizens we can say very loudly and clearly we do want a focus on child health and wellbeing… we can bring in child health in all national policies and make sure our government does have a strategy that crosses all departments.”

The Child Poverty Action Group also applauded the report’s recommendations. “The Royal College’s report demonstrates all too clearly how poverty in the UK is jeopardising children’s health,” said Alison Garnham, chief executive. 

“We are nowhere near where we should be on children’s wellbeing and health given our relative wealth. In the face of a projected 50% increase in child poverty by 2020, this report should sound alarms. It is saying that unless we act, the price will be high – for our children, our economy and our overstretched NHS which will take the knock-on effects.

A cross-governmental approach, considering child health in every policy, was the right one, Garnham said. “But the overall question the report raises for our prime minister is will she continue with the deep social security and public service cuts she inherited – to the detriment of our children’s health – or will she act to ensure that families have enough to live on so that all children get a good start? If other comparable countries can produce results that put them in the top ranks for child health, why not us?” 

A spokesman from the Department of Health in England claimed the government would be investing more than £16bn in local government public health services to “help tackle inequalities.”

There was no mention, however, of protecting children from poverty. The austerity programme, which impacts on the poorest citizens most of all, and other government policies cannot possibly do anything else but extend and deepen social inequalities.

Recommended key actions

  • Governments must introduce comprehensive programmes to reduce child poverty.
  • Increase awareness among health professionals of the impact of poverty on health and support all professionals working with children to become advocates for their patients experiencing poverty.
  • Ensure universal early years’ public health services are prioritised and supported, with targeted supports for children and families experiencing poverty.
  • Provide good quality, safe and effective prevention and care throughout the public health and healthcare service with a particular focus on primary care in order to mediate the adverse health effects of poverty.
  • Support research that examines the relationship between social and financial disadvantage and children’s health. 
  • Support the continued recording of income-based measures of poverty so that trends and impacts of service provision can be meaningfully assessed, with a focus on achieving a target of less than 10% of children experiencing relative low income poverty.

what-is-the-spread-of-incomes-in-the-uk-2014-15

Our children are the first generation in the UK in a very long time, if ever, to have much less than their parents and grandparents. Their lives are far less secure than ours have been. It’s not because of a lack of resources, it’s because of the greed of a small ruling elite and because of neoliberal ideology and policies. We have already lost the social gains of our post-war settlement: public services, social housing, legal aid, universal welfare and unconditional healthcare are either gone, or almost gone.

We must not allow this steady dismantling of our shared, public services, supports and safeguards to continue, as a society. We are one of the wealthiest nations in the world, and we have sufficient resources to support those most in need. It’s simply that the government chooses not to, preferring to be generous to the wealthiest minority, with tax cuts handed out from the public purse, and spending our public finds on being “business friendly” instead of recognising and reflecting public needs.

We must work together to challenge the toxic dominant ideology that places profit over and above human need and social wellbeing. We each share some of the responsibility for this. We now need to work on how to change this for the better, collectively. For our children and the future.

For a copy of the State of Child Health report, and the recommendations for each UK nation, visit the State of Child Health web pages.

xwqmoakmvjdjrpau0pbz
Children in poverty (before housing costs), UK, financial years 1998/99 to 2012/13; Institute for Fiscal Study (IFS) projections to 2020/21.  (Source:
 Child poverty for 2020 onwards: Key issues for the 2015 Parliament.)

Related

Nearly two-thirds of children in poverty live in working families

Poverty has devastating impact on children’s mental health

Health cuts most likely cause of steep rise in mortality, government in denial

New research uncovers ‘class pay gap’ in Britain’s professions – Social Mobility Commission.

 


 

I don’t make any money from my work. But you can help me continue to research and write informative, insightful and independent articles, and to provide support to others by making a donation. The smallest amount is much appreciated – thank you.

DonatenowButton cards

Poverty has devastating impact on children’s mental health

images

Research from the University of Liverpool – published today in The Lancet Public Health shows that children who “move into” poverty are more likely to suffer from social, emotional and behavioural problems than children who remain out of poverty.

The UK Government has recently questioned whether the relative measure of income poverty used in this research (a household income that is less than 60% of the national average) is a good indicator of children’s life chances.

The Government has claimed that it is better to increase the number of parents who are employed, than use the social security system to prevent children moving into poverty. However, we know that being employed carries no guarantee of escaping poverty.

Exploring the impact

This research challenges the government’s view, it was found that living in poverty adversely affected children’s and mothers’ mental health even if there was no change in the mother’s employment status.

Researchers from the University’s Department of Public Health and Policy explored the impact that being in poverty had on the mental health of children and their mothers,  using a nationally representative sample of children born in 2000 and followed up until 2012 (UK Millennium Cohort Study).

The researchers identified 6063 families who were not in poverty and had no mental health problems when their child was 3 years old. They tracked these families and compared the mental health of those that “moved into poverty” to those that remained out of poverty by the time their child was 11 years old.

Negative effect

Fourteen percent (844) of these 6063 families experienced poverty over this period. The children that experienced poverty were 40% more likely to develop social, emotional or behavioural problems, compared to those that remained out of poverty. The mothers who “moved into” poverty were also 44% more likely to develop mental health problems and this partially explained the negative effect that poverty had on children’s mental health.

Dr Sophie Wickham, Wellcome Trust Research Fellow at the University’s Department of Public Health and Policy, said: “Our study shows that moving into poverty damages children’s mental health. Child mental health in the UK is poor, with roughly one in eight children reporting mental health problems, and this is partly because Child poverty is higher in the UK than in other European countries.

“Our findings reinforce the need to monitor income-based measures of child poverty to track the effect that government’s policies are having on children’s lives. In order to improve mental health in the UK it is essential that children are protected from the toxic effects of growing up in poverty.”

Damaging life chances

Alison Garnham, Chief Executive of Child poverty Action Group, said: “This comprehensive study shows how children’s mental health is compromised by poverty.   It tells us loud and clear that inadequate family income damages children’s life chances – and having a working parent doesn’t stop that damage from happening.

“Working poverty is still poverty. With one in four children in poverty in the UK, and projections that numbers may rise by half by 2020, that should ring alarms. The well-being of our next generation is at stake: surely that is a compelling reason for re-instating poverty-reduction targets that, along with most of the Child Poverty Act, were scrapped last year.  Without targets to track progress on eradicating poverty, how can we know if we’re improving or further jeopardising our children’s well-being?”

The report says that in a UK cohort, first transition into income poverty during early childhood was associated with an increase in the risk of child and maternal mental health problems. These effects were independent of changes in employment status. Transitions to income poverty do appear to affect children’s life chances and actions that directly reduce income poverty of children are likely to improve child and maternal mental health.

Mental health problems, many of which have their origins in childhood, are a substantial cause of morbidity globally, and improvement of child mental health is a policy priority. Findings from the study indicate that increases in child poverty in the UK are likely to negatively affect child and maternal mental health, independent of employment transitions and other important confounders. This finding is important in the UK policy context because use of income-based poverty measures have been the subject of debate and child poverty levels are predicted to rise by 50% by 2020.

Receipt of tax credits in the UK, which operate below the 60% household income threshold, could have minimised the fall in income experienced by people experiencing poverty during this time and declines in income and mental health effects could have been greater in the absence of this policy than with this policy. The Government plans to replace tax credits with a new benefit—Universal Credit—reducing payments to low-income families. Future research should investigate whether or not these changes in welfare policy modify the relation between poverty transitions and mental health observed in this study.

The research findings reinforce the need to maintain an income-based measure of child poverty and use it to monitor trends and the effects on health of policies that affect children’s lives. 

The full study, entitled The effect of a transition into poverty on child and maternal mental health: a longitudinal analysis of the UK Millennium Cohort Study can be found here.

maslows_hierarchy_of_needs-4
Related

The impact of a Conservative government on Child Poverty – analysis of report by UNICEF

Conservative policies are in breach of the UN Convention on the Rights of the Child

The poverty of responsibility and the politics of blame. Part 3 – the Tories want to repeal the 2010 Child Poverty Act

Largest study of UK poverty shows full-time work is no safeguard against deprivation


I don’t make any money from my work. But you can help me continue to research and write informative, insightful and independent articles, and to provide support to others by making a donation. The smallest amount is much appreciated – thank you.

DonatenowButton cards

Select Committee says governance code for large companies with social impact is crucial, following inquiry into collapse of BHS

imgres

Philip Green

The Work and Pensions Committee have called for new duty on company directors to have regard to pension schemes and for Insolvency Service reports to be published in the public interest. 

On 28 April last year the Committee launched its joint inquiry into the collapse of British Home Stores (BHS) and the origins of its huge pension scheme deficit. BHS was a private company but the effects of its collapse spanned widely: not least to its thousands of employees and pensioners.

The three month inquiry examined corporate governance in Sir Philip Green’s companies, which are privately held and ultimately owned offshore by Lady Green. It found a near-complete absence of the constructive challenge that is the hallmark of good corporate governance. Green, a “dominant personality”, ran his companies as a personal empire with boards taking decisions with reference to a shared understanding of his wishes rather than the interests of each individual company.

An extraordinary and scandalous tale unfolded in which the greedy main players took lavish rewards at the expense of the employees and pensioners of the company. Inter-company loans and property deals, related-party transactions and the hurried disposal of BHS to a wholly unsuitable buyer all proceeded with woefully inadequate checks and balances. The poor corporate governance in Green’s companies was epitomised by the complacent performance of Lord Grabiner, a director of several of the Green empire subsidiaries.

In July last year, MPs catalogued a litany of failures culminating in an “at any cost” disposal of the company and pension deficit to a wholly unsuitable “chancer”. In their inquiry report about BHS, the Work and Pensions and Business and Innovations and Skills Committees concluded that Green chose to rush through the offloading of a beleaguered high street institution, which was losing money and encumbered with a massive pension fund deficit, to a buyer who he was clearly aware was “manifestly unsuitable”, with Green forced to finance the sale himself.

Though the ownership of Dominic Chappell and his associates was “incompetent and self-serving”, the ultimate fate of the company was sealed on the day it was sold. Advisers were paraded by both sides as an “expensive badge of legitimacy for people who would otherwise be bereft of credibility” while the Taveta group directors (owned by Green’s billionaire wife, Tina Green) failed to provide a semblance of independent oversight or challenge in a corporate group run as a personal fiefdom by a single dominant individual.

MPs heard hours of oral testimony and considered thousands of pages of written evidence in the inquiry, which began when BHS crashed into administration just 13 months after the ill-advised and under-funded sale to Chappell. The Committees said that the evidence at times resembled a “circular firing squad”, with a series of key witnesses appearing to believe they could absolve themselves of responsibility by blaming others. Green himself “adopted a scattergun approach”, liberally firing blame to all angles except his own.

The unacceptable face of capitalism

The report documents the systematic plunder of BHS at the cost of the 11,000 jobs and 20,000 people’s pensions now at risk.  Green, Chappell and the respective directors, advisers and hangers-on who all got rich or richer are all culpable, with the losers being the ordinary employees and pensioners.

The Committees said this is “the unacceptable face of capitalism” and that the story of BHS begs much wider questions about the gaps in company law and pension regulation that must be addressed. The two Committees turned to those question in subsequent inquiry hearings.

The headline figures that Green bought BHS for £200 million and sold it 14 years later for £1 cannot disguise the true picture. He did not invest in the company and then “unfortunately” failed to make it succeed. Green systematically extracted hundreds of millions of pounds from BHS, paying very little tax and fantastically enriching himself and his family, leaving the company and its pension fund weakened to the point of the inevitable collapse of both. Lady Green is still being paid tens of millions of pounds of tax free repayments on the loan that was engineered to sell BHS from one Green family business to another, and will be for some years to come.

A moral duty to act on the pension schemes

  • When Green bought BHS the pension schemes were in surplus. As these schemes declined into substantial and unsustainable deficit he and his directors repeatedly resisted requests from trustees for higher contributions. Such contributions were not charitable donations: they were the means of the employer meeting its obligations for deferred pay. Green had a responsibility to be aware of the growth of the deficit and he was aware of it. That there is a massive deficit is ultimately his responsibility.
  • The Committees say Green must act now to find a resolution for the BHS pensioners, a “moral duty” which will undoubtedly require him to make a large financial contribution. Green’s failure until now to resolve the pension fund’s problems contributed substantially to the demise of BHS, along with chronic under-investment and the systematic extraction of hundreds of millions of pounds from the increasingly ailing company.
  • The Arcadia board cited a variety of explanations for pausing Project Thor, ranging from Christmas to the Scottish independence referendum and instability in Ukraine. In fact, the primary reason was Green’s resistance to TPR’s moral hazard requests. He did not wish to respond to requests for information regarding historic dividends, management charges, sale and leaseback arrangements, inter-company loans and the use of BHS shares or assets as collateral for company purchases. At best this demonstrated a lack of willingness to act to secure the pension fund’s future.

Incredible wealth followed by retail demise

  • In his early years of ownership, Green cut costs, sold assets and paid substantial dividends offshore to the ultimate benefit of his wife.  The so-called “King of the High Street” failed to invest sufficiently in stores or reinvent the business to beat the prevailing high street competition. The Committees found “little to support the reputation for retail business acumen for which he received his knighthood” and say “we don’t doubt that Green had some affection for BHS – to an extent it created him. Now it could also bring him down” 
  • Green’s family accrued incredible wealth during the early, profitable years of BHS ownership. Over the duration of their tenure, significantly more money left the company than was invested in it. There is no evidence of improved turnover, market share, or major increase in investment that might be expected from a leading retailer. BHS was involved in a number of transactions with a complex web of companies, many registered offshore: whether BHS benefited financially from these transactions is far from clear. What is clear is that the Green family did.
  • The report documents the ways Green was able to boost BHS’s profitability in the short-term while ultimately fatally undermining its ability to survive. The early years improvement in BHS’s profitability appears to have been achieved primarily through cost-cutting measures and squeezing suppliers. Crucially, BHS’s turnover remained flat through much of Green’s tenure and declined in the latter years. Green initially cut costs but he did not grow the business.
  • One mechanism of (tax-lite) cash extraction to other Green family companies was through the sale of property: in 2001, BHS Group sold ten BHS stores for £106 million to Carmen Properties Ltd – a Jersey-registered company owned ultimately owned by Lady Green – as part of a sale-and-leaseback arrangement. BHS Ltd then paid rent to Carmen for the use of these properties. They were ultimately sold back to BHS as part of the sale to RAL for only £70m (with the proceeds of the sale going to Lady Green as the sole beneficial owner) but, over the lifetime of the sale-and-leaseback arrangement, rent of £153 million was paid by BHS to Carmen.

Egregious failures of corporate governance

  • Green’s rush to drive through the sale of BHS – “a chain that had become a financial millstone and threatened his reputation” – was the culmination of a sorry litany of failures of corporate governance and greed.  Regulatory concerns were circumvented, advisers were heavily incentivised to progress the deal. Dominic Chappell, his friends and associates were enticed by the personal rewards on offer without taking any personal risks. The Committees published for the first time with their report the Due Diligence reports produced by Olswang (and associated RAL Board minutes), which show their advice against the purchase and express concern that RAL were reliant on Green making good his unwritten assurances. (RAL= Retail Acquisitions Ltd.)
  • The complacent performance of Lord Grabiner as the non-executive Chairman of the Taveta group boards represented the apogee of weak corporate governance. It was his responsibility to provide independent challenge and oversight. Instead he was content to provide a veneer of establishment credibility to the group while happily disengaging from the key decisions he had a responsibility to scrutinise. For this deplorable performance he received a considerable salary. It is permissible in law for a director to delegate certain functions to other persons, but if a director allows himself to be dominated, or manipulated by one of their number, he may have gone beyond the boundaries of what is proper. He could be found to be in breach of duty and subject to disqualification. All directors of Taveta and RAL have serious questions to answer about their performance in those roles.
  • Green faced a considerable challenge in finding a credible buyer for a business that was consistently losing money and had a pension scheme with a large and growing deficit. It was clear that Chappell’s team were out of their depth, woefully short of the requisite experience and expertise, notably lacking the credible senior retailer Green once insisted on. They brought no new money to the deal, took no personal risk, could offer no equity and had no means of raising funds on a sustainable basis. Ultimately, Chappell and RAL failed all of Sir Philip’s nominal tests for a buyer. They were manifestly unsuitable owners of BHS. It is inconceivable that someone with Green’s experience seriously considered otherwise.

Collapse under incompetent and self-serving RAL

  • The report documents the true numbers behind the sale. The board of Taveta Investments Ltd was presented, two weeks after the event, with a rosy picture, while the reality was very different. The balance sheet included cash for immediate liabilities, property deals that took many months to materialise, funds that went to RAL never to return and equity that was a loan on punitive terms. It was patently obvious that there was not enough cash in BHS to give it a realistic chance of even medium term survival.
  • RAL’s failures include some blame for the pension scheme, which they accepted responsibility for with a “negligent and cavalier disregard for the risks and potential consequences”, negligence which “continued into their incompetent and self-serving ownership of the company”. In putting his “home team” first, Chappell and his fellow directors were personally enriched as BHS failed around them. Two directors jumped ship on the day that RAL acquired the business with personal financial rewards that it would take many BHS employees decades to  earn. The others continued to profit handsomely from their positions without fulfilling their requisite responsibilities.
  • In effect, Chappell “had his hands in the till”. His description of £2.6 million that he personally took, in addition to an outstanding £1.5 million family loan, as a “drip” in the ocean is an insult to the employees and pensioners of BHS that he let down.

Chairs’ comments

 Frank Field MP, Chair of the Work and Pensions Committee, said:

“One person, and one person alone, is really responsible for the BHS disaster. While Sir Philip Green signposted blame to every known player, the final responsibility for up to 11,000 job losses and a gigantic pension fund hole is his. His reputation as the king of retail lies in the ruins of BHS. His family took out of BHS and Arcadia a fortune beyond the dreams of avarice, and he’s still to make good his boast of ‘fixing’ the pension fund. What kind of man is it who can count his fortune in billions but does not know what decent behaviour is?”

Iain Wright MP, Chair of the Business, Innovation and Skills Committee, said:

“BHS’s demise has created many losers, particularly the 11,000 staff facing the loss of their jobs and the 20,000 pensioners facing significant reductions to their pensions. The actions of people in this sorry and tragic saga have left a stain on the reputation of business which reputable and honourable people in enterprise and commerce will find appalling. The sale of BHS in March 2015 is crucial to its eventual collapse a year later. The sale of BHS to a consortium led by a twice-bankrupt chancer with no retail experience should never have gone ahead; and this was obvious at the time. The reason it did, however, was Sir Philip Green. He was determined to get the deal done, no matter that the buyer could not deliver what BHS needed. There was a complete failure of corporate governance, with Sir Philip bulldozing the sale through, without proper oversight or challenge from his weak and impotent board.

While BHS staff face uncertain job prospects and pensioners worry about their future entitlements, it’s clear that a large cast of directors, advisers, and hangers-on enriched themselves off the back of BHS, including Dominic Chappell and his fellow RAL directors. Chappell took no risk and put no money into the venture and yet gained huge rewards as BHS crumbled around him. His failure is bad enough but that he effectively had his hands in the till is an insult to the employees and pensioners of BHS that he let down so badly.”

In response to the Government’s consultation on corporate reform, the Work and Pensions Committee’s most recent report says that the corporate governance and reporting requirements for public listed companies should be extended to private companies that have an important social impact: large private companies and those with over 5,000 defined benefit pension scheme members.

It also says that company directors should have a new duty to pension fund trustees, as the representatives of pension scheme members, in addition to those stakeholders they are already obliged to have regard to. Allied to the more substantial recommendations on pension law and regulation in its December 2016 Report, the Committee concluded these changes would reduce the chance of another company collapsing in the manner of BHS.

The key themes that emerged during the inquiry included:

  • lamentable corporate governance in what was a large private company
  • a paucity of publicly available information about the state of the company and its pension fund
  • the absence of a voice in the running of the company for those who relied on its success for the security of their pension saving.

Committee recommendations

Holding company directors to account

  • Public listed companies are required to comply with the Financial Reporting Council Corporate Governance Code and its reporting requirements or publicly explain why they are not. This is a proportionate approach for companies of social importance. Transparency about governance arrangements, performance and risk can better equip stakeholders to hold company directors to account. Wider awareness of the state of the BHS pension schemes may have pressured Sir Philip Green into taking more reparative action, sooner.

Large companies should be subject to the Financial Reporting Council Corporate Governance Code

  • Private companies that are large, as defined by Government, or have over 5,000 defined benefit pension scheme members, should be made subject to the the Financial Reporting Council (FRC) Corporate Governance Code on a comply or explain basis. The report includes a table of the top 30 largest private companies in the UK, with many household names like John Lewis, Clarks, Matalan, Virgin Atlantic, River Island, Pret a Manger – and the Arcadia Group – that would fall under the parameters of this recommendation. Many well-governed large private companies already follow best practice on transparency.

Include pension scheme trustees in section 172 of Companies Act

  • Pension scheme trustees should be added to section 172(1) of the Companies Act 2006. The list of stakeholders company directors must have regard to – and report on the exercise of their duties to – does not include defined benefit pension scheme beneficiaries or the trustees who must act in their interests. Incomes of pensioners in retirement are reliant on the sustained success of the sponsoring company but they are at particular risk of being neglected in corporate decision making as no one makes the case for former employees. The inclusion of pension scheme trustees in section 172 might increase the chances both that directors would take into account the interests of current and future pensioners in carrying out their duties, and that those who have failed to do so will be held accountable in the courts.

Publication of Insolvency Service investigation reports

Publication of correspondence with Arcadia

The Committee publishes with the report a series of correspondence with Ian Grabiner, Arcadia Chief Executive, and the Arcadia Group pension trust, charting its efforts to get information about the group’s pension schemes into the public domain. Arcadia’s pension schemes are over £200 million in deficit, but all parties have refused to provide information regarding the 2013 valuation and recovery plan, or the levels of employer contributions.

Chair’s comment

Frank Field MP, Chair of the Committee, said:

“For a company with a big social and economic footprint like BHS it is simply not enough to be accountable to shareholders – particularly when one shareholder owns most of the stock. The sorry tale of its sale and collapse, putting 11,000 people out of work and leaving a pension fund £571million in the red, with 20,000 pensioners facing an uncertain financial future, was a result of gross failures of corporate governance. Would the story have played out the same way if its directors had to be open about the financial decisions they were making for its future? The finances and leadership of a company with so many people depending on it should be open to scrutiny.

We have already expressed our grave concerns about corporate governance in the Green empire, and we know the Arcadia pension fund is also now in substantial deficit. We have been pressing Arcadia’s directors and pension trustees for detailed information on their schemes but very little is published and neither the company nor the trustees – who unlike the BHS schemes do not have an independent Chair – will tell us. Does Sir Philip not want us to know that he was being relatively generous to the Arcadia schemes while the BHS schemes floundered and the company headed inexorably for insolvency? Was he neglecting both? It can’t be right that basic information like the schedule of employer contributions and the length of the recovery plan is not in the public domain. If it goes under then levy-payers and pensioners foot the bill.”

You can read the full consultation response on corporate governance reform from the Work and Pensions Committee here.

804-cover-1200

You can watch Philip Green present evidence on the collapse of BHS to the Business, Innovation and Skills Committee and Work and Pensions Committee, Wednesday 15 June 2016 here:  https://goo.gl/eeUggP

Related

In 2010, UK Uncut’s spokesman, Daniel Garvin, said: “Philip Green is a tax avoider, and yet is regarded by David Cameron as an appropriate man to advise the government on austerity. His missing millions need to be reclaimed and invested into public services not into his wife’s bank account.”  See: Philip Green to be target of corporate tax avoidance protest The Guardian.


I don’t make any money from my work. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton cards

Critique of the ‘Origins of Happiness’ study. Psychologists Against Austerity respond

PAA-550x369

Clinical psychologists have widely criticised Labour peer and economist, Richard Layard, over research he led that claims failed relationships and physical and mental illness were bigger causes of misery than poverty. 

“Happiness scholars” and authors of the study report, Andrew Clark, Sarah Fleche, Richard Layard, Nattavudh Powdthavee and George Ward say:

“Understanding the key determinants of people’s life satisfaction will suggest policies for how best to reduce misery and promote wellbeing. This column discusses evidence from survey data on Australia, Britain, Germany, and the US which indicate that the things that matter most are people’s social relationships and their mental and physical health; and that the best predictor of an adult’s life satisfaction is their emotional health as a child.”

In the their study, the Origins of Happiness, the authors call for a new focus for public policy: not ‘wealth creation’ but ‘wellbeing creation.'”

The authors say: “Most human misery is due not to economic factors but to failed relationships and physical and mental illness. Eliminating depression and anxiety would reduce misery by 20% while eliminating poverty would reduce it by 5%. And on top of that, reducing mental illness would involve no net cost to the public purse.” 

So the authors propose the delivery of more Cognitive Behavioural Therapy (CBT), whilst income redistribution and social justice perspectives are considered trivial and insignificant because they are deemed too costly. Layard in particular enthusiastically endorses CBT, which he regards as the modern evidence-based psychological therapy of choice. Layard was one of the key signatories of The Depression Report, and one of the main campaigners, along with David Clark, for the Increasing Access to Psychological Therapies (IAPT) programme, which has entailed the mass provision of CBT.

CBT is a cheap, short-term, goal-oriented treatment that practitioners claim takes a “hands-on, practical approach to problem-solving.” Its goal is to change patterns of thinking or behaviour that are claimed to be behind people’s difficulties, and so change the way they feel about their circumstances. However, I have critiqued this approach more than once. 

I’ve also critiqued the use of quantitative methodology and survey methods more generally in policy-making, as such methods frequently fail to pay due regard to authenticity, reliability and validity, inclusion and full participation: quantitative methods tend to be used non-prefiguratively. (See for example: The importance of citizen’s qualitative accounts in democratic inclusion and political participation.)

 what-is-the-spread-of-incomes-in-the-uk-2014-15

Happiness is a neoliberal warm gun: depopulating policy

CBT is of course premised on the assumption that interpreting situations “negatively” is a bad thing, and that thinking positively about bad events is beneficial.

The onus is on the individual to adapt by perceiving their circumstances in a stoical and purely “rational” way. CBT is primarily about self-governance techniques.

So we need to ask what are the circumstances that the authors are expecting people to accept stoically. Socioeconomic inequality? Absolute poverty? Sanctions? Work fare? Being forced to accept very poorly paid work, abysmal working conditions and no security? The loss of social support, public services and essential safety nets? Starvation and destitution? Political authoritarianism? The end of democracy?

It’s all very well challenging people’s thoughts but for whom is CBT being used, and for what purpose? It seems to me that this is about helping those people on the wrong side of draconian government policy to accommodate that, and to mute negative responses to negative situations. CBT in this context is not based on a genuinely liberational approach, nor is it based on any sort of democratic dialogue. It’s all about modifying and controlling behaviour, particularly when it’s aimed at such narrow, politically defined and specific economic outcomes, which extend and perpetuate inequality. In this context, CBT becomes state “therapy” used only as an ideological prop for neoliberalism.

CBT is too often founded on blunt oversimplifications of what causes human distress – for example, it is currently assumed that the causes of unemployment are psychological rather than sociopolitical, and that particular assumption authorises intrusive state interventions that encode a Conservative moral framework, which places responsibility on the individual, who is characterised as “faulty” in some way. The deeply flawed political/economic system that entrenches inequality isn’t challenged at all: its victims are discredited and stigmatised instead.

Yet historically (and empirically), it has been widely accepted that poverty significantly increases the risk of mental health problems and can be both a causal factor and a consequence of mental ill health. Mental health is shaped by the wide-ranging characteristics and circumstances (including inequalities) of the social, economic and physical environments in which people live. Successfully supporting the mental health and wellbeing of people living in poverty, and reducing the number of people with mental health problems experiencing poverty, requires engagement with this complexity. (See: Elliott, I. (June 2016) Poverty and Mental Health: A review to inform the Joseph Rowntree Foundation’s Anti-Poverty Strategy. London: Mental Health Foundation).

In the social sciences there is a longstanding and unresolved debate over the primacy of structure or agency in shaping human behaviour. Structure is the recurrent patterned social, economic and political arrangements which influence or limit the choices and opportunities available to citizens. Agency is the capacity of individuals to act autonomously and independently of “outside forces” to make their own free choices. 

Layard et al. dismiss the importance of context on human behaviours, cognitions, perceptions, attitudes and states of mind, and the study is premised and proceeds as if this controversy has been resolved. It hasn’t. 

Such an approach crucially overlooks conflict, the impacts of political decision-making, economic arrangements, social structure, prevailing cultural norms and ideologies, for example.

Rather predictably, Layard’s approach to research (for he’s an economist, not a psychologist, hence his approach shares more in common with the behavioural economists from the cost-cutting, antidemocratic Nudge Unit) conflates human needs and wellbeing with narrow ideological (antiwelfarist, “small state” neoliberal) outcomes, by removing any consideration of the complex interactions, constraints and impacts of the economic, social, cultural and political context on human happiness. Layard’s neuroliberal approach therefore may be read as an endorsement of existing socioeconomic inequalities. 

Furthermore, definitions of “happiness” are culturally specific. They are susceptible to culturally (and politically defined) dominant moral judgements. The happiness imperative may be regarded as an artifact of modern history, not as an inherent feature of the human condition. Across cultures and time, happiness has most frequently been defined as “good luck” and arising because of favourable external conditions. Some definitions place notions of a virtuous life and “hard work” as essential and central qualities of happiness. It’s worth noting that from 1997 to 2001, Layard was an adviser to New Labour and one of the key architects of the “New Deal” and “Welfare to Work” policies. He certainly has clearly defined ideological inclinations.

In those countries with a dominant ideology that is founded on competitive individualism, such as the US and the UK, the definitions of happiness and wellbeing based on chance and context were replaced by definitions focused on favourable internal feelings and states. In other words, happiness came to be regarded as an inner state that we have some personal control over. The significant rise in the availability and popularity of “self help” literature in the western world is a testament of this view that the happiness of citizens is a personal responsibility, and not a political one.

A central theme in this individualist approach is a relentless optimism about the capacity of individuals to improve their own mental health, and accept things as they are in order to bask in earned and fully deserved human happiness and fulfilment. The starting point of the self help perspective, (dating back to Samuel Smiles and his moralising, conservative disquisitions on Thrift and Self help: the austerity ideologue of mid Victorian laissez faire) is that the world is basically okay, the problems arising at an individual level are simply because of how we choose to perceive it – this is reflected in an emphasis on the necessity of changing the way you see and think about the world, particularly in neoliberal economies. It’s very clear why CBT is so appealing to the UK Conservative government. It doesn’t challenge the status quo at all. 

Establishing happiness as a metric is only meant to serve a political end. Indeed, it may even be regarded as a form of political gaslighting. I’m not alone in my concern that “happiness” research could be used to advance authoritarian aims. Studies show that in European elections since 1970, the subjective “life satisfaction” of citizens is the best predictor of whether the government gets re-elected  – this apparently is much more important than economic growth, social conditions, unemployment or inflation.

CBT is the modern descendant of the discredited, ever so quantitative behaviourist tradition, spearheaded by B.F. Skinner, who views persons as nothing more than empty and simple mediators between behaviour and the environment. Integral to this perspective of behaviourism is the concept of behaviour modification through rewards or “consequences.” This has been politically translated into a reductionist economic language of incentives and outcomes. (Stimulus => response.)

This is paralleled with the growth of nudge, which is a technocratic behaviourist solution and ideological prop in the form of behavioural economics, which is also all about generating public policies that aim to quantifiably change the perceptions and behaviours of citizens, aligning them with narrow neoliberal outcomes.

Even the likes of Oliver James (author of Affluenza and The Selfish Capitalist, among other works) critique the symptoms of neoliberal policies rather than the disease: neoliberalism itself.

This is precisely why independent research findings consistently highlight the value of adopting less idiomatic and more value neutral historical, political, cultural and linguistic perspective in the study of public happiness.

00122e59eb74fe0acab5f6838951c280

I think it’s fair to say that mental illness is not caused by just one thing. Poverty can be one factor or trigger that interacts with a complexity of other events, such as adverse life events, genetic predisposition, poor physical health or substance abuse. But so far, the strongest evidence suggests that poverty can lead to mental illness, especially disorders such as depression.

Living in poverty causes chronic distress and struggle. Failure to meet basic human needs certainly has an impact on human and social potential – Abraham Maslow explored how our cognitive priorities are reduced when our physiological needs are not met or our survival is threatened. Struggle and distress may have an ultimate biological impact on brain function. According to one controversial hypothesis, schizophrenia is the result of chronic experience of social adversity and defeat, which disturbs the dopamine level and function in the brain, for example.

 maslows_hierarchy_of_needs-4

A report published by the World Health Organization this year strongly suggests that poor individuals are twice as affected by mental health conditions compared to rich individuals. The report concludes: “Whilst the relationship between poverty and mental health is complicated, individual measures taken to reduce global poverty are likely to have positive impacts on mental health issues in underprivileged populations.”

Regardless, a society may be judged on how it treats its most disadvantaged citizens. The harrowing problems of poverty, as described in Charles Dickens’ David Copperfield, and social rehabilitation, or lack of it, as portrayed by Victor Hugo in Les Misérables, sadly remain as pressing today.

The statement from Psychologists Against Austerity

The Origins of happiness study overlooked the social and political context of mental health, say campaign group Psychologists Against Austerity. This lets politicians and the architects of austerity off the hook.

The London School of Economics (LSE) study, led by Layard, was published in early December. The report claims that eliminating depression and anxiety would be a cheap way to reduce misery by 20 per cent, while eliminating poverty would be more difficult – and, besides, it would only reduce unhappiness by 5 per cent.

Psychologists against austerity (PAA) have condemned the stark and simplistic dichotomy presented in the report between income and mental illness as predictors of life satisfaction.

In a response published online, the group, which is made up of practising mental health professionals, highlighted the fact “some media reports have gone further, apparently taking the results to imply that there is no causal relationship between poverty and mental illness”, and blamed the researchers for not making the complex relationship between poverty and mental health clearer. According to the psychologists, the two things “are related in a complex variety of ways, with both causally influencing the other”.

The group of psychologists said it was easy for the researchers to downplay the link in their findings, because the relationship is not as simple as happiness being dependent on income alone.

“Living in poverty is more stressful, with fewer buffers, so challenges are more likely to be catastrophic,” their statement said. “People living in poverty have less agency and control over their lives, and live with lower status, often accompanied by stigma, powerlessness and shame.”

Layard’s emphasised that as UK average incomes have increased, the country has not got happier. But PAA point out that in addition to becoming richer, Britain has also become a profoundly more unequal society since the 1980s.

The original study states that relative poverty is more important than absolute poverty in mental health terms, but does discuss this in detail.

Decades of previous research supports PAA’s statement, and many individual psychologists and academics agree with the anti-austerity group’s statement. 

The study “lets politicians off the hook, it lets austerity off the hook” by treating mental illness as if it exists in a void and is not intrinsically linked to societal factors, director of clinical psychology at Canterbury Christ Church University, Dr Anne Cooke, told the Guardian:

“It says that all that doesn’t matter, making a better society doesn’t matter, just offering technical treatments,” she said. “I am one of the people that offers technical treatments and I think they can be extremely helpful to some people but that argument is being stretched beyond the point at which it applies.”

Dr Peter Kinderman, president of the British Psychological Society, has said he welcomed Lord Layard’s call for a focus on national wellbeing through investment in mental health services. But he added, speaking to the Guardian, that he had misgivings about how the study had treated mental illness as a distinct variable from human misery.

Layard’s work has previously led to David Cameron’s adoption of national “wellbeing” statistics, and he was also a driving force behind the adoption of the Improving Access to Psychological Therapies to increase access to “talking therapies” on the NHS.

That latter policy was particularly controversial because it established finding work as an outcome of psychological treatment, which critics said may not be a suitable outcome for some and encouraged a policy of forcing people into work which may not be appropriate for them. PAA and other campaign groups have previously called aspects of the scheme’s implementation “profoundly disturbing”, attacking 2015 plans by then-chancellor George Osborne to link welfare and therapy by placing IAPT therapists in job centres. Layard, who is an economist rather than a psychologist, is now calling for a “new role for the state” that “swaps wealth creation for wellbeing creation” through targeted mental health interventions.

The LSE study has worried psychologists because Layard is highly influential with policymakers. The Labour peer’s recommendations previously led David Cameron to adopt national wellbeing statistics, and Lord Layard was also a driving force behind the Improving Access to Psychological Therapies (IAPT) scheme to increase access to “talking therapies” on the NHS.

Dr Jay Watts, a clinical psychologist, told the Guardian Layard’s call “negates decades worth of data linking mental health to poverty”.

“It’s ripe for misuse … in the current political climate,” she added.

Dr Anne Cooke said there were better ways to improve wellbeing than by focusing on isolated mental health interventions. Policy should take a more holistic public health approach, she proposed.

“Cholera wasn’t eradicated by developing new treatments, it was eradicated by improving drains back in pre-Victorian times.

What [Layard] neglects is the people at the bottom of the pile who are really, really struggling, and in current circumstances there are a lot of them. People who you see at food banks for example, who are in incredible distress and certainly would – most of them or a lot of them – meet the criteria for an anxiety disorder or depression,” she said.

But it’s largely a response to their circumstances. If we do something about that, rates of mental illness in the population are going to come down a lot more effectively than providing a lot more therapy.”

Meanwhile, PAA suggested that rather than doing nothing to help the most disadvantaged people, the study could actually contribute to perpetuating poverty.

“Discussions of mental health that leave out a thorough analysis of poverty and income inequality may be used uphold policies that maintain disadvantage and oppression in society,” the group said.

You can read PAA’s full response here

 

b

Adults in the poorest fifth are much more likely to be at risk of developing a mental illness as those on average incomes: around 24% compared with 14%.

cp5w8ifxgaauf-u

Related

The Psychological Impact of Austerity – Psychologists Against Austerity

Psychologists Against Austerity: mental health experts issue a rallying call against coalition policies 

The power of positive thinking is really political gaslighting

 


I don’t make any money from my work. But you can contribute by making a donation and help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton cards

Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died.

pizapcom14829621211221

Abbie and her late father, James Harrison.

Julia Savage is a manager at Birkenhead Benefit Centre in Liverpool. She wrote a letter addressed to a GP regarding a seriously ill patient. It said:

“We have decided your patient is capable of work from and including January 10, 2016.

“This means you do not have to give your patient more medical certificates for employment and support allowance purposes unless they appeal against this decision.

“You may need to again if their condition worsens significantly, or they have a new medical condition.” 

The patient, James Harrison, had been declared “fit for work” and the letter stated that he should not get further medical certificates. 

However, 10 months after the Department for Work and Pensions (DWP) contacted his doctor without telling him, James died, aged 55, the Daily Record has reported.

He was clearly not fit for work.

His grieving daughter, Abbie, said: “It’s a disgrace that managers at the Jobcentre, who know nothing about medicine, should interfere in any way in the relationship between a doctor and a patient.

“They have no place at all telling a doctor what they should or shouldn’t give a patient. It has nothing to do with them.

“When the Jobcentre starts to get involved in telling doctors about the health of their patients, that’s a really slippery slope.”

Abbie said James had worked since leaving school at a community centre near his home. But his already poor health went downhill after the centre was shut down because of austerity cuts.

James had a serious lung condition and a hernia before the centre closed, and also developed depression and anxiety afterwards.

Abbie said: “He’d worked all his life. He wasn’t the kind of guy who knew anything about benefits.

“But as his health deteriorated, there wasn’t any chance he could do a job. He applied for employment and support allowance.”

James received Employment and Support Allowance (ESA), but only at the low rate of £70 a week, the same amount as jobseekers’ allowance. He was then sent to attend one of the DWP’s controversial Work Capability Assessments – and declared fit for work.

Despite that decision, Abbie said James remained in constant need of medical help and had to visit his doctor regularly.

However, the GP concerned repeatedly refused to give him a sick note, and James began to suspect the Jobcentre were to blame for this.

Abbie said: “He really needed a note. He was too ill to go to the constant appointments at the Jobcentre and he didn’t want to be sanctioned.

“He became convinced the DWP had been talking to his doctor behind his back.”

Although Abbie felt her father was confused, and didn’t think his explanation was right at the time, she later asked to see her father’s medical records. She found the letter in his file from Julia Savage, the manager at Birkenhead Benefit Centre, in James’s home city of Liverpool.

The letter was addressed to James’s GP.

Context: Government claims that work is a “health outcome”

James Harrison was very worried that his ill health interfered with his obligation to comply with the inflexible and constant conditions attached to his eligibility for welfare support, and that this would lead to sanctions – the withdrawal of his lifeline support, which was calculated to meet basic survival needs only.

The GP should have provided evidence that this was the case. The doctor was advised not to provide further fit notes by the DWP, however, unless James appealed. Yet the circumstances warranted that the GP provide a fit note. 

fit-note-guidance

Last year, the Department for Work and Pensions issued an ideologically directed new guidance to GPs regarding when they should issue a Fit Note. This was updated in December 2016.

In the document, doctors are warned of the dangers of “worklessness” and told they must consider “the vital role that work can play in your patient’s health”.  According to the department, “the evidence is clear that patients benefit from being in some kind of regular work”.

The biopsychosocial model, with a current political emphasis on the psychological element, has become a disingenuous euphemism for psychosomatic illness, which has been exploited by successive governments (and rogue insurance companies) to limit or deny access to social security, medical and social care.

Nobody would deny that illness has biological, psychological and social dimensions, however, the model has been adapted to fit a neoliberal “small state” ideology – one that rests almost entirely on Conservative individualist notions of citizen responsibility, as opposed to a rights-based approach and provision of publicly funded state support.

This approach to disability and ill health has been used by the government to purposefully question the extent to which people claiming social security bear personal responsibility for their own health status, rehabilitation and prompt return to work. It also leads to the alleged concern that a welfare system which was originally designed to provide a livable income to those with disabling health problems, may provide “perverse incentives” for perverse behaviours, entrenching “worklessness” and a “culture of dependency”. It’s worth pointing out at this point that there has never been any empirical evidence to support the Conservative notion of welfare “dependency”. 

Instead of being viewed as a way of diversifying risk and supporting those who have suffered misfortune and ill health, social and private insurance systems are to be understood as perverse incentives that pay people, absurdly, to remain ill and keep them from being economically productive.

The idea that people remain ill deliberately to avoid returning to work  – what Iain Duncan Smith and David Cameron have termed “the sickness benefit culture” – is not only absurd, it’s very offensive. This is a government that not only disregards the professional judgements of doctors, it also disregards the judgements of sick and disabled people. However, we have learned over the last decade that political “management” of people’s medical conditions does not make people healthier or suddenly able to work. Government policies, designed to “change behaviours” of sick and disabled people have resulted in harm, distress and sometimes, in premature deaths

The government have made it clear that there are plans to merge health and employment services. In a move that is both unethical and likely to present significant risk of harm to many patients, health professionals are being tasked to deliver benefit cuts for the DWP. This involves measures to support the imposition of work cures, including setting employment as a clinical outcome and allowing medically unqualified job coaches to directly update a patient’s medical record.

The Conservatives (and the Reform think tank) have also proposed mandatory treatment for people with long term conditions (which was first flagged up in the Conservative Party Manifesto) and this is currently under review, including whether benefit entitlements should be linked to “accepting appropriate treatments or support/taking reasonable steps towards “rehabilitation”.  The work, health and disability green paper and consultation suggests that people with the most severe illnesses in the support group may be subjected to welfare conditionality and sanctions.

Many campaigners have raised concerns about the DWP interfering with people’s medical care and accessing their medical files. I wrote an article last year about how the government plans to merge health and employment services and are now attempting to redefine work as a clinical outcome. I raised concerns about the fact that unemployment has been stigmatised and politically redefined as a psychological disorder, and that the government claims, somewhat incoherently, that the “cure” for unemployment due to illness and disability, and sickness absence from work, is work.

In a critical analysis of the recent work, health and disability green paper, I said: 

“And apparently qualified doctors, the public and our entire health and welfare systems have ingrained “wrong” ideas about sickness and disability, especially doctors, who the government feels should not be responsible for issuing the Conservatives recent Orwellian “fit notes” any more, since they haven’t “worked” as intended and made every single citizen economically productive from their sick beds.

It seems likely, then, that a new “independent” assessment and some multinational private company will most likely very soon have a lucrative role to ensure the government get the “right” results.”

The medical specialists are to be replaced by another profiteering corporate giant who will enforce a political agenda in return for big bucks from the public purse. Health care specialists are seeing their roles being incrementally and systematically  de-professionalised. That means more atrocious and highly irrational attempts from an increasingly authoritarian government at imposing an ideological “cure” – entailing the withdrawal of any support and imposing punitive “behavioural incentives” – on people with medical conditions and disabilities. Doctors, who are clever enough to recognise, diagnose and treat illness, are suddenly deemed by this government to be insufficiently clever to judge if patients are fit for work.

The political de-professionalisation of medicine, medical science and specialisms (consider, for example, the implications of permitting job coaches to update patient medical files), the merging of health and employment services and the recent absurd declaration that work is a clinical “health” outcome, are all carefully calculated strategies that serve as an ideological prop and add to the justification rhetoric regarding the intentional political process of dismantling publicly funded state provision, and the subsequent stealthy privatisation of Social Security and the National Health Service. 

“De-medicalising” illness is also a part of that process:

“Behavioural approaches try to extinguish observed illness behaviour by withdrawal of negative reinforcements such as medication, sympathetic attention, rest, and release from duties, and to encourage healthy behaviour by positive reinforcement: ‘operant-conditioning’ using strong feedback on progress.” Gordon Waddell and Kim Burton in Concepts of rehabilitation for the management of common health problems. The Corporate Medical Group, Department for Work and Pensions, UK. 

Waddell and Burton are cited frequently by the DWP as providing “evidence” that their policies are “evidence based.” Yet the DWP have selectively funded their research, which unfortunately frames and constrains the theoretical starting point, research processes and the outcomes with a heavy ideological bias. 

This framing simply shifts the focus from the medical conditions that cause illness and disability to the “incentives”, behaviours and perceptions of patients and ultimately, to neoliberal notions of personal responsibility and self-sufficient citizenship in a context of a night watchman, non-welfare state. 

Medication, rest, release from duties, sympathetic understanding – the remedies to illness – are being appallingly redefined as “perverse incentives” for ill health, yet the symptoms necessarily precede the prescription of medication, the Orwellian renamed (and political rather than medical) “fit note” and exemption from work duties. Notions of “rehabilitation” and medicine are being redefined as behaviour modification: here it is proposed that operant conditioning in the form of negative reinforcement – which the authors seem to have confused with punishment – will “cure” ill health. 

People cannot simply be “incentivised” into not being ill. 

The political use of the biopsychosocial model to cut costs at the expense of people who are ill will undoubtedly have further extremely serious implications. Such an approach, which draws on behaviourism and punishment (such as the threat and implementation of sanctions) is extremely unethical and makes the issue of consent to medical treatment very problematic if it is linked to the loss of lifeline support or the fear of loss of benefits.

This is clearly the direction that government policy is moving in and this represents a serious threat to the health, welfare, wellbeing and human rights of patients and the political independence of health professionals.

75629_107145729354964_2536493_n

 


 

I don’t make any money from my work. But you can contribute by making a donation and help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton cards

 

The government’s in-work sanctions are incompatible with ‘halving the disability employment gap’ (and other ideological problems)

imgres

The government have introduced in-work sanctioning for low paid and part-time workers to “incentivise” them to “progress” in work. Historically, wages and employment conditions were raised, and hours were often negotiated by Trade Unions. Now those decisions are entirely down to the executive decisions of employers not employees. Sanctioning employees is grossly unfair, because they have very little negotiating and bargaining power (especially since the raft of Conservative anti-collectivist and anti-Trade Union legislation) to improve their lot.

There is also a significant growing body of empirical evidence that informs us sanctions do not work as the government claim.

It’s not as if employees’ behaviour is at fault or that they would ever actually want poor pay, fewer rights and adverse working conditions – that’s down to exploitative employers who are primarily profit driven. It’s hardly fair to punish workers for the motivations and behaviour of their employers.

There are profoundly conflicting differences in the interests of employers and employees. The former are generally strongly motivated to purposely keep wages as low as possible so they can generate profit and pay dividends to shareholders and the latter need their pay and working conditions to be such that they have a reasonable standard of living. 

Clearly, the weight of favour in policy-making is heavily towards big business profiteering. Implying that the behaviours of workers are a problem in this context is simply another way justification is presented for the further erosion of state responsibility and support and ultimately, the long term plan is to remove such support completely.

Workplace disagreements about wages and conditions are now typically resolved neither by collective bargaining nor litigation but are left to management prerogative. This is because Conservative aspirations are clear. Much of the government’s discussion of legislation is preceded primarily with consideration of the value and benefit for big business and the labour market. They want a cheap labour  force and low cost workers, unable to withdraw their labour, unprotected by either Trade Unions or employment rights and threatened with destitution via benefit sanction cuts if they refuse to accept low paid, low standard work. Similarly, desperation and the “deterrent” effect of the 1834 Poor Law Amendment Act – the principle of less eligibility – also served to drive down wages.

In the Conservative’s view, trade unions distort the free labour market which runs counter to New Right and neoliberal dogma. Since 2010, the decline in UK wage levels has been amongst the very worst in Europe. The fall in earnings under the Coalition is the biggest in any parliament since 1880, according to analysis by the House of Commons Library, and at a time when the cost of living has spiraled upwards.

In-work conditionality enforces a lie and locates blame within individuals for structural problems – political, economic and social – created by those who hold power. Despite being a party that claims to support “hard-working families,” the Conservatives have nonetheless made several attempts to undermine the income security of a significant proportion of that group of citizens recently. Their proposed tax credit cuts, designed to creep through parliament in the form of secondary legislation, which tends to exempt it from meaningful debate and amendment in the Commons, was halted only because peers in the House of Lords have been paying attention to the game.

Sanctioning people in work flies in the face of the government’s previous “hard working families” mantra. But it also flies in the face of their aim to “help” disabled people into work. Many of disabled people would have to work part-time: reduced and flexible hours are also a reasonable adaptation, especially for people who are ill. Many of us also have to accommodate hospital appointments, often with a variety of specialists, as well as hospital based treatment regimes. All of which probably makes us much more likely to face in-work sanctioning in the future.

How does this address the “disability employment gap”? 

The government propose tax cuts and other rewards for employers who employ disabled people in their recent consultation on work, health and disability. However, it is against the law to treat someone less favourably than someone else because of a personal characteristic, such as being disabled.

Furthermore, disabled people have a legal RIGHT to work and to be included in the economy, and I think in light of this, employers should be fined for not employing a quota of disabled people instead. “Disability Confident” is supposed to be about supporting disabled people, not providing publicly funded handouts to employers, whilst at the same time, financially punishing the very people that the policy is supposedly designed to “support.”

There was some very worrying discussion in the recent work health and disability green paper about new mandatory “health and work conversations” in which work coaches will use “specially designed techniques” to “help” disabled Employment and Support Allowance (ESA) claimants “identify their health and work goals, draw out their strengths, make realistic plans, and build resilience and motivation.” Apparently these conversations were “co-designed with disabled people’s organisations and occupational health professionals and practitioners and the Behavioural Insights Teamthe controversial Nudge Unit, which is part-owned by the Cabinet Office and Nesta. 

It’s very evident that “disabled people’s organisations” were not major contributors to the design. It’s especially telling that those people to be targeted by this “intervention” were completely excluded from the conversation. Sick and disabled people are reduced to objects of public policy, rather than being seen as citizens and democratic subjects capable of rational dialogue.

Systematically reducing social security, and increasing conditionality, particularly in the form of punitive benefit sanctions, doesn’t “incentivise” people to look for work. It simply means that people can no longer meet their basic physiological needs, as benefits are calculated to cover only the costs of food, fuel and shelter. In fact sanctioning people make it less likely that they will find work.

Food deprivation is closely correlated with both physical and mental health deterioration. Maslow explained very well that if we cannot meet basic physical needs, we are highly unlikely to be able to meet higher level psychosocial needs. The government proposal that welfare sanctions will somehow “incentivise” people to look for work is pseudopsychology at its very worst and most dangerous. State imposed sanctions on sick and disabled people are known to have very harmful consequences. In fact sanctions create significant difficulties and distress for everyone subjected to them. (See also An example of in-work conditionality: when work doesn’t pay).

In the UK, the government’s welfare “reforms” have further reduced social security support, originally calculated to meet only basic physiological needs, which has had an adverse impact on people who rely on what was once a social safety net. Poverty is linked with negative health outcomes, but it doesn’t follow that employment will alleviate poverty sufficiently to improve health outcomes.

In fact record numbers of working families are now in poverty, with two-thirds of people who found work in 2014 taking jobs for less than the living wage, according to the annual report from the Joseph Rowntree Foundation a year ago.

Essential supportive provision is being systematically reduced by increasing conditionally; by linking support to such a narrow outcome – getting a job – and this will ultimately reduce every service to nothing more than a state behaviour modification programme based on punishment, with a range of professionals being politically co-opted as state enforcers of an ideology  which is perpetuating and accentuating socioeconomic problems in the first place.

Work is not a “health” outcome

The Government is intending to “signpost the importance of employment as a health outcome in mandates, outcomes frameworks, and interactions with Clinical Commissioning Groups.”

A Department for Work and Pensions research document published back in 2011 – Routes onto Employment and Support Allowance – said that if people believed that work was good for them, they were less likely to claim or stay on disability benefits.

It was decided that people should be “encouraged” to believe that work was “good” for health. There is no empirical basis for the belief, and the purpose of encouraging it is simply to cut the numbers of disabled people claiming ESA by “encouraging” them into work. Some people’s work is undoubtedly a source of wellbeing and provides a sense of purpose. That is not the same thing as being “good for health”.

For a government to use data regarding opinion rather than empirical evidence to claim that work is “good” for health indicates a ruthless mercenary approach to fulfill their broader aim of dismantling social security and to uphold their ideological commitment to supply-side policy.

From the document: “The belief that work improves health also positively influenced work entry rates; as such, encouraging people in this belief may also play a role in promoting return to work.”

The aim of the research was to “examine the characteristics of ESA claimants and to explore their employment trajectories over a period of approximately 18 months in order to provide information about the flow of claimants onto and off ESA.”

The document also says: “Work entry rates were highest among claimants whose claim was closed or withdrawn suggesting that recovery from short-term health conditions is a key trigger to moving into employment among this group.”

“The highest employment entry rates were among people flowing onto ESA from non-manual occupations. In comparison, only nine per cent of people from non-work backgrounds who were allowed ESA had returned to work by the time of the follow-up survey. People least likely to have moved into employment were from non-work backgrounds with a fragmented longer-term work history. Avoiding long-term unemployment and inactivity, especially among younger age groups, should, therefore, be a policy priority. ” 

“Given the importance of health status in influencing a return to work, measures to facilitate access to treatment, and prevent deterioration in health and the development of secondary conditions are likely to improve return to work rates”

The government made a political and a particularly partisan decision, rather than one that has any an evidence base, to promote the cost-cutting and unverified, irrational belief that work is a “health” outcome.

Furthermore, the research does conclude that health status itself is the greatest determinant in whether or not people return to work. That means that those not in work are not recovered and have longer term health problems that tend not to get better.

Work does not “cure” ill health. To mislead people in such a way is not only atrocious political expediency, it’s actually potentially downright harmful and dangerous.

The government’s Work and Health programme involves a plan to integrate health and employment services, aligning the outcome frameworks of health services, Improving Access To Psychological Therapies (IAPT), Jobcentre Plus and the Work programme.

2020health – Working Together is a report from 2012 that promotes the absurd notion of work as a health outcome. This is a central theme amongst the ideas that are driving the fit for work and the work and health and programme. Developing this idea further, Dame Carol Black and David Frost’s Health at Work – an independent review of sickness absence was aimed at reviewing ways of “reducing the cost of sickness to employers, ‘taxpayers’ and the economy.”

Seems that the central aim of the review wasn’t a genuine focus on sick and disabled people’s wellbeing and “health outcomes,” then. Black and Frost advocated changing sickness certification to further reduce the influence of GPs in “deciding entitlement to out-of-work sickness benefits.”

The subsequent “fit notes” that replaced GP sick notes (a semantic shift of Orwellian proportions) were designed to substantially limit the sick role and reduce recovery periods, and to “encourage” GPs to disclose what work-related tasks patients may still be able to perform. The idea that employers could provide reasonable adjustments that allowed people who are on sick leave to return to work earlier, however, hasn’t happened in reality.

The British Medical Association (BMA) has been highly critical of the language used by the government when describing the fit for work service. The association said it was “misleading” to claim that fit for work was offering “occupational health advice and support” when the emphasis was on sickness absence management and providing a focused return to work.

The idea that work is a “health” outcome is founded on an absurd and circular Conservative logic: it’s an incorrect inference based on the fact that people in work are healthier than those out of work. It’s true that they are, however, the government have yet again confused causes with effects. Work does not make people healthier: it’s simply that healthy people can work and do. People who have long term or chronic illnesses most often can’t work. It has been historically  and empirically established that poverty is closely correlated with disproportionate levels of ill health, and it’s most probable that targeted austerity, leading to increasingly inadequate welfare provision, has made a significant contribution to poorer health outcomes, too.

The government’s main objection to sick leave and illness more generally, is that it costs businesses money. The government remain committed to a supply-side labour market model. However, as inconvenient as it may be, politically and economically, it isn’t ever going to be possible to cure people of serious illnesses by cruelly coercing them into work.The government’s aim to prompt public services to “speak with one voice” is founded on questionable ethics. This proposed multi-agency approach is reductive, rather than being about formulating expansive, coherent, comprehensive and importantly, responsive provision.

This is psychopolitics. It’s all about (re)defining the experience and reality of a social group to justify dismantling public services (especially welfare), and that is form of gaslighting intended to extend oppressive political control and micromanagement. In linking receipt of welfare with health services and “state therapy,” with the single intended outcome explicitly expressed as employment, the government is purposefully conflating citizen’s widely varied needs with economic outcomes and diktats, isolating people from traditionally non-partisan networks of relatively unconditional support, such as the health service, social services, community services and mental health services.

Public services “speaking with one voice” will invariably make accessing support conditional, and further isolate already marginalised social groups. It will damage trust between people needing support and professionals who are meant to deliver essential public services, rather than simply extending government dogma, prejudices and discrimination.

However, unsatisfactory employment – low-paid, insecure and unfulfiling work – can result in a decline in health and wellbeing, indicating that poverty and growing inequality, rather than unemployment, increases the risk of experiencing poor mental and physical health.

People are experiencing poverty both in work and out of work. Moreover, in countries with an adequate social safety net, poor employment (low pay, short-term contracts), rather than unemployment, has the biggest detrimental impact on mental health. There is ample medical evidence to challenge the current political dogma, and to support this account. (See the Minnesota semistarvation experiment, for example. The understanding that food deprivation in particular dramatically alters cognitive capacity, emotions, motivation, personality, and that malnutrition directly and predictably affects the mind as well as the body is one of the legacies of the experiment.)

Systematically reducing social security, and increasing conditionality, particularly in the form of punitive benefit sanctions, doesn’t “incentivise” people to look for work. It simply means that people can no longer meet their basic physiological needs, as benefits are calculated to cover only the costs of food, fuel and shelter.Food deprivation is closely correlated with both physical and mental health deterioration. Maslow explained very well that if we cannot meet basic physical needs, we are highly unlikely to be able to meet higher level psychosocial needs.

The government proposal that welfare sanctions will somehow “incentivise” people to look for work is pseudopsychology at its very worst and most dangerous.In the UK, the government’s welfare “reforms” have further reduced social security support, originally calculated to meet only basic physiological needs, which has had an adverse impact on people who rely on what was once a social safety net.

Poverty is linked with negative health outcomes, but it doesn’t follow that employment will alleviate poverty sufficiently to improve health outcomes.In fact record numbers of working families are now in poverty, with two-thirds of people who found work in 2014 taking jobs for less than the living wage, according to the annual report from the Joseph Rowntree Foundation a year ago.

Essential supportive provision is being reduced by conditionally; by linking it to such a narrow outcome – getting a job – and this will reduce every service to nothing more than a political semaphore and service provision to a behaviour modification programme based on punishment, with a range of professionals being politically co-opted as state enforcers. 

I have pointed out previously that there has never been any research that demonstrates unemployment is a direct cause of ill health or that employment directly improves health, and the existing studies support the the idea that the assumed causality between unemployment and health may actually run in the opposite direction.It’s not that unemployment is causing higher ill health, but that ill health and discrimination are causing higher unemployment. If it were unemployment causing ill health, at a time when the government assures us that employment rates are currently “the highest on record,” why are more people becoming sick?

The answer is that inequality and poverty have increased, and these social conditions, created by government policies, have long been established by research as having a correlational relationship with increasing mental and physical health inequalities. For an excellent, clearly written and focused development of these points, the problem of “hidden” variables and political misinterpretation, see Jonathan Hulme’s Work won’t set us

– childhood immunisation
– antibiotics
– access to education, and particularly, improving female literacy
– increasing social equality

Given that, as statistics sadly show, the health of the poorest in the UK is again declining despite the first four factors mainly still being accessible to even the UK’s very poorest, one can only point at the worsening inequalities and social injustices as a significant cause. The Marmot review pretty much concludes the same. “

Addressing these issues is not consistent with the ideological thrust of Conservative policies, unfortunately, since the government insist that social problems such as poverty and ill health (the biopsychosocial model, with an emphasis on the “psychosocial” elements) are due to individual “behaviours.” Their approach to date has been to level punitive policies with an embedded core of behaviour modification techniques which usually entails the punitive removal of lifeline income at the poorest citizens – casually called “incentivising” and “supporting” – whilst addressing the behaviours of the wealthy with a system of publicly funded financial reward. This simply recreates, deepens, perpetuates and accentuates existing inequalities.

Empirical research published two years ago demonstrated the high a cost the country paid in terms of health and wellbeing for the Thatcher administration’s neoliberal economic and social policies. The study, which examined at material from existing research and data from the Office for National Statistics, illustrates that Thatcherism resulted in the unnecessary and unjust premature deaths of British citizens, together with a substantial and continuing burden of suffering and a widespread degradation of wellbeing.

Co-author and researcher Professor Clare Bambra from the Wolfson Research Institute of Health and Wellbeing said that deaths from violence and suicide all increased substantially during the Thatcher era in comparison with other countries. Regional inequalities in life expectancy between north and south were also exacerbated, as were health inequalities between the richest and poorest in British society.

Professor Bambra also says that the welfare cuts implemented by Thatcher’s governments led to a rise in poverty rates from 6.7% in 1975 to 12% by 1985; poverty is well known to be one of the major causes of ill health and mortality. Income inequality also increased in the Thatcher period, as the richest 0.01% of society had 28 times the mean national average income in 1978 but 70 times the average by 1990. Other research (The Spirit Level) indicates that income inequality is internationally associated with higher mortality and morbidity.

Yet earlier this year, the welfare reform minister, Lord Freud, refused to monitor the number of people who take their own lives as a result of the £120-a-month cut planned for those people in the work related activity group (WRAG), claiming employment and support allowance from April 2017. Concerns were raised in the House of Lords, when Baroness Meacher, amongst others, warned that for the most vulnerable citizens, the cut was “terrifying” and bound to lead to increased debt.

Condemning the truly callous and terrible actions of the Treasury, she urged ministers to monitor the number of suicides in the year after the change comes in, adding: “I am certain there will be people who cannot face the debt and the loss of their home, who will take their lives.”

Many people have died as a consequence of the welfare “reforms.”

Not only have the government failed to carry out an impact assessment regarding the cuts, Lord Freud said that the impact, potential increase in deaths and suicides won’t be monitored, apart from “privately” because individual details can’t be shared and because that isn’t a “useful approach”.

He went on to say “We have recently produced a large analysis on this, which I will send to the noble Baroness. That analysis makes it absolutely clear that you cannot make these causal links between the likelihood of dying – however you die – and the fact that someone is claiming benefit.”

However, a political refusal to investigate an established correlation between the welfare “reforms” and an increase in the mortality statistics of those hit the hardest by the cuts – sick and disabled people – is not the same thing as there being no causal link. Often, correlation implies causality and therefore such established links require further investigation. It is not possible to disprove a causal link without further investigation.

Whilst the government continue to deny there is a “causal link” between their punitive welfare policies, austerity measures and an increase in premature deaths and suicides, they cannot deny there is a clear correlation , which warrants further research and political accountability.

We have a government that provides disproportionate and growing returns to the already wealthy, whilst imposing austerity cuts on the very poorest. How the government possibly claim that inequality is falling, when inequality is so fundamental a prop to their ideology and when social inequalities are extended and perpetuated by all of their policies? It seems an Orwellian re-writing of language about inequality is being used to mislead us into thinking that the economy is far more “inclusive’ than it is. The number of vulture private businesses payrolled by the government to deliver increasingly ideologically biased and punitive welfare, health and social care “services” has risen dramatically this past six years, all of which has cost the UK taxpayer billions.

Meanwhile, those people who need essential supportive public services are facing severe cuts to their lifeline provision. Many of the multinationals contracted by the government are paid to cut the costs of public services, but are costing the public far more than they save.far more than they save. This brand of neoliberal crony capitalist is an entrenched mindset that needs to radically change, because the only beneficiaries are big businesses, and at the expense of those people with the highest level of need. The government’s policies are harming our most vulnerable citizens.

It seems that for wealthy people, “incentives” are always financial rewards, and for poor people, “incentives” simply involve grossly unfair financial punishments, which have too often challenged people’s  capacity to meet basic survival needs.

It’s time to challenge the class-based prejudice and blatant discrimination that is embedded in Conservative policies, which ultimately may only serve to deepen existing wealth and health inequality and increase social and economic division.

75629_107145729354964_2536493_n

 

 

 


 

I don’t make any money from my work. But you can make a donation and help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton cards

Government welfare policies are ‘historically obsolete’ say researchers

images

Historical research shows that the National Health Service (NHS) and welfare state are fundamental to a healthy, productive economy.

The government has been accused of following a “historically obsolete” welfare strategy by a team of Cambridge University researchers.  

Research by Simon Szreter, Ann Louise Kinmonth, Natasha M Kriznik, and Michael P Kelly also supports the work of campaigners, charities and other academics raising their concerns about the harmful social and economic impacts of the Conservatives’ austerity measures. These include the draconian welfare “reforms” and the consequences of the increasing privatisation of and political under-investment in the NHS from 2012 onwards. 

In an article published on Friday in The Lancet, titled  Health and welfare as a burden on the state? The dangers of forgetting history, the group of academics criticised Conservative austerity policies, which were instituted by David Cameron and George Osborne’s and continued by Theresa May and her chancellor Philip Hammond. The researchers point out that investment in welfare has always been crucial for Britain’s economic success.

The Conservatives have frequently claimed that welfare provision isn’t “sustainable”. Welfare support has been reduced so much that many people have been unable to meet even their most basic needs. Food and fuel poverty have significantly increased over the past four years, for example. We have witnessed the return of absolute poverty in the UK, something we haven’t seen since before the inception of the welfare state, until now. Social security is also harshly conditional, with punishment regimes and psycho-compulsion embedded in the diminishing “support” being offered. The emphasis has shifted from “support” to managing and enforcing poor citizen’s compliance and conformity.

Crucially, the researchers, who are based at St John’s College are opposing the idea that welfare and health spending is a “burden” on the country’s economy, arguing instead that economic prosperity is intrinsically tied to an adequate level of welfare provision.

Simon Szreter is a Professor of History and Public Policy at Cambridge’s Faculty of History. He writes: “The interests of the poor and the wealthy are not mutually opposed in a zero-sum game. Investment in policies that develop human and social capital will underpin economic opportunities and security for the whole population.”

The report also states: “The narrow view that spending on the National Health Service and social care is largely a burden on the economy is blind to the large national return to prosperity that comes from all citizens benefiting from a true sense of social security.”

The authors continue: “There are signs that Theresa May subscribes to the same historically obsolete view.

Despite her inaugural statement as Prime Minister, her Chancellor’s autumn statement signals continuing austerity with further cuts inflicted on the poor and their children, the vulnerable, and infirm older people.””

To support their position, the researchers point to the period of economic growth the UK experienced following the post-war settlement – including the development of the welfare state and the NHS, something which they argue also brought about greater equality, with the rich-poor divide falling to an all-time low during the 1970s.

Drawing on recent historical research, they also trace the origins of the British welfare state to reforms to the Poor Laws introduced under Elizabeth I in 1598 and 1601, and claim that investment in supporting the poorest citizens has always gone hand in hand with economic growth.

The report establishes an interesting and useful historical context, following the effect of welfare provision on the nation’s economic prosperity prior to the creation of the modern health and welfare apparatus and institutions that we are familiar with today, arguing that the concept of a British welfare state can be traced back to the reign of Elizabeth I. There are also parallels drawn in the report between the perceived problem of the “idle poor” during the Victorian era and the contemporary political narratives that intentionally label benefit claimants as “scroungers” who allegedly benefit unduly at the expense of “hard-working families”.

Many of us have drawn the same parallels over the past four years. In my  some of my own work, three years ago, I also compared the 1834 Poor Law Amendment Act – particularly the principle of less eligibility with the Conservative’s recent punitive and regressive approach to “making work pay”, which is about reducing social security provision, rather than raising national wages. Basically the idea behind both ideas is that any support given to people out of work needs to be punitive, and much less than the poorest wages of those in the lowest paid employment. That tends to drive wages down, as people who are desperate to survive have little bargaining power, and are more likely to be forced to work for much less, because employers can exploit a desperate reserve army of labour.

The Poor Law Amendment Act of 1834 is largely remembered through its connection to the punitive workhouses that were infamously instituted across Victorian Britain.

The researchers argue that, though the 1834 Act was passed out of “concerns” that the welfare system was being abused and was an unduly heavy burden on taxpayers, there isn’t any evidence that it had much an economic benefit. They also point out that Britain’s growth actually fell behind that of rival nations after 1870, only recovering in the 1950s, following the post-war settlement

Simon Szreter said: “We are arguing from history that there needs to be an end to this idea of setting economic growth in opposition to the goal of welfare provision. A healthy society needs both, and the suggestion of history is that they seem to feed each other.”

 

proper Blond

 


 

I don’t make any money from my work. But you can help by making a donation to help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated – thank you.

DonatenowButton cards