Category: Social Policy

Lords table motion to kill new Tory restrictions on PIP

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Around 160,000 disabled people will be stripped of their entitlement to support for the additional costs they face because of their disability after the government shifted the goalposts to deal with upper tribunal legal rulings, according to the Labour Party.

Debbie Abrahams, shadow work and pensions secretary, said: “Instead of listening to the court’s criticisms of personal independence payment assessments and correcting these injustices, the government has instead decided to undermine the legal basis of the rulings.

This is an unprecedented attempt to subvert an independent tribunal judgment by a government with contempt for judicial process.

By shifting the goalposts, the Tory government will strip entitlements from over 160,000 disabled people, money which the courts believe is rightfully theirs.

This is a step too far, even for this Tory government. Labour will stand with disabled people, who have already borne the brunt of seven years of austerity, in fighting this injustice.”

(See also:  Government subverts judicial process and abandons promise on mental health ‘parity of esteem’ to strip people of PIP entitlement. )

According to the Liberal Democrat Voice, the Liberal Democrats have tabled a motion to kill the government attempts to severely restrict disability benefits.

The move follows the recent undemocratic announcement by the government that they will be tightening the criteria for claimants of Personal Independence Payments (PIP) which will see people with serious illnesses such as diabetes, epilepsy and a wide range of mental illnesses left without support.

The purpose of Upper Tribunals

The government has introduced the restrictive regulations after losing two cases at tribunals, showing an utter contempt for the UK judiciary system. However, the UK tribunal system is part of the national system of administrative justice

Administrative law is the body of law that governs the activities of administrative agencies of government. It is designed to independently review the decisions of governments, and as such, it provides protection and promotion of fundamental rights and freedoms for citizens.

The Upper Tribunal is a superior court of record, giving it equivalent status to the High Court and it can both set precedents and can enforce its decisions (and those of the First-tier Tribunal) without the need to ask the High Court or the Court of Session to intervene. It is also the first (and only) tribunal to have the power of judicial review. (The Conservatives have a historical dislike of judicial review. See for example: The real “constitutional crisis” is Chris Grayling’s despotic tendencies and his undermining of the Rule of Law.)

The Tribunals, Courts and Enforcement Act 2007 created a new unified structure for tribunals and recognises legally qualified members of tribunals as members of the judiciary of the United Kingdom who are guaranteed continued judicial independence. This means that the judiciary is kept discrete from other branches of government. That is so that courts are not subjected to improper influence from the other branches of government, or from private or partisan interests.

Judicial Independence is vital and important to the idea of separation of powers. The intent behind this concept is to prevent the concentration of political power and provide for checks and balances. It has been significantly influenced by judicial independence principles developed by international human rights constitutional documents. in the application of the European Convention on Human Rights in British law through the Human Rights Act 1998, which came into force in the UK in 2000.

The government’s new regulations are a particularly autocratic move, aimed at simply overturning two legal rulings that the government did not like, partly because their zealotry concerning their anti-welfarism and “small state” neoliberal ideology has been challenged. The regulations were ushered in and imposed so that they would not be subjected to parliamentary scrutiny and debate or democratic dialogue with disabled people or groups and organisations that support and advocate for those with disability. 

From Penny Mordaunt’s statement:

“The first judgement held that needing support to take medication and monitor a health condition should be scored in the same way as needing support to manage therapy, like dialysis, undertaken at home. Until this ruling, the assessment made a distinction between these two groups, on the basis that people who need support to manage therapy of this kind are likely to have a higher level of need, and therefore face higher costs.

The second held that someone who cannot make a journey without assistance due to psychological distress should be scored in the same way as a person who needs assistance because they have difficulties navigating. By way of example, the first group might include some people with isolated social phobia or anxiety, whereas the second group might include some people who are blind. Until this ruling, the assessment made a distinction between these two groups, on the basis that people who cannot navigate, due to a visual or cognitive impairment, are likely to have a higher level of need, and therefore face higher costs.”

Responding to the announcement, Baroness Cathy Bakewell, Liberal Democrat Shadow Secretary of State for Work and Pensions, said:

“The government is using its recent losses in court as an excuse to severely restrict disability benefits. Rather than listening to the ruling they are using it to make matters worse for disabled people – that is utterly outrageous.

What makes things even worse is that they have sneaked this announcement out under the cover of by-elections. These decisions impact the lives of vulnerable people, Liberal Democrats will not allow the Conservatives to get away with treating people with disabilities with such total contempt.”

The Liberal Democrats contributed to scuppering the government’s plans to restrict tax credits back in October 2015.

Personally, I welcome any collaborative effort to challenge the Conservative’s draconian policies which deny people the help and support that they need. 


I don’t make any money from my work. I am disabled because of illness and have a very limited income. 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.

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Dangerous new changes planned to force sick people into work – or into poverty – Debbie Abrahams

With many thanks to Open Democracy.

The government promised to help disabled people back into work. They’re failing – and now it looks like they’re targeting those who need higher levels of support.


The punitive changes to social security for sick and disabled people were recently highlighted in the film I, Daniel Blake

The Government published its long-awaited ‘Improving Lives: Work, Health and Disability’ Green Paper at the end of October 2016 after originally promising a White Paper in 2015. The White Paper was supposed to define how disabled people would be supported into work and meet the Government’s manifesto pledge of halving the disability employment gap of 34% by 2020 (currently it stands at 32%).

The employment gap was used to justify further draconian cuts in social security support for disabled people in the Welfare Reform and Work (WRW) Bill published last summer. In particular, the Bill announced cuts of approximately £1,500 a year in Employment and Support Allowance to half a million people in the Work-Related Activity Group (ESA WRAG) – those people who had been found not fit for work, but who may be in the future – to be introduced in April 2017.

The 2016 Welfare Reform and Work Act followed the 2012 Welfare Reform Act which Scope estimated by 2018 will have cut nearly £28bn of social security support to 3.7m disabled people. Of course this doesn’t include £4.6bn cuts in social services support since 2010 or the NHS crisis, both of which affect disabled people.

The Green Paper, the consultation for which closed on 17th February just 6 weeks before the ESA WRAG cuts come into place, makes the bold claim that ‘…employment can… promote recovery.’

The issue I have with this statement, and the tone of the Green Paper as a whole, is that this implies that disabled people and people with chronic conditions would recover if only they tried a bit harder, or their doctors weren’t such soft touches. It doesn’t mention ‘shirkers’ directly but comments on how some people with the same condition languish in the ESA Support Group whilst others “flourish at work”, making it clear that’s what they’re thinking, ignoring their own rhetoric about “not treating everyone in a one-size-fits-all way”.

As a former Public Health consultant who researched into the health effects of work and worklessness, I agree that some work is good for health, but I don’t agree with the Government’s flawed thinking underpinning this: that it’s OK for people to return to work when they are still not fit, because it may help. This is not just unsound, it’s dangerous.

The scapegoating of disabled people, which includes people with physical or mental impairments and long-term health conditions as defined under the 2010 Equality Act, has been a hallmark of this Government and the previous Coalition. But even the conclusion of the United Nations inquiry that the UK Government has been responsible for ‘grave…systematic violations’ of the UN Convention on the Rights of Persons with Disabilities since 2010, has been met with Government stonewalling.

It is already well established that disabled people are twice as likely to live in poverty as non-disabled people as a result of the extra costs associated with their disability. Currently 4.2 million disabled people live in poverty and I have been informed from unpublished analysis by an Economic and Social Research Council research project that this is getting worse.

The Government has refused to stop the cuts to ESA WRAG and Universal Credit’s Limited Capacity to Work which come in this April, which will undoubtedly increase the numbers of disabled people living in poverty, threatening their health and well-being. Various discretionary funds may be available, for example the Flexible Support Fund, but there is no guarantee of support and they are quite specific in what they can be used for.

The timing of these cuts when there has been a negligible reduction in the disability employment gap is quite shocking. The Green Paper rings alarm bells that people in the ESA Support Group are the next to be targeted. Linked to this, the new Work Capability Assessment criteria which the Government announced last September (after I committed to scrap the Work Capability Assessment) will be published later this year. These will give a clear indication what the Government’s real agenda is.

The Green Paper also talks about employers and the need for them to invest more in workplace health and occupational health support. This is, of course, very important; 90% of disability and long-term health conditions are acquired, so it is absolutely right to examine what can be done to reduce the risk of employees falling ill and how employers can make reasoned adjustments to support an employee to stay in work if they become disabled. But Access to Work helped only 36,000 disabled people stay in or access work in 2015 out of the 1.4m disabled people who are fit and able to work.

To date, the Disability Confident Campaign launched in 2015 has been a dismal failure making a negligible impact on the disability employment gap. Changes in employer attitudes and behaviour needs practical support, including Access to Work. But what is the Government doing to support employers, especially small businesses given that nearly half the workforce is employed by them? How can a small business access affordable, timely occupational health support? With the NHS in crisis and waiting times for non-urgent treatments escalating, how will timely interventions to help people back to work be delivered?

As always with this Government and the previous Coalition, they are happy to point fingers at everyone else without taking any responsibility themselves. They talk about the impact of work on health and the need for ‘culture change’ and to ‘reinforce health as a work outcome’ but what about the impacts of the social security system on the health of claimants? Their policies have a direct impact on people’s health in the punitive, humiliating way they are too often implemented, but also through the real, enduring poverty and hardship people are forced to live under.

Labour will hold this Conservative Government to account on all these areas, developing meaningful, alternative, approaches with disabled people, employees, and employers as part of our Disability Equality Roadshow. If this Government is committed to a fairer society, they should stop trying to rebuild the economy off the backs of poor, sick and disabled people.

Labour believe, like the NHS, our social security system should be there for all of us in our time of need, based on principles of inclusion, support and security for all, assuring us of our dignity.   

Related

Labour’s Disability Equality Roadshow is a nationwide public consultation about policy with disabled people  Make sure you go and have your say – Labour’s Disability Equality Roadshow comes to Newcastle

The next Disability Equality Roadshow event will be held in London on 27th Feb. Sign up here, to see when the consultation will be held in your area: Eventbrite -Labour’s Disability Equality Roadshow-Brixton. Attending the consultations is free.


I don’t make any money from my work. I am disabled because of illness and have a very limited income. 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.

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Government subverts judicial process and abandons promise on mental health ‘parity of esteem’ to strip people of PIP entitlement

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Personal Independence Payment is a non means tested benefit for people with a long-term health condition or impairment, whether physical, sensory, mental, cognitive, intellectual, or any combination of these. It is an essential financial support towards the extra costs that ill and disabled people face, to help them lead as full, active and independent lives as possible.

Before 2010, policies that entailed cutting lifeline support for disabled people and those with serious illnesses were unthinkable. Now, systematically dismantling social security for those citizens who need support the most has become the political norm.

Any social security policy that is implemented with the expressed aim of “targeting those most in need” and is implemented to replace a policy that is deemed “unsustainable” is invariably about cost cutting by reducing the eligibility criteria for entitlement. The government were explicit in their statement about the original policy intent behind Personal Independence Payment. However, those being targeted as “most in need” is an ever-shrinking, constantly redefined category – an ever-shifting and ever-shrinking shrinking goalpost.

Disability benefits were originally designed to help sick and disabled people meet their needs, additional living costs and support people sufficiently to allow  a degree of dignity and independent living. You would be mistaken in thinking, however, that Personal Independent Payment was designed for that. It seems to have been designed to provide the Treasury with ever-increasing pocket money. Or as the source of profit for private providers who constantly assess, monitor, coerce and attempt to “incentivise” those people being systematically punished and impoverished by the state to make “behaviour changes,” which entail them not being disabled or ill and taking any available employment, regardless of its suitability. 

The government have already considered ways of reducing the eligibility criteria for the daily living component of Personal Independence Payment (PIP) by narrowing definitions of aids and appliances, and were kite flying further limits to eligibility for PIP last  year

Two independent tribunals have ruled that the Department for Work and Pensions (DWP) should expand the scope and eligibility criteria of Personal Independence Payment (PIP), which helps both in-work and out-of work disabled people fund their additional living costs. 

Following a court ruling in favour of disabled people last month, the government is rushing in an “urgent change” to the law to prevent many people with mental health conditions being awarded the mobility component of PIP. The court held that people  with conditions such as severe anxiety can qualify for the enhanced rate of the mobility component, on the basis of problems with “planning and following a journey”, or “going out”. 

The government’s new regulations will reverse the recent ruling and means that people with mental health conditions such as severe anxiety who can go outdoors, even if they need to have someone with them, are much less likely to get an award of even the standard rate of the PIP mobility component. The new regulations also make changes to the way that the descriptors relating to taking medication are interpreted, again in response to a ruling by a tribunal in favour of disabled people.

The first tribunal said more points should be available in the “mobility” element for people who suffer “overwhelming psychological distress” when travelling alone. The second tribunal recommended more points in the “daily living” element for people who need help to take medication and monitor a health condition. 

The Department for Work and Pensions (DWP) warned that it would cost £3.7bn extra by 2022 to  implement the court rulings. The government have responded by formulating “emergency legislation” to stop the legal changes that the upper tribunals had ruled on from happening. From 16 March the law will be changed, without any democratic conversation with disabled people and related organisations, or debate in parliament, so that the phrase “For reasons other than psychological distress” will be added to the start of descriptors c, d and f in relation to “Planning and following journeys” on the PIP form.

It’s worth noting that the Coalition Government enshrined in law a commitment to parity of esteem for mental and physical health in the Health and Social Care Act 2012. In January 2014 it published the policy paper Closing the Gap: priorities for essential change in mental health (Department of Health, 2014), which sets out 25 priorities for change in how children and adults with mental health problems are supported and cared for. The limiting changes to PIP legislation does not reflect that commitment.  

The new regulations are being rushed in without any dialogue with the Social Security Advisory Committee, too. 

The government have designed regulations which would, according to Penny Mordaunt, be about “restoring the policy originally intended when the Government developed the PIP assessment”.

The original policy intent was to create an opportunity to limit eligibility for those people previously claiming Disability Living Allowance (DLA) whilst they were being reassessed for PIP, which replaced DLA. And to limit successful new claims. 

Mordaunt also said in a written statement to MPs: “If not urgently addressed, the operational complexities could undermine the consistency of assessments, leading to confusion for all those using the legislation, including claimants, assessors, and the courts.

“It is because of the urgency caused by these challenges, and the implications on public expenditure, that proposals for these amendments have not been referred to the Social Security Advisory Committee before making the regulations.”

An ever-shifting, ever-shrinking goalpost

Any social security policy that is implemented with the expressed aim of “targeting those most in need” is invariably about cost cutting and reducing eligibility criteria for entitlement. The government were explicit in their statement about the original policy intent of Personal Independence Payment. 

The government has already considered ways of reducing eligibility criteria for the daily living component of Personal Independence Payment by narrowing definitions of aids and appliances, last  year

Prior to the introduction of PIP, Esther McVey stated that of the initial 560,000 claimants to be reassessed by October 2015, 330,000 of these are targeted to either lose their benefit altogether or see their payments reduced.

We ought to challenge a government that displays such contempt for the judicial system, and ask where the ever-reductive quest for the ever-shrinking category of “those with the greatest need” will end. 

Labour’s Shadow Work and Pensions Secretary, Debbie Abrahams MP, criticised the government’s decision to overturn the tribunal rulings, she said“Instead of listening to the court’s criticisms of PIP assessments and correcting these injustices, this government have instead decided to undermine the legal basis of the rulings”.

Abrahams added: “This is an unprecedented attempt to subvert an independent tribunal judgement by a right-wing government with contempt for judicial process.

By shifting the goal posts, the Tory Government will strip entitlements from over 160,000 disabled people, money which the courts believe is rightfully theirs. This is a step too far, even for this Tory government.”

The government seem to think that PIP is a policy that ought to benefit only the needs of a government on an ideological crusade to reduce social security away to nothing – “to target those in greatest need” – an ever-shrinking, constantly redefined and shifting category of disability.

It is not a democratic government: they are unwilling to engage in a dialogue with the public or to recognise and reflect public needs: that’s an authoritarian elite taking public money and handing it out to a very wealthy minority group in the form of “incentivising” tax cuts, who then say to the public that providing lifeline support for disabled people and those with mental health/medical conditions is “unsustainable”.

Implications for the UK’s obligations regarding the UN convention on the human rights of disabled persons and the Equality Act

The new PIP changes, pushed through without any public conversation or democratic exchange with disabled people, are in breach of both the UN convention on the rights of disabled persons, and the UK Equality Act.

In the Equality Analysis PIP assessment criteria document, the government concede that: “Since PIP is a benefit for people with a disability, impairment or long-term health condition, any changes will have a direct effect on disabled people. The vast majority of people receiving PIP are likely to be covered by the definition of “disability” in the Equality Act 2010.

By definition, therefore, the UT [upper tribunal]judgment results in higher payments to disabled people, and reversing its effect will prevent that and keep payments at the level originally intended. The difference in income will clearly make a real practical difference to most affected claimants, and (depending on factors such as their other resources) is capable of affecting their ability to be independently mobile, access services etc – all matters covered by the UN Convention on the Rights of Persons with Disabilities as set out at the start of this Analysis.”

It goes on to say in the document: “However, this does not necessarily mean that the increased payments that would result from the judgment are a fair reflection of the costs faced by those affected, or represent a fair approach as between different groups of PIP claimants.” 

People with the following conditions are likely to be affected by the reversal of the upper tribunal’s ruling on those needing support to manage medication, monitor a health condition, or both:

Diabetes mellitus (category unknown), Diabetes mellitus Type 1 (insulin dependent), Diabetes mellitus Type 2 (non-insulin dependent), Diabetic neuropathy, Diabetic retinopathy, Disturbances of consciousness – Nonepileptic – Other / type not known, Drop attacks, Generalised seizures (with status epilepticus in last 12 months), Generalised seizures, (without status epilepticus in last 12 months), Narcolepsy, Non epileptic Attack disorder (pseudoseizures), Partial seizures (with status epilepticus in last 12 months), Partial seizures (without status epilepticus in last 12 months), Seizures – unclassified Dizziness – cause not specified, Stokes Adams attacks (cardiovascular syncope), Syncope – Other / type not known.

People with the following conditions are likely to be affected by the reversal of the independent tribunal’s ruling on the effect of the upper tribunal’s judgment, regarding mobility, with conditions in the general category of “psychological distress”:

Mood disorders – Other / type not known Psychotic disorders – Other / type not known, Schizophrenia, Schizoaffective disorder, Phobia – Social Panic disorder, Learning disability – Other / type not known, Generalized anxiety disorder, Agoraphobia, Alcohol misuse, Anxiety and depressive disorders – mixed Anxiety disorders, – Other / type not known, Autism, Bipolar affective disorder (Hypomania / Mania), Cognitive disorder due to stroke Cognitive disorders – Other / type not known, Dementia, Depressive disorder, Drug misuse, Stress reaction disorders – Other / type not known Post-traumatic stress disorder (PTSD), Phobia – Specific Personality disorder Obsessive compulsive disorder (OCD).

The government’s so-called commitment to a “parity of esteem for mental health and physical health” was clearly nothing more than an empty promise – an opportunistic platitude. This is a government that says  one thing and then does exactly the opposite.

 It’s all part of a broader gaslighting and linguistic techniques of neutralisation strategy that passes as Conservative “justification” for their draconian deeds and bullying, discriminatory and uncivilised austerity regime, aimed disproportionately at disabled people.

Commenting on the Ministerial announcement (made yesterday, 23rd February), Rob Holland, Public Affairs Manager at Mencap and Disability Benefits Consortium Parliamentary Co-Chair said:

“We are concerned by these changes to the criteria for Personal Independence Payment (PIP). These risk further restricting access to vital support for thousands of disabled people. Last year, MPs strongly opposed restrictions to PIP and the Government promised no further cuts to disability benefits. Other changes have already had a devastating impact on thousands and in far too many cases people have had to rely on tribunals to access the support they need.

We are deeply disappointed as a coalition of over 80 organisations representing disabled people that we were not consulted about these proposals and their potential impact. The Government must ensure the views of disabled people are properly considered before they proceed with these changes.”

tough-choices

 

The full ministerial statement can be read here.

Download a copy of the new regulations here.

Related

PIP disability benefit test ‘traumatic and intrusive’

PIP and the Tory monologue

Government guidelines for PIP assessment: a political redefinition of the word ‘objective’


I don’t make any money from my work. I am disabled because of illness  and have a very limited income. 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.

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The poor state of child health in the UK

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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.

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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.

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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.

 


 

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

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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. 

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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.

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Labour’s Disability Equality Roadshow comes to Newcastle

Jeremy Corbyn, Paul Rutherford and Debbie Abrahams, Shadow Work and Pensions Secretary, at the launch of Labour’s Disability Equality Roadshow. She is talking to people across the country about what disabled people want to see in Labour’s next manifesto. If you’re a Labour Party member keep an eye on updates from the National Policy Forum for more opportunity to get involved.

The Labour Party’s Disability Equality Roadshow was launched in Manchester in November and is set to go nationwide over the coming months. This democratic engagement process is the vitally important first step in developing policies which will address the structural  (social, cultural, political and economic) issues affecting disabled people and their carers across the UK, as well as the challenges we all face in building a fairer, more equal society.

At the launch, Paul Rutherford said: “This initiative will enable Labour to develop real policies which will properly support disabled people, not punish and harm them, making their often difficult lives harder, which is what this government’s policies are doing.”

Debbie Abrahams added: “The roadshow will draw on the experiences and expertise of disabled people themselves who have been particularly affected by this Tory Government’s changes to social security.”

After six years of Conservative policies that have not involved any genuine consultation and engagement with disabled people in political decision-making processes, we have witnessed a raft of increasingly punitive measures and cuts that have been imposed on us, supposedly to “incentivise” the poorest citizens – presumably to be less poor – by imposing financial punishments and stigma on them. Invisible bootstraps were included in the government’s basic incentives package.

The phrase “behavioural change” has become a euphemism for traditional Conservative prejudice, blaming individuals for structural barriers and politically constructed problems. “Incentivising” is another euphemism for discrimination and punitive state behaviour modification policies, such as benefit sanctions, for the poorest people. It’s also a fundamental part of a justification narrative to advance the dismantling of the welfare state in stages, a cut at a time.

The wealthiest people, however, have been presented with the deluxe package of Conservative “incentives”, which entail generous handouts in the form of tax cuts and endorsed exemptions. Such policies, which take lifeline income from the poorest citizens, including those in low paid or part-time work, and award it to the very wealthiest cannot fail to extend and accentuate growing inequalities and increase social and economic exclusion.

This topical comment was very welcomed on Saturday: 

“Tax justice means that supporting disabled people IS sustainable. This is our flag in the sand”. Grahame Morris, Labour MP, on Labour Party priorities at the Disability Equality Roadshow, Newcastle.

Debbie said: Firstly, an inclusive labour market is one that finds the right job for those who can work. The Tory government has focused solely on getting people ‘off-flow’, forcing them into any job to bring down claimant numbers, or none, for example, as a result of sanctions.

I believe there is a fairer way; a more holistic, person-centred approach that looks at people’s strengths and barriers to work whether this relates to skills or housing issues. We need to provide them with the best possible employment support but also opportunities to work.”

And on support for disabled people in work: “Ensuring that proper workplace adjustments are made to retain disabled people who are in work is a vital part of an inclusive labour market. These adjustments could be in the form of more flexible leave arrangements as well as extending Access to Work which currently only supports a tiny minority of disabled people, approximately 36,500 out of 3.7 million in work.”

The Roadshow is part of Labour’s commitment to transform our social security system, ensuring that, like our NHS, it is fit for purpose; there for us all in our time of need.

The Disability Equality Roadshow is using the UN Convention on the Rights of Disabled Persons as a framework to help develop a wide array of policies, not just those concerning social security, but also embedding the convention articles in education, health and social care, justice policies and many others.

The Labour Party has already pledged to scrap the discriminatory and unfair Bedroom Tax. Debbie Abrahams announced at Labour Party Conference that a Labour government will also scrap the discredited Work Capability Assessment. Debbie said she wants to replace it with “a system based on personalised, holistic support; one that provides each individual with a tailored plan, building on their strengths and addressing barriers, whether skills, health, care, transport, or housing-related.”

Debbie has asked for our help in exploring how this might be achieved.

Many of us welcomed the announcement from Debbie that a Labour government will get rid of this Government’s punitive sanctions too. As Debbie pointed out: “This will mean Job Centre Plus and employment support providers’ performance will not just be assessed on how many people they get off their books.”

She also discussed the need for a culture change regarding the prejudiced attitudes of many regarding people with disabilities and those out of work.

The event on Saturday was hosted at Unite the Union.

Saturday 3 December was also the International Day for Disabled People.

dis-eq-roadshow Democracy and inclusion in action: discussing social security

Some of the issues that we discussed:

  • We raised individual cases that demonstrated the terrible distress caused by the work capability assessment (WCA) and the serious impact that being told wrongly they are fit for work has on people who are very ill. Labour will scrap the WCA. We said that the evidence that should be considered in claims for disability related benefit should always be medical – presented by qualified doctors and specialists, not from “functional assessment” carried out by non-specialised occupational therapists and nurses employed by private companies hired to cut benefits and make a massive profit at our expense.
  • We must also move away from any process of assessment that is intimidating and distressing. People generally felt that the DLA system was much fairer, with provision for life long awards for chronic and progressive conditions.
  • Increasingly, private companies are taking up money from the social security budget, whilst those that the budget is meant to assist are seeing their support cut and their standard of living plummet. Many are now unable to meet their most basic needs – such as having sufficient income to meet the costs for food and fuel.  It was suggested that benefit levels are set by a specialised  committee, ensuring that the costs of basic needs can be met.
  • As benefits were originally calculated to meet only basic needs, the additional costs of housing and council tax were not included in the benefit level when it was originally calculated. It was assumed that people would remain exempt from paying any additional rent and council tax. That needs to be addressed, since benefits do not cover these or the bedroom tax (though Labour intend to scrap the bedroom tax).
  • The new in-work conditionality is likely to impact on disabled people, many of who may need to work part-time. Shorter and flexible working hours are a reasonable adjustment. Some of us have to also manage hospital appointments with more than one specialist and hospital based treatment regimes. The threat and use of sanctions aimed at part-time and low paid workers is incompatible with the aim of “halving the disability employment gap.”
  • We suggested that employers should fined for not employing a quota of disabled people, rather than being rewarded, as suggested in the government Green Paper, for employing disabled people, given that disabled people have a right to socioeconomic inclusion, including the right to work, without discrimination.
  • The Equality Act was not implemented in full by the Coalition. This limits redress for disabled people regarding:  
    • Dual discrimination: the government decided not to bring this into force as a way of reducing the cost of regulation to business. 
    • Socioeconomic inequalities under the Public Sector Equality Duty 
    • Provisions relating to auxiliary aids in schools
    • Diversity reporting by political parties
    • Provisions about taxi accessibility among other things. These omissions need to be remedied. 
  • Accessibility issues were also raised, ranging from the lack of provision and accessibility for disabled users of public transport and taxis to the lack of large print ESA forms available for people with visual impairments and barriers regarding the availability of home visits for assessments.
  • Run-on benefits for people starting work need to be reinstated, since people usually work a month at least before being paid a wage. Previously, housing benefit, council tax and other benefits were payable for the first month of employment.
  • We discussed the need for culture change to address prejudice, and the now commonly held negative perceptions and attitudes towards disabled people and those out of work.

There were three other task groups, some worked on addressing barriers to access to justice, others worked on disability and barriers at work, among other topics, all of who raised many other issues, which were also fed back. 

It was a very productive and positive event: an excellent opportunity for democratic inclusion in the decision-making process and to contribute positively towards progressive Labour policies.

Of course that process doesn’t stop with the Roadshow events, but in the coming months, if you can get to the Roadshow when it comes to your area, it’s recommended you do. If you’re a Labour Party member you can follow updates from the National Policy Forum, which also provides further opportunity to get involved.

“Nothing about us without us,” as Gail Ward summarised on the day. 

Debbie has asked if I would contribute in a collaborative response to the government’s recent consultation and green paper on work, health and disability, which I’ve agreed to do. 

Government policies are expressed political intentions regarding how our society is organised and governed. They have calculated social and economic aims and consequences. In democratic societies, citizen’s accounts of the impacts of policies ought to matter. It’s very reassuring to know that the Labour party recognise this, especially in a context of an increasingly authoritarian government that isn’t interested in first-hand witness accounts concerning the terrible consequences of their draconian policies. 

Any consideration of future policy and its impacts must surely engage citizens in dialogue, on a democratic, equal basis and ensure participation in decision-making, to ensure an appropriate balance of power between citizens and government.

The Labour Party recognise that democracy is not something we have: it’s something we  must DO, and that process includes all of us. 

One final point that needs raising is that the progressive left – particularly Labour – do not find any favour with the mainstream corporate media, generally speaking. It is therefore down to all of us to bypass the constraints of media neoliberal framing, to ensure that news of Labour policies and events like this are shared widely. Otherwise genuine alternative narratives to the current socioeconomic paradigm and order will continue to be systematically stifled, at a time when there has never been a greater need for alternatives.

Upwards and onwards. 

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With Alex Cunningham, Debbie Abrahams and Gail Ward on Saturday at the Disability Equality Roadshow 

I’d like to thank Debbie Abrahams, Grahame Morris, Alex Cunningham, Ian Lavery, Ian Mearns, Emma Lewell-Buck, Richard Williams, Dave Allen, Labour North, Unite the Union, and every one who came on Saturday for an excellent and very productive, hope-inspiring event.

Government welfare policies are ‘historically obsolete’ say researchers

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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

 


 

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