Tag: poverty

The Labour Party’s approach to the United Nations

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The United Nations Association (UNA-UK) has written to all major UK political parties, asking them for a statement on the United Nations. By shedding light on the approaches taken by different parties we hope to contribute to an informed national conversation on foreign policy, and help raise awareness of the ways in which the international system delivers benefits to British citizens.

Read more on this initiative and read other parties’ statements.

The Labour Party’s approach to the United Nations

The next few years provide the greatest opportunities in a generation for Britain to take a leading part in advancing a progressive international agenda in key areas of international concern from climate change, environmental degradation, womens’ rights, poverty reduction, natural disasters, disease and tackling some of the worst human rights abuses.

For Britain to prosper both at home and abroad, we need to seize the opportunity to shape the international agenda and support institutions like the UN from the dangers arising from global instability.

This means taking unmistakable steps to demonstrating our commitment to the UN and invest in greater diplomacy to harness respect, cooperation and goodwill for Britons across the globe.

The life chances, security and prosperity of our citizens are interdependent on our international agenda. Achieving our goals for our own nation requires working in harmony with other nations and the UN to accomplish a peaceful, progressive international agenda, one that reduces rather than increases tensions with other countries.

Unlike the Conservatives, Labour is deeply committed to improving and enhancing Britain’s support for the UN and we will redouble our efforts to distribute the proceeds of internationalism fairly, protecting and promoting rights and taking a steer from the UN to mitigate conflict.

A Labour Government will put human rights at the heart of our foreign policy and forge meaningful solidarity with other countries to entrench peace, security and trade relations for Britain.

The next Labour Government will commit to smooth British/UN relations, supportive of the UN and cooperative with various UN organs. And as a permanent member of the UN Security Council we will provide a lead by respecting the authority of international law with the aim of establishing a new world order based on conflict resolution, social justice, mutual respect and benefit.

 

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See also: UNA-UK LAUNCHES MANIFESTO FOR 2017 GENERAL ELECTION

Conditionality and discretionary housing payments: when paying rent is more important than buying food

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The government’s behavioural change agenda, which targets the poorest citizens, is being delivered via the increasing conditionality of social security and public service support provision. The underpinning rhetoric is that individual behaviours cause poverty, rather than government policies, which are causing a systemic unequal distribution of wealth.

Councils who are facing shortfalls in government funding to meet their statutory obligations have recently introduced behavioural conditionality to applications for awards of Discretionary Housing Payments (DHP). Most local authorities are now saying they will only help those who will have a “positive outcome” as a result of the support. Yet they claim that this is to ensure limited funds go to only those “most in need”.

The reasoning provided by councils for only supporting those “nearest to the labour market” to encourage “financial independence” is at odds with the aim of ensuring support goes to “those most in need”. Surely those unable to work through illness and disability, who are furthest away from the labour market, actually have more need, yet will be less likely to meet conditionaility requirements and so won’t receive the support that the government tells us is supposed to be in place for us.

DHP is now much less likely to be awarded for those in greatest need precisely because of the new conditionality criteria. It specifically supports people who are more able to find work. Those who can’t are expected to go without food and fuel to meet their housing costs and potentially face destitution.

Disabled people paying for disabled people’s support

On Thursday I went to apply for DHP as I no longer have enough money to live on, partly because of now having to pay council tax and bedroom tax. Like many people, my essential outgoings are considerably greater than my income. The government have claimed that disabled people like me can claim DHP as a safeguard from the financially damaging impact of the bedroom tax, which disproportionately affects disabled people.

However, my own council have warned me in advance that they have little funding left for providing DHP support.

ESA and other benefits were originally calculated to meet the costs of food and fuel, and other essential living costs, based on an assumption that you would also get FULL housing and council tax benefit. There hasn’t been full housing benefit provision for some years now, but previously, people who are disabled were exempt from paying council tax, until recent years.  

This is leaving some people without enough money to meet the costs of their basic survival needs – food and fuel. One reason I now have to pay more council tax, according to the statement from my local authority on my bill, is to raise money to meet the costs for the government’s pledged funds for improving adult social care – the adult social care precept. That is being taken from every household, including the poorest, many of which have people with serious medical conditions and disabilities in them.

My local authority says: “The introduction of the National Living Wage and increase in population means this is an area where we have seen significant financial pressures. The 2% increase will help us to maintain our current services.”

There’s a certain horrible irony here, too.

My local authority inform me that I now have to pay council tax to fund support for:

  • older people
  • people with a learning disability
  • people with a physical disability
  • people with sensory loss
  • people with mental health needs

The never-ending need to justify need: facing the bureaucratic wall around support provision

I am a person with physical disabilities because of an illness, and my only income is my ESA, at the support group rate. I ought to have claimed Personal Independence Payment (PIP) before now. However my experiences claiming ESA were pretty distressing and extremely anxiety provoking, that has deterred me. The enormous stress and anxiety of the assessments, facing a tribunal and then the reassessment almost immediately after I won my case in court exacerbated my already serious illness, and left me acutely and desperately ill for at least two years.

I’m a reasonably robust person ordinarily. I have worked most of my life, and I enjoyed my work, particularly the youth and community posts I undertook. I did a vocational part-time Master’s whilst I worked full time, and later went on to do mental health social work with young people at risk.

I was very unprepared for what followed when I suddenly became very ill with lupus. I was used to being fit, healthy and very active. I also had a good salary and a relatively comfortable standard of living. Though I was never very affluent, I had enough to cover my family’s needs, and to provide enough for my children to have stability.

I was forced to give up work as I was much too ill to fulfil my role competently and there were significant risks to my health in the workplace. My illness and some of the treatments I have also mean that I am very susceptible to infection. I caught a cold from a colleague in work and ended up with pneumonia and pleurisy more than once, for example. My illness impacted on my capacity to work for many reasons, such as an autoimmune bleeding disorder, widespread joint and tendon damage affecting my mobility, severe nerve pain, deteriorating eyesight, neurological problems and cognitive difficulties and so on. The tribunal panel (regarding my ESA eligibility) concluded that I had made the right decision to leave work because of the further serious risks to my health, after reading my medical reports from my specialists. 

My house was repossessed because my modest mortgage payments became unmanageable as I had no way of making the payments. I did approach my local housing office for help, who told me they could only offer support once I was actually homeless. That would have meant having all my family’s possessions left on the street, too.

I found a house to rent just down the street for a very reasonable amount. In fact initially there was very little shortfall between my housing benefit and actual rent. I had two boys at school, they didn’t want to leave the area as they were in their final years, and we have other family in this area. I was informed by the council that I would be eligible for housing benefit for a three bedroom house at that time. I took out a small loan for my deposit, as by then my last wage had long gone. The council were pleased I had managed to find cheap accommodation that suited my family’s needs.

I moved into the property, but I was very ill and struggled coping. My disability advisor at the job centre advised me to claim ESA at this time. By then I was having weekly chemotherapy treatment (Methotrexate) at the hospital and was considered unavailable for work, I didn’t (and couldn’t) meet thhe jobseeker’s allowance conditionality requirements, and my advisor recognised this.

Within two months of moving into the property, the law changed, and I had to pay bedroom tax for my older son’s room, as he was suddenly expected to share a room with his younger brother. There are no smaller houses locally, none with lower rents, and all of the limited number of two bedroom council flats here are inhabited. Not that moving again would have been easy for me as I was so poorly at this time. The first move down the street had affected my health, and exhausted me for months.

However, after almost a year of struggling to pay the bedroom tax, my oldest son reached 18 and my housing benefit went back up not long before he left for university.  I got almost a year of backpay when I won my ESA tribunal and that helped me get on top of my increasing debt, after months of really struggling. I also got a tax rebate from when I worked, also helped enormously. 

The Department for Work and Pensions (DWP) decided that they would take back an overpayment they made in 2007, whilst I was struggling on basic rate ESA, awaiting tribunal in 2011. I was also paying bedroom tax then. I had claimed income support briefly when I changed jobs, whilst I waited for social services to complete background checks that were necessary for my post. I couldn’t start the post until the checks were done. Meanwhile we had nothing to live on. The checks took three months.

I was entitled to a month of run-on benefit as a lone parent once I took up the post. However, despite the fact I had signed off, the income support payments continued another two months. I had phoned a couple of times and then written twice to inform the job centre again that I had taken up my post.

I don’t mind paying back the money I was overpaid. I did mind that the DWP also took back the run-on benefit that I was actually entitled to for the first month, and told me it was far too late to appeal that decision. The hefty deductions from my reduced ESA did cause me a lot of hardship, but at least I didn’t owe anything by the time I won the tribunal. It was claimed I did still owe money at one point and I had a letter saying my ESA back dated payment wasn’t going to be released as I owed money. I didn’t.

It’s almost as if the DWP want to keep you in a state of constant anxiety, despair and precarity, and to make sure that your life is never remotely acceptably comfortable, secure and safe. Social security is no longer a safety net, it seems to have been transformed into a bureacratic wall that exists simply to discipline poor people and ensure as few people as possible have access to any lifeline support. The letters are written in a way that intends to cause anxiety, I am sure.

I managed financially for a couple of years, though budgeting on such a limited income is difficult. But having worked for a long time, I had furniture and household items, enough clothing and when things got very bad, I had a few personal items to sell if need be. 

Of course over time, vacuum cleaners, washing machines, fridges, kettles and cookers break down.  Children grow and need clothes and shoes. I went a whole year without a washing machine when mine broke, but saved a little every month until I had enough for a second hand one. I don’t know how I managed to get by because much of the time I could barely walk or use my wrists/hands, but I had to wash clothes and bedding in the bath. It took up a lot of my time and effort. Poverty is cumulative, too. It gets much worse and more wearying as time goes by. If you are ill and disabled, the impacts of poverty are considerably greater.

Both my youngest sons are at university now. They come home out of term times. I feed them and support them as best I can, though we don’t have any money to cover their living costs. Both are at universities out of the region, they have student finance for term times, but both have struggled to meet living costs. When they come home, it’s for a couple of weeks, though considerably longer at christmas. They have never managed to find work locally to tide them over out of term time, despite trying. No-one wants to hire people for a couple of weeks.

My oldest son found a part time job in his first year at university. He didn’t have regular hours and his employer simply called him when he needed him. However, my son’s travel costs to and from work exceeded what he earned, and more than once his allocated hours coincided with his lectures, which are compulsory.

Both boys are considered as living at home as they return home out of term times and are expected to return home once they complete their studies. 

In the new year, I caught ‘flu and within a couple of days I ended up with pneumonia and sepsis. At the time I was far too ill to know I was so poorly. It was my son who realised how serious my condition was and rang the ambulance, just in time.

I was already in a critical condition with septic shock when the ambulance arrived. My illness means my immunity to infection is very low, so I’m always at risk from pneumonia, kidney infections, random abscesses and so on, but this was the first time I have ever had life-threatening and severe sepsis. I was very ill in hospital and spent a couple of days drifting in and out of a bottomless sleep and hallucinating, whilst on the lifesaving IV treatments and fluids. I needed oxygen support for five days afterwards, anticoagulant injections, and continued taking combined oral antibiotics, steroids and a course of Tamiflu for a couple of weeks after I came home. 

When I got home from hospital in late Jaunary, we had no hot water or heating as my boiler had broken. But we used fan heaters, and I managed to keep warm in my room, I focused on recovery, until the electric went off because of a fault on a circuit. My landlord lives in the US currently and I had difficulty in contacting him. I had no choice but to find somewhere else to stay as the house was so cold it was uninhabitable, and we couldn’t cook food. I was still very weak and very slowly recovering. By this time my youngest son had returned to university. My oldest son and I had to stay with a friend.

The electrical fault was fixed and I got a new boiler fitted the following week. I remained weak and my pulmonary specialist told me it would likely be at least three months before I was fully recovered. I have been diagnosed with additional lung problems since, which showed up on a scan, following more tests showing my lung function is just 40% of what it is expected to be. Some of the problems are related to lupus, which has caused a lot of inflammation in both lungs.

My son decided I needed some additional support to recover and he has taken six months out from his degree to care for me. The alternative was for me to contact social services for support.

I now have to pay bedroom tax for his room, in addition to the council tax, as he is classed as a non-dependent adult. Having no boiler for several months has also meant I used a lot more eletricity, so my bill is much bigger than usual, so my direct debit has more than doubled every fortnight. I managed to negotiate it down a bit, but it is still more than twice my ususal payment. My new boiler is a lot more efficient than the old one, luckily, but I am nonetheless struggling to make ends meet.

So I applied for DHP.

I had an interview on Thursday at our local housing benefit office. 

Rent and council tax are more important than food and fuel, apparently

The interview went as follows:

Firstly, I was asked to give an account of my income and outgoings. 

Housing Officer: What have you done to look for work?

Me: I am in the Employment Support and Allowance Support Group (ESA). This is because I became too ill to work and it’s been agreed by my doctors, myself and the state that I can’t work “consistently, reliably and safely” due to the severity of my illness and the substantial risks I would face if I were to return to the workplace. I have tried to find a job writing from home that pays a wage to support myself, but had no luck so far. 

Housing Officer: What have you done to look for cheaper accommodation?

Me: I wasn’t aware I was expected to. However, there is no cheaper accommodation in the area, unless you have any two bedroom social housing to offer me. Then I would need considerable support in moving, as my illness means I have mobility problems, severe problems with profound fatigue, other health problems that make moving risky, and I also need to be organised to accommodate a strict routine for my health care.

Housing Officer: Have you considered taking in a lodger?

Me: I have no spare room to offer a lodger as my sons occupy them out of term time and are expected to return home once they graduate. However, I would not consider taking a stranger into my home because I am disabled and ill, therefore I am potentially vulnerable and feel that this may present an unacceptable risk to my wellbeing and safety. (See for example: Mother and son who ‘gave shelter to homeless man’ stabbed to death at family home.)

Housing Officer: Your weekly shopping average looks slightly high.

Me: Well at the moment it is for two of us. On Friday my youngest son is home for the Easter break, and I will then need to feed him too.

Housing Officer: I only want details of what you spend on yourself.

Me: Do the council expect that I leave my children without food?

(No response)

Me: My weekly shop includes essential items I can no longer get on prescription, such as eye drops, because my tear film is very poor, I don’t produce tears as I have Sjogren’s – painfully dry eyes – as part of my illness. I used to get moisturising drops on prescription from my opthalmologist but they have been discontinued. If I don’t use the eyedrops my cornea becomes scarred and I get eye infections.

I also have to buy sunblock, because I get a blistering and painful rash in the sunlight, even in winter – that’s also part of my illness.  

I have to buy detergents and toiletries that are very hypoallergenic and gentle because my skin is fragile, hypersensitive, prone to rashes and painful blistering in places because I have lupus and eczema, all of which leaves me prone to infection if I don’t treat the conditions with care. I also have to buy cleaning products and antibacterial items, to keep my home as clean as possible because my illness and treatments mean my immunity to infection is very poor. 

None of these items are available on prescription, but I do unfortunately need them. I have also included very modest clothing/footwear costs (I have to take care with footwear because I have severe Raynaud’s – a condition that causes very poor circulation that shuts down in my hands, feet and nose with even slight fluctuations in temperature – and so I need to keep my feet and hands warm.  I am prone to blisters from badly fitted shoes which then turn into serious infections and have developed sepsis at least once because of this. I also need shoes that are cushioned and support my Achilles tendons because of damage to them and my joints. 

I’ve also included modest costs for essential household items, which everybody needs sometimes due to wear and tear. I have a bleeding disorder, which affects me in a way that means I have to spend more on sanitary items than most people. I also have additional dietary needs because I am underweight, and I have IBS and acid reflux, which means I have to eat small meals frequently throughout the day. This is not a lifestyle choice: it’s because of my medical conditions.

Housing Officer: Don’t take any of the questions personally, everyone is asked the same.

Me: The problem with having the expectation of everyone having the same needs is that you then don’t have any opportunity to recognise the more vulnerable clients who need additional support because of their additional needs. Not everyone finds it easy to find suitable employment to support themselves.  Illness and disability can happen to anyone, it is sometimes a major barrier to working and I am not ill because of “lifestyle choices”: it’s not because of something I did or didn’t do. I have worked. Now I can’t. 

People are dying because of that built-in oversight and other government policies that don’t accommodate people’s circumstances and disregard their additional needs because of disability and illness. Many others are suffering unacceptable distress and harm to their health.

Housing Officer: I know.

She delivered that comment with complete and almost menacing detachment. I was so taken aback I couldn’t speak for a few moments. She didn’t even pause for breath, however.

The part that was by far the worst during the interview was this matter-of-fact agreement that people are dying as a result of the policies that she was calmly sat implementing.

It was delivered almost like a veiled threat: that if I didn’t or couldn’t comply with certain unstated behavioural requirements, which were not made explicit at any point during the interview or prior to it, I would also be left to die. 

I was then told I must “prioritise” my rent and council tax payments above everything else.

I explained that my rheumatology consultant has also told me I must prioritise eating well, putting weight on (I weighed less than 8 stones), and keeping warm. I don’t have enough income to do both of those things, as it is. I explained again that I could meet my husing costs before I had to pay council and bedroom tax, and have managed to do so until now, and this is why I had applied for DHP.

My comment was met with silence. 

Apparently, not falling into rent and council tax arrears is more considered more important than meeting basic survival needs such as eating and keeping warm.

I was also almost casually asked if I had any pets or Sky TV. Next I was asked if I had a TV, broadband and a mobile phone contract. I was asked how much I spend on my phone monthly (it’s a pay as you go). I felt I was being turned into a Daily Mail stereotype by bureaucratic questioning that was designed to find ways of dismissing me as ineligible for support in an arbitrary way, under the cover of mundane chit chat.

The more I responded the more demand was placed on me to justify my outgoings, the more information I presented, the bigger the scope for potentially finding reasons for refusing my application.

ESA and PIP assessments work in much the same way – assessors fish for as much information as possible about your everyday life so they can use it to try and claim you are more able to work and less disabled than you and your doctor are claiming.

For example, “Do you watch soaps on TV?” – a deceptively conversational and informal question – may translate your response on the report potentially, as “Can sit unaided and concentrate for at least half an hour”.  The aims and motives behind the questions are deliberately obscurred, so that you don’t have an opportunity to explain or clarify any details or challenge the assumptions being made to justify ending your lifeline support.

That gold locket and chain that was your mother’s, which you wear all the time because you can’t take it off, as the clasp is too difficult for your arthritic fingers, becomes a sign of finger and hand dexterity to an assessor, as it’s just assumed you take it off and put it on again. When I had a chest x-ray rencently, I had to ask the radiographer to take it off. The whole process is designed to search out ways to discredit your doctor’s and your own account by any means at all concerning the level of your disability and the impact it has on your day to day living and work capability.  

Agents of state control and “changing behaviours”

Behavioural conditionality has now been built into every aspect of social safety net provision, this is to save costs and ultimately, to justify the dismantling of social security, public services and healthcare provision. It is justified by an ideological narrative of the neoliberal “small state”, austerity and paying off the national deficit, the “unsustainability” of safety net provision and the state re-translation of competitive individualism into a rhetoric of self help, thrift and “personal responsibility”.

However, the behavioural change programme is being applied only to poor and vulnerable citizens. Against a backdrop of austerity and welfare “reforms” (cuts), millionaires were awarded a tax cut of £107,000 each per year, exempting them from the same obligation to practice personal responsibility, thrift and self help. The Conservatives’ low tax and low welfare society means that perversely, those who have a lot of money are not expected to contribute to our society, whereas those who are low earners or unemployed are expected to pay down the deficit and pull themselves up by invisible bootstraps.

If you suffer or die in the process, apparently that is okay because the government inform us there is no “causal link” between such “adverse” consequences and their adverse policies. However, a correlation has been well-established by independent research and the narratives of many of those affected by the draconian polcies, as well as campaigners.

What really struck me during my housing benefit interview was how the ordinary and seemingly reasonable woman in front of me seemed to suddenly shapeshift into a resentful, disapproving and prejudiced state drone who didn’t feel I deserved any support, about a third of the way into our interview.  I felt like Iain Duncan Smith was conducting the interview.

The government have built up almost impenetrable walls of authoritarian bureacracy around social security provision, and a hive mind army to deliver their distinctive and punitive approach to poverty, which is now all pervasive. All bullies seek the “behavioural change” of others to get their own way.  Conditionality is built upon a behavioural change agenda to prop up neoliberal policies aimed at removing social provisions that the poorest citizens need to survive. Work is no longer the panacea it is held to be, since labour market deregulation and intentionally low social security creates a reserve army of labour, which “incentivises” profiteering employers to keep wages low. 

Even a trip to your GP is likely to trigger the question “do you work” these days, as job coaches are co-located in surgeries to enforce the government’s “work cure” and suck you back into a supply side reserve army of desperate labour. However, sometimes people are simpy too ill to work. The state and its wall of bureaucracy, however, are absolutely refusing to accept this.

There is no end to intrusive state nudging and shoving, especially when you just want to be left to cope with being progressively ill in peace. The government believe that illness and disability are simply a set of “faulty” behaviours that need correcting, and that people will respond to a particularly punitive form of operant conditioning in order to change their behaviours to bring about a miraculous recovery. Work is considered a “health” outcome. However, work is a work outcome and has nothing whatsoever to do with a person’s health. In my own experience, work considerably contributed to the progression of my illness. Being constantly expected to work has also contributed significantly to the deterioration in my health.

Furthermore, I don’t recall giving consent for my taxes and national insurance to be used to pay rogue companies that cost the public billions to “save” relatively meagre amounts in welfare and public service spending just to punish, bully and coerce people who need support.

Nor did I give consent to a state experiment in value-laden, poorly designed and prejudice-determined operant conditioning on ill, disabled and unemployed citizens. 

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Cameron was surely mocking when he used this phrase as a slogan from Terry Gilliam’s darkly dystopic film, “Brazil”, which was coincidently about nightmarish totalitarian bureaucracy 

There were no innocent and random comments from the interviewing housing officer. Almost every question was geared towards making me feel guilty for being poor and not being in work, I was challenged over every single penny I spent, as if I have no right to food, items that I need to meet my complex health needs, and no right to extend an ordinary gesture of basic kindness and decency by taking in a stray cat that had no home and no-one. I’m surprised I wasn’t asked to sell everything I had bought and kept from when I worked.

I had no idea that disabled people could be refused support if they had a pet. Regardless of whether that pet was one you had when you were in better circumstances, working. How utterly callous to expect people to dispose of their cherished companions when they experience hard times, it’s cruel on the person and cruel on the poor and innocent animal.

Most pets cost very little to feed, too.

My cat is a great source of calm and comfort for me, at a time when I am struggling trying to constantly adapt to a progressive illness, and increasing absolute poverty.  I couldn’t bear to part with her.

I wonder what the decision-makers, who are gatekeeping funds that are meant to support disabled people rather than punish them, expect a person should actually do with a cherished family pet, which may have been a part of a family long before severe financial problems and illness came along.

It’s rather like financially penalising people by cutting off support for some children just because a parent has lost a job and encountered difficult times. It’s a Poor house mentality – we are all categorised as either “deserving” or “undeserving” based on our previous choices as well as our current ones. How very dare anyone have anything at all that gives them a little joy and comfort if they become too ill to work. Even if they worked for it prior to losing their job or becoming ill.

This said, those people who have never been able to work should be supported, unconditionally and without any resentment, to meet their living needs and to lead safe and secure lives. This is how a democratic, decent and civilised society should behave, after all.

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I don’t need a behavioural change agenda. My behaviour didn’t put me in a position of hardship: ill conceived state policies that disproportionately target ill and disabled people for austerity cuts are the root cause of my financial problems. I am not ill because of my behaviour, my medical condition arose because of a complex interplay between genetics (my mother and her father had a connective tissue disease, and both my maternal aunt and uncle do), hormonal events (pregnancy was probably the trigger in my case, as that is when I first became ill, 21 years ago) and possibly some environmental triggers too, such as an infection. It was not because I did or didn’t do something. No-one could have predicted a pregnancy would trigger a connective tissue disease. No-one knows how it will progress either, unfortunately. I managed to work for some years whilst being ill, and stopped only because I absolutely had too when I my symptoms became too severe.

Neoliberalism is founded on the principles of “market competition” and competitive individualism. In competition, a few people do very well and “win”, and many more don’t. That is the nature of competition. This is how it works.

Neoliberalism itself causes inequality and poverty, whilst rewarding most the people who are already very wealthy. Addressing the “behaviours” of poor people to punish them into not being poor won’t change the consequences of inequality because of our socioeconomic organisation one bit. Poverty, by it’s very nature, reduces behavioural choices and opportunity.

It’s really the government who need to change their policies and prejudiced behaviours, not poor, ill and disabled people.

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Related 

What do good Local Welfare Support and Conditionality Schemes look like? – The introduction of local welfare support and conditionality schemes are a side-effect of localisation.


I don’t make any money from my work. I am disabled because of illness and have a very limited income. Successive Conservative chancellors have left me in increasing poverty. 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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A bad job is worse for your mental health than unemployment, say UK’s top psychologists

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Last month, the following letter was sent to the Independent, titled The DWP must see that a bad job is worse for your mental health than unemployment:

“We, the UK’s leading bodies representing psychologists, psychotherapists, psychoanalysts, and counsellors, call on the Government to immediately suspend the benefits sanctions system. It fails to get people back to work and damages their mental health.

Findings from the National Audit Office (NAO) show limited evidence that the sanctions system actually works, or is cost effective.

But, even more worrying, we see evidence from NHS Health Scotland, the Centre for Welfare Conditionality hosted by the University of York, and others, which links sanctions to destitution, disempowerment, and increased rates of mental health problems. This is also emphasised in the recent Public Accounts Committee report, which states that the unexplained variations in the use of benefits sanctions are unacceptable and must be addressed.

Vulnerable people with multiple and complex needs, in particular, are disproportionately affected by the increased use of sanctions.

Therefore, we call on the Government to suspend the benefits sanctions regime and undertake an independent review of its impact on people’s mental health and wellbeing.

But suspending the sanctions system alone is not enough. We believe the Government also has to change its focus from making unemployment less attractive, to making employment more attractive – which means a wholesale review of the back to work system.

We want to see a range of policy changes to promote mental health and wellbeing. These include increased mental health awareness training for Jobcentre staff – and reform of the work capability assessment (WCA), which may be psychologically damaging, and lacks clear evidence of reliability or effectiveness.

We urge the Government to rethink the Jobcentre’s role from not only increasing employment, but also ensuring the quality of that employment, given that bad jobs can be more damaging to mental health than unemployment.

This should be backed up with the development of statutory support for creating psychologically healthy workplaces.

These policies would begin to take us towards a welfare and employment system that promotes mental health and wellbeing, rather than one that undermines and damages it.

Professor Peter Kinderman, President, British Psychological Society (BPS)

Martin Pollecoff, Chair, UK Council for Psychotherapy (UKCP)

Dr Andrew Reeves, Chair, British Association for Counselling and Psychotherapy (BACP)

Helen Morgan, Chair, British Psychoanalytic Council (BPC)

Steve Flatt, Trustee, British Association of Behavioural and Cognitive Psychotherapies (BABCP)”

“Making work pay” for whom?

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It’s a draconian, crude behaviourist and armchair technocratic government that would claim to “make work pay” by decreasing social security support for the poorest members of society, rather than raising wages to meet the rising costs of living. This approach was justified by claims that poor people became “dependent” on benefits because the welfare state provides “perverse incentives” for people seeking employment. However, there is no empirical evidence of these claims. Keith Joseph, a leading New Right advocate of the welfare dependency theories, set out to try and establish evidence dependency during the Thatcher era, and failed. Both Thatcher and Joseph wanted to extend Victorian bourgeois values of thrift, self-reliance and charity among all classes.

Such an approach has benefitted no-one but wealthy employers motivated by a profit incentive, as people who are out of work or claiming disability related benefits have become increasingly desperate. These imposed conditions have created a reserve army of labour, which has subsequently served to devalue labour, and drive wages down. We now witness high levels of in-work poverty, too. The Victorian Poor Law principle of less eligibility had the same consequences, and also “made work pay.” It’s shameful that in 2017, the government still believe that it is somehow effective and appropriate to punish people into not being poor. Especially when the government’s own policies are constructing inequality and poverty.

Last week I wrote about the Samaritans report: Dying from inequality: socioeconomic disadvantage and suicidal behaviour, which strongly links socioeconomic disadvantage and inequality with psychological distress and suicidal behaviours. The report reiterates that countries with higher levels of per capita spending on active labour market programmes, and which have more generous unemployment benefits, experience lower recession-related rises in suicides.

Research has consistently found that in countries with a generous social safety net, poor employment (low pay, poor conditions, job insecurity short-term contracts), rather than unemployment, has the biggest detrimental impact on mental health. This is particularly true of neoliberal states with minimal and means tested welfare regimes. It seems health and wellbeing are contingent on the degree to which individuals, or families, can uphold a socially acceptable standard of living independently of market participation, and on the kind of social stratification  (socioeconomic hierarchies indicating levels of inequality) is fostered by social policies.

Furthermore, despite the government’s rhetoric on welfare “dependency”, and the alleged need for removing the “perverse incentives” from the social security system by imposing a harsh conditionality framework and a compliance regime – using punitive sanctions – and work capability assessments designed to preclude eligibility to disability benefits, research shows that generous social security regimes make people more likely to want to work, not less.

The government’s welfare “reforms” have already invited scathing international criticism because they have disproportionately targeted cuts at those with the least income. Furthermore, the government have systematically violated the human rights of those with mental and physical disabilities. In a highly critical UN report last year, following a lengthy inquiry, it says: “States parties should find an adequate balance between providing an adequate level of income security for persons with disabilities through social security schemes and supporting their labour inclusion. The two sets of measures should be seen as complementary rather than contradictory.”

However, the UK government have continued to conflate social justice and inclusion with punitive policies and cuts, aimed at coercing disabled people towards narrow employment outcomes that preferably bypass any form of genuine support and the social security system completely. 

See – UN’s highly critical report confirms UK government has systematically violated the human rights of disabled people.

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Kitty.

 


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. The budget didn’t do me any favours at all.

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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IAPT is value-laden, non-prefigurative, non-dialogic, antidemocratic and reflects a political agenda

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Arnstein’s ladder of citizen participation and inclusion. It represents the redistribution of power that enables marginalised citizens, presently excluded from the political and economic processes, to be purposefully included in the future.

The government’s Work and Health Programme, due to be rolled out this autumn, 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.

But the government’s aim to prompt public services and commissioned providers to “speak with one voice” is founded on traditional Conservative prejudices about people who need support. This proposed multi-agency approach is reductive, rather than being about formulating expansive, coherent, comprehensive and importantly, responsive mental health provision.

What’s on offer is psychopolitics, not therapy. It’s about (re)defining the experience and reality of a marginalised social group to justify dismantling public services (especially welfare). In linking receipt of welfare with health services and state therapy, with the single politically intended outcome of employment, the government is purposefully conflating citizens’ widely varied needs with economic outcomes and diktats, which will isolate people from traditionally non-partisan networks of unconditional support, such as the health service, social services, community services and mental health services.

Services “speaking with one voice” will invariably make accessing support conditional, and further isolate 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. And meeting ideologically designed targets.

As neoliberals, the Conservatives see the state as a means to reshape social institutions and social relationships hierarchically, based on a model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged and modified. Social groups that don’t conform to ideologically defined economic outcomes and politically defined norms are stigmatised and outgrouped. 

Othering and outgrouping have become common political practices, it seems.

The Work and Health Programme is a welfare-to-work programme for people with disabilities, mental health problems and for long-term unemployed people, due to be rolled out in the autumn. In the recent Work, Health and Disability green paper, the government mentioned new mandatory “health and work conversations” in which work coaches will use “specially designed techniques” to “help” those people in the ESA Support Group – those assessed by their own doctors and the state as being unlikely to work in the near future – “identify their health and work goals, draw out their strengths, make realistic plans, and build resilience and motivation.” 

Apparently these “conversations” were “co-designed” by the Behavioural Insights Team.

Democracy is based on a process of dialogue between the public and government, ensuring that the public are represented: that governments are responsive, shaping policies that address identified social needs.

However, policies increasingly reflect a behaviourist turn. They are no longer about reflecting citizens’ needs: they are increasingly about telling some citizens how to be. This has some profound implications for democracy.

Neoliberal policies increasingly extend behaviour modification techniques that aim to quantifiably change the perceptions and behaviours of citizens, aligning them with narrow neoliberal outcomes through rewards or “consequences.” Rewards, such as tax cuts, are aimed at the wealthiest, whereas the most vulnerable citizens who are the poorest are simply presented with imposed cuts to their lifeline support as an “incentive” to not be poor. Taking money from the poorest is apparently “for their own good”.   

Defining human agency and rationality in terms of economic outcomes is extremely problematic. And dehumanising. Despite the alleged value-neutrality of behavioural economic theory and CBT, both have become invariably biased towards the status quo rather than progressive change and social justice.

Behavoural economics theory has permited policy-makers to indulge ideological impulses whilst presenting them as “objective science.” From a libertarian paternalist perspective, the problems of neoliberalism don’t lie in the market, or in growing inequality and poverty: neoliberalism isn’t flawed, nor are governments – we are. Governments and behavioural economists don’t make mistakes – only citizens do. No-one is nudging the nudgers. It’s assumed that their decision-making is infallible and they have no whopping cognitive biases of their own. 

“There’s no reason to think that markets always drive people to what’s good for them.” Richard Thaler.

There’s no reason whatsoever to think that markets are good for people at all. Let’s not confuse economics with psychology, or competitive individualism and economic Darwinism with collectivism and mutual aid. Behavioural economics may offer us titbit theories explaining individual consumer’s decision making, but it’s been rather unreliable in explaining socioeconomic and political contexts and complex systems such as financial crises, and of course behavioual economists don’t feel the same pressing need to explore the decision making and “cognitive bias” of the handful of people who cause those.

It wasn’t those with mental health problems currently claiming social security. They do much less damage to the economy, in fact IAPT means vulture capitalist private companies like G4S and trusts like Southern Care can turn a profit offering “support”. 

The current emphasis on quantitative methodology and standardisation has led to an overwhelming focus on measurement in IAPT settings. Mental health services are now dominated by IAPT, which focuses exclusively on “evidence-based” and short-term interventions for clients with particular diagnoses – mostly anxiety disorders and depression. Most workers in IAPT services offer CBT, often by minimally trained psychological wellbeing practitioners offering “low-intensity” interventions over few sessions.

Verificationism and standardisation leads to a focus on measurement in IAPT settings. CBT mutes the causes of distress, which do not reside “within” the individual: they are intersubjectively constructed, with cultural, socioeconomic and political dimensions. Furthermore, there is little room left for authentic dialogue – qualitative accounts of client’s experiences are not accommodated. In this context, CBT is authoritarian, rather than being prefigurative and genuinely dialogic.

Under the government’s plans, therapists from the IAPT programme are to support jobcentre staff to assess and treat claimants, who may be referred to online cognitive behavioural therapy (CBT) courses. 

We must question the ethics of linking receipt of welfare with “state therapy,” which, upon closer scrutiny, is not therapy at all. Linked to such a narrow outcome – getting a job – it amounts to little more than a blunt behaviour modification programme. The fact that the Conservatives have planned to make receipt of benefits contingent on participation in “treatment” also worryingly takes away the fundamental right of consent.

CBT facilitates the identification of “negative thinking patterns” and associated “problematic behaviours” and “challenges” them. This approach is at first glance a problem-solving approach, however, it’s 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. 

So we need to ask what are the circumstances that we expect people to accept stoically. Socioeconomic inequality? Precarity? 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?  

It’s all very well challenging people’s thoughts but for whom is CBT being used. For what purpose? It seems to me that this is about coercing those people on the wrong side of draconian government policy to accommodate that; to mute negative responses to negative situations. CBT in this context is not based on a genuinely liberational approach, nor is it based on democratic dialogue. It’s 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 tends to generate oversimplifications of the causes human distress. It’s not about helping people make better choices, it’s about coercing people to make the choices that policymakers want them to make. Those “choices” are based on enforced conformity to the ideological commitments of policymakers.

It’s assumed that the causes of unemployment are personal and attitudinal rather than sociopolitical or because of health barriers, 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.

There is also widely held assumption that working is good for mental health, and that being in employment indicates mental wellbeing. It’s well-established that poverty is strongly linked with a higher likelihood of being diagnosed with a mental illness. That does not mean working is therefore somehow “good” for mental health. Encouraging people to work should entail genuine support, it shouldn’t entail taking away their lifeline income as punishment “incentive” if they can’t work.

An adequate level of social security to meet people’s basic survival needs is not mutually exclusive from encouraging people to find a suitable job.

It’s worth noting that research indicates in countries with an adequate social safety net, poor employment (low pay, short-term contracts), rather than “worklessness”, has the biggest detrimental impact on mental health. 

CBT does not address the socioeconomic and political context. It permits society to look the other way, whilst the government continue to present mental illness as an individual weakness or vulnerability, and a consequence of “worklessness” rather than a fairly predictable result of living a distressing, stigmatised, excluded existence and material deprivation in an increasingly unequal society.

Inequality and poverty arise because of ideology and policy-formulated socioeconomic circumstances, but the government have transformed established explanations into a project of constructing behavioural and cognitive problems as “medical diagnoses” for politically created socioeconomic problems. Austerity targets the poorest disproportionately for cuts to income and essential services, it’s one ideologically-driven political decision taken amongst alternative, effective and more humane choices.

Both nudge and CBT are being used to prop up austerity and reflect neoliberal managementspeak at its very worst. Neoliberal policies are causing profound damage, harm and distress to those they were never actually designed to “help”. Let’s not permit techniques of neutralisation: the use of rhetoric to obscure the real intention behind policies. It’s nothing less than political gaslighting.

The government’s profound antiwelfarist rhetoric indicates that there’s no genuine intention to support those people with mental health problems and others in need, despite their semantic thrifts and diversions.

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, all citizen’s accounts of the impacts of policies ought to matter. 

However, in the UK, the way that policies are justified is being increasingly detached from their aims and consequences, partly because democratic processes and basic human rights are being disassembled or side-stepped, partly because the government employs the widespread use of linguistic strategies and techniques of persuasion to intentionally divert us from the aims and consequences of their ideologically driven and increasingly dehumanising policies. Furthermore, policies have become increasingly detached from public interests and needs. 

For people with mental health problems, policies are being formulated to act upon them as if they are objects, rather than autonomous human subjects. Such a dehumanising approach has contributed significantly to a wider process of social outgrouping, increasing stigmatisation and ultimately, to further socioeconomic and mental health inequalities.

It’s the government that need to change their behaviour.

It’s us that need to make a stand against hegemonic neoliberal discourse and injustice.

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This article was written for a zine to mark the protest at the 10th annual New Savoy conference on 15 March in London #newsavoy2017. You can read the zine, with other people’s excellent contributions, here.

Also, see: New Savoy Protest against psycho-compulsion of MH claimants – 15th March 2017.

You can read about the background to the Mental Wealth Alliance and the New Savoy demo and lobby here.

You can watch the video here from Let Me Look TV: Protest at the 10th Annual New Savoy Conference 15 March 2017.

Please share.

Related

The power of positive thinking is really political gaslighting

The importance of citizen’s qualitative accounts in democratic inclusion and political participation

A critique of the ‘Origins of Happiness’ study

A critique of Conservative notions of social research

Research finds damaging mental health discrimination ‘built into’ Work Capability Assessment. Again.

The Conservative approach to social research – that way madness lies


 

I don’t make any money from my work. I am disabled because of illness and have a very limited income. The budget didn’t do me any favours at all.

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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Poverty has devastating impact on children’s mental health

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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.

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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


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The still face paradigm, the just world fallacy, inequality and the decline of empathy

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UNICEF’s reports have consistently put the UK at the bottom of the child well-being league table. See also: UNICEF criticises UK’s failure to tackle child inequality as gap grows.

pie-wealthSource: The Equality Trust 

The still face paradigm and inequality

Before Christmas I read an excellent and insightful article by Michael Bader called The Decline of Empathy and the Appeal of Right-Wing Politics, which was about Edward Tronick’s Still Face experiment in part. Tronick is an American developmental psychologist at the University of Massachusetts, Boston. His studies illuminate the importance of trusting relationships and consistent human responses in children’s development and learning.

Tronick’s experimental design was very simple: mothers were asked to play as they usually would with their six-month-old infants. The mothers were then instructed to suddenly blank their face: to make their facial expression flat and neutral – completely “still”  – and to do so for three minutes, regardless of her baby’s activity.  Mothers were then told to resume normal play. The design came to be called the “still face paradigm.

The study demonstrated that when the connection between an infant and caregiver is broken, the infant tries to re-engage the caregiver, and then, if there is no response, the infant withdraws – first physically and then emotionally. Recent studies have found that four-month-old infants, when re-exposed to the “Still Face” two weeks after the first time, show rapid physiological changes that were not present when they were exposed to it the first time.

Tronick said: “It speaks to the incredible emotional capacities [of] the infant — to pick up on the fact that the mother’s not reacting emotionally the way she normally does. The baby has not only this ability to process what’s [happening], but [also] the capacity to respond in a really appropriate way — that is, they try to get the mother’s attention, and then when they fail, they give up, with a sense of their own helplessness. They may be angry and then they become sad.”

Tronick also emphasised the impact of parenting practices embedded in the sociocultural and ecological environment of the infant.

Bader’s inspiring article draws on Tronick’s experimental findings, which he then applies to citizen’s life experiences in the US, in the face of dehumanising encounters with bureacracy, increasingly depopulated policies and a profoundly alienating sociopolitical system. He goes on to discuss how “the pain of the “still face” in American society is present all around us.”

He says: “People feel it while waiting for hours on the phone for technical support, or dealing with endless menus while on hold with the phone or cable company, or waiting to get through to their own personal physician. They feel it in schools with large class sizes and rote teaching aimed only at helping students pass tests.  

They feel it when crumbling infrastructure makes commuting to work an endless claustrophobic nightmare.  And, too often, they feel it when interacting with government agencies that hold sway over important areas of their lives, such as social services […] and city planning departments, or a Department of Motor Vehicles.  Like Tronick’s babies, citizens who look to corporations and government for help, for a feeling of being recognized and important, are too often on a fool’s errand, seeking recognition and a reciprocity that is largely absent. 

This problem is greatly exaggerated by the profoundly corrosive effects of social and economic inequality. Under condition of inequality, the vulnerability of those seeking empathy is dramatically ramped up, leading to various forms of physical and psychological breakdowns. In a classic epidemiological study [The Spirit Level] by Richard Wilkinson and Kate Pickett, researchers found a strong correlation between the degree of inequality in a country (or a state, for that matter) and such problems as rates of imprisonment, violence, teenage pregnancies, obesity rates, mental health problems such as anxiety, depression, and addiction, lower literacy scores, and a wide range of poor health outcomes, including reduced life expectancy. 

Wilkinson and Pickett’s key finding is that it is the inequality itself, and not the overall wealth of a society that is the key factor in creating these various pathologies.  Poorer places with more equality do better than wealthy ones marked by gross inequality.

Inequality makes people feel insecure, preoccupied with their relative status and standing, and vulnerable to the judgment of others, and it creates a greater degree of social distance between people that deprives them of opportunities for intimate and healing experiences of recognition and empathy.”

The still face of the neoliberal state

It’s impossible to fail to recognise the parallels with citizen’s experiences here in Britain. We have ideological and socioeconomic commonality with the US, especially as both the UK and US are neoliberal states. Neoliberalism is an ongoing, totalising ideological and political-economic project of a resurgent political right that gained ascendancy in the US under Ronald Reagan and in the UK under Margaret Thatcher in the 1980s.   

Bader says: “As a metaphor for adult life in contemporary society, the “still face” paradigm—the helplessness intrinsic to it and the breakdown of empathy that lies at its foundation—aptly describes the experience of many people as they interact with the most important institutions in their lives, including government.

And, as with Tronick’s babies and their mothers, when our social milieu is indifferent to our needs and inattentive to our suffering, widespread damage is done to our psyches, causing distress, anger, and hopelessness.  Such inattention and neglect lead to anxiety about our status and value, and a breakdown of trust in others.”

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I agree that the growing inequalities we are witnessing in western neoliberal “democracies” create profound psychological trauma and hermetic material and ontological insecurity. Humans are fundamentally social beings. We thrive best when we have a social rationale which tends towards the promotion of cooperative and collective creativity. This was perhaps expressed best in our civilised, progressive institutions and civilising practices, facilitated by the social gains and economic organisation that arose from the post-war settlement.  

Those gains are now being systematically dismantled. Our culture has been saturated with conceptual schema that demand we remain committed to an socioeconomic Darwinism, a kind of economic enclosure: a neoliberal competitive individualist obsession with our private, inner experiences, the pursuit of economic self-interest, and ultimately, this embellishes our separability from other human beings. It alienates us. 

Neoliberalism scripts social interactions that are founded on indifference to others, tending to be dehumanising, adversarial and hierarchical in nature, rather than social and cooperative. Neoliberalism is the antithesis of the responsive, animated human face; of collectivism, mutual support, universalism, cooperation and democracy. Neoliberalism has transformed our former liberal democracy into an authoritarian “still faced” state that values production, competition and profit above all else; including citizens’ lives, experiences, freedoms, well-being, democratic inclusion and social conditions that support all of this.  

Citizens are seen and are being politically redefined in isolation from the broader political, economic, sociocultural and reciprocal contexts that invariably influence and shape individual experiences, meanings, motivations, behaviours and attitudes, causing a problematic duality between context and cognition. This also places responsibility on citizens for circumstances which lie outside of their control, such as the socioeconomic consequences of political decision-making, whilst at the same time, the state is steadily abdicating responsibility for the basic welfare of ordinary citizens. 

Geographer David Harvey describes neoliberalism as a process of accumulation by dispossession: predatory policies are used to centralise wealth and power in the hands of a few by dispossessing the public of their wealth and assets.  

Neoliberals see the state as a means to reshape social institutions and social relationships based on the model of a competitive market place. This requires a highly invasive power and mechanisms of persuasion, manifested in an authoritarian turn. Public interests are conflated with narrow economic outcomes. Public behaviours are politically micromanaged. Social groups that don’t conform to ideologically defined outcomes are stigmatised and outgrouped.  

Stigma is a political and cultural attack on people’s identities. It’s used to discredit, and as justification for excluding some groups from economic and political consideration, refusing them full democratic citizenship. 

Stigma is being used politically to justify the systematic withdrawal of support and public services for the poorest – the casualties of a system founded on competition for allegedly scarce wealth and resources. Competition inevitably means there are winners and losers. Stigma is profoundly oppressive. It is used as a propaganda mechanism to draw the public into collaboration with the state, to justify punitive and discriminatory policies and to align citizen “interests” with rigid neoliberal outcomes. Inclusion, human rights, equality and democracy are not compatible with neoliberalism. 

Othering and outgrouping have become common political practices, and are now culturally embedded. 

This serves to desensitise the public to the circumstances of marginalised social groups. Outgroups serve to de-empathise society and dehumanise stigmatised others

This political and cultural process legitimises neoliberal “small state” policies, such as the systematic withdrawal of state support for those adversely affected by neoliberalism, and it also justifies inequality. By stigmatising the poorest citizens, a “default setting” is established regarding how the public ought to perceive and behave towards politically demarcated outgroups. That default setting is indifference to the plight of others. 

Authors of The Spirit Level, Richard Wilkinson and Kate Pickett, say “The truth is that human beings have deep-seated psychological responses to inequality and social hierarchy. The tendency to equate outward wealth with inner worth means that inequality colours our social perceptions. It invokes feelings of superiority and inferiority, dominance and subordination – which affect the way we relate to and treat each other.”

Neoliberalism and the myth of meritocracy

How does inequality and social injustice become acceptable? And why do we, as a society, permit the political construction of scapegoats and outgroups? 

Neoliberalism is premised on the assumption that the market place can somehow replace the state as the ultimate arbiter of cultural logic and value. Relationships between people are mediated by the depersonalising market place.

It is fundamentally Hobbesian in character, neoliberalism privatises citizen’s experiences, who are valued for their economic productivity and are therefore only responsible for themselves. 

Bader says: “The failure of our institutions to empathize with the plight of the middle and working classes, to recognize their sacrifice and reward their hard work is traumatic. It is the same type of trauma that children experience when their caretakers are preoccupied or rejecting. The trauma erodes trust. It overwhelms systems that people have developed to deal with stress and creates psychological suffering and illness.” 

He goes on to tell us how our social brains seek a collective experience – of “we” rather than “I” – and often do so by creating a fantasy of an “us” versus “them” that we can devalue and fight.

Tribalism draws on our need for sociability and interconnectedness but it can also be used to pervert it. Rejected by government, employers and wider society, some citizens then go on to reject and demean others. It’s a coping strategy: they are trying to cope with the pain, powerlessness, and lack of empathy that they experience in their social lives.

And we must we also recognise the play of hidden ideologies and the influence of dog whistle and wedge issue politicking. This is a state tactic which manipulates our fundamental human need for a sense of belonging. It’s also about the creation of scapegoats and diversion from the real problem: neoliberalism, authoritarianism and the inequality and increasing precarity that this extends and perpetuates. Hierarchical thinking is embedded in neoliberal and authoritarian ideologies.

Neoliberalism also extends a myth that citizens are autonomous and free to make choices. However, this ignores the well-researched reality that those without resources have few or no choices. 

Neoliberalism is an ideology that manufactures consent to inequalities by offering the myth of meritocracy: the false promise that everyone will eventually benefit by working hard to earn merit, status and wealth. However, it isn’t logically possible for equal opportunities to exist in a highly unequal society. 

This myth undermines the principles of social and economic rights and discredits solidarity, collective responsibility and contravenes our human need for belonging. Success, according to the meritocrats, is shaped by your IQ and individual talents, hard work and personal effort. Yet at least a third of those touting this myth are millionaires who simply inherited their wealth.   

The ideology of meritocracy conceals the fact that class privileges are institutionalised, and are reinforced through the education system, for example. The UNICEF report, Fairness for Children, emphasised the importance of a strong welfare system in reducing inequality – and carried a strong suggestion that the UK Government should reconsider its cuts to benefits. In June last year, following its investigation, the United Nations committee on the rights of the child called on ministers to act regarding austerity, the benefit cap and tax credit cuts, which are undermining children’s rights to an adequate standard of living. The government were also urged to do more to ensure children’s rights to adequate health, housing and education are met, too. 

The government, however, have claimed that welfare cuts reduce poverty by “incentivising” people to work. Meanwhile, over half of those families queuing at food banks are in work, and nearly two thirds of children in poverty live in working families. “Making work pay” is nothing more than a Conservative euphemism for the incremental dismantling of the welfare state, which they intend to continue, regardless of the social consequences. 

Neoliberalism is sustained by ideologues employed by governments, in think tanks, PR companies and as individual consultants, that invent technical justifications for small state neoliberal policies on the grounds of: “efficiencies”, savings, democracy, economic growth, and more recently “fairness” and “social justice.” The latter two especially are founded on the myth of meritocracy, in this context. 

In any competitive system, there are invariably a few “winners” and many more “losers”.  The system itself creates the conditions which mean that many people “lose”. It has nothing to do with the IQ, character or qualities of those people. Competition is adversarial – it’s defined as a situation in which two or more people or groups are fighting to get something which not everyone can have

The Nudge Unit is one example of a technocratic think tank that promotes the myth of meritocracy, which is embedded in the Cabinet Office. The neoliberal Reform think tank and the Adam Smith Institution are others. There is a raft of contemporary academics who are also fueling ideological justifications of neoliberal policies – the likes of Adam Perkins, Richard Layard, Mansel Aylward and Simon Wessley, for example, each in their respective academic fields have each presented “studies” that endorse “small state” antiwelfarism and enforce notions of personal responsibility and competitive individualism. Public interests are steadily being aligned with economic outcomes, driven by private interests. 

Status and rewards in society do not go “naturally” to those who are best “performers” or those who “earn” their privilege: the hierarchy of wealth and power is being purposefully shaped by the state.

Stigma and the just world fallacy

Sociologist Imogen Tyler at Lancaster University, says “[…] the centrality of stigma in producing economic and social inequalities has been obscured ‘because bodies of research pertaining to specific stigmatized statuses have generally developed in separate domains’ (Hatzenbuehler, 2013). In short, stigma is widely accepted to be a major factor in determining life chances, yet research on stigma is fragmented across academic disciplines.”

Tyler’s ongoing work – The Stigma Doctrine, is focused on policy design and implementation, ‘The Stigma Doctrine’ aims to develop a new theoretical account of the ways in which neoliberal modes of government operate not only by capitalizing upon ‘shocks’ but through the production and mediation of stigma.” 

Her explicit focus is on “stigmatization as a central dimension of neoliberal state-crafting.” The project is focussing in particular on welfare “reform”, the neoliberal de/recomposition of class, poverty, work and dis/abilities.

At a basic level, stigma is seen as a mark of disgrace associated with particular circumstances, qualities, or persons. However, it has a fundamental normative dimension, which is culturally and historically specific. 

We tend to make assumptions about people, based on what their circumstances or characteristics are. Central to these assumptions lies a basic moral dichotomy founded on the binary notions of “deserving” and “undeserving”. 

Everyone has heard “what goes around comes around” before, or maybe you’ve seen a person “get what was coming to them” and thought, “that’s karma for you.” These are all shades of the just world fallacy. But in reality, we don’t always “reap what we sow.”

In social psychology, the just world hypothesis is the tendency to attribute consequences to – or expect consequences as the result of – a universal force that restores moral balance. This belief generally implies the existence of destiny, cosmic justice, or divine providence. 

It is very common in fiction for the villains to lose and the virtuous folk to win. It is a reflection of how we would like to see the world – just and fair. In psychology the tendency to believe that this is how the real world actually works is a known cognitive error: the just world is a fallacy. 

Many people have a strong desire or need to believe that the world is an orderly, predictable, and fair place, where people simply get what they deserve. Such a belief plays an important role in our lives – in order to plan our lives or achieve our goals we need to assume that our actions will have predictable consequences. 

Moreover, when we encounter evidence suggesting that the world is not just, we either act to restore justice by helping victims or we persuade ourselves that no injustice has occurred.  We comfort ourselves with the idea that the person without a job is simply lazy, the homeless person is irresponsible, and the ill person made the “wrong” lifestyle choices. These attitudes are continually reinforced in the ubiquitous fairy tales, fables, popular fiction, comics, TV, the mainstream media, current political rhetoric and other morality tales of our culture, including the great myth of meritocracy, embedded in neoliberal narrative, in which “good” is always rewarded and “evil” punished. Only it isn’t.

Deep down, we all would probably like to believe hard work and virtue will lead to success, and laziness, evil and manipulation will lead to ruin, quite often we simply edit the world to match those expectations. 

The normalisation of socioeconomic hierarchy: a nod to Milgram

Social psychologist, Melvin Lerner documents people’s eagerness to convince themselves that beneficiaries deserve their benefits and victims their suffering. In a 1965 study, Lerner reported that subjects who were told that a fellow student had won a cash prize in a lottery tended to believe that the student worked harder than another student who lost the lottery. Lerner observed that when one of two men was chosen at random to receive a reward for a task, that somehow caused him to be more favourably evaluated by observers, even when the observers had been informed that the recipient of the reward was chosen at random. (Lerner, M. J., & Miller, D. T. (1978). Just world research and the attribution process: Looking back and ahead. Psychological Bulletin, 85(5), 1030–1051).

Existing social psychological theories, including cognitive dissonance, do not fully explain these phenomena. In another study a year later, Lerner and a colleague recorded a simulated “learning” experiment in which it appeared that the “participants” were subjected to electric shocks. Lerner found that subjects who observed the videotapes tended to form much lower opinions of these “victimised” participants when there was no possibility of the victim finding relief from the ordeal, or when the victim took on the role of “martyr” by voluntarily remaining in the experiment despite the apparent unpleasantness of the experience.

Lerner concluded that “the sight of an innocent person suffering without possibility of reward or compensation motivated people to devalue the attractiveness of the victim in order to bring about a more appropriate fit between her fate and her character.”

If the belief in a just world simply resulted in humans feeling more comfortable with the universe, its uncertainties and our own precarity, it would not be a matter of great concern for human rights activists, ethicists or social scientists. But Lerner’s just world hypothesis, if correct, has significant social implications. The belief in a just world may well seriously undermine a commitment to social justice.

So, the just world fallacy is founded on a massive misconception: that we always get what we “deserve”. We like to think that people who are not doing well in their lives must have done something to deserve it. Yet we also know that the beneficiaries of good fortune often do nothing to earn it, and people doing harmful deeds often get away with their actions without consequences.

Lerner’s research extended, to some extent, on Stanley Milgram‘s research on social conformity and obedience. Lerner was curious as to how regimes that cause cruelty and suffering manage to maintain popular support, and how people come to accept social norms and laws that produce misery and suffering.

Lerner’s direction of inquiry was influenced by his frequent witnessing of the tendency of observers to blame victims for their suffering, particularly during his clinical training as a psychologist, when he observed treatment of mentally ill persons by the health care practitioners with whom he worked. Though he knew them to be basically kind, educated people, they often blamed patients for the patients’ own suffering. Lerner also describes his surprise at hearing his students derogate disadvantaged people, believing that poor people somehow caused their own poverty, whilst being seemingly oblivious to the social, political and economic (structural) forces that contribute significantly to poverty. 

Zick Rubin of Harvard University and Letitia Anne Peplau of the UCLA conducted surveys to examine the characteristics of people with strong beliefs in a just world. They found that people who have a strong tendency to believe in a just world also tend to be more religious, more authoritarian, more Conservative, more likely to admire political leaders and existing social institutions, and more likely to have negative attitudes and and hold prejudices toward underprivileged groups. To a lesser but nonetheless significant degree, the believers in a just world tend to “feel less of a need to engage in activities to change society or to alleviate plight of social victims.”

It’s ironic that the belief in a just world may take the place of a genuine commitment to justice. For some people, it is simply easier to assume that forces beyond their control mete out justice. When that occurs, the result may be the abdication of personal responsibility, acquiescence in the face of suffering and misfortune, and indifference towards injustice

In the murky waters of real life, evil people often prosper whilst harming others, and quite often never face justice and retribution.

Social reality isn’t founded on some intrinsic and fair principle or quality of the universe. Social justice is something that we must construct and re-construct our selves. In the same way, democracy isn’t something we “have”, it is something we must do.

As a society, we make our own “karma”. We participate in, shape and distribute social justice. That affects those around us. We do need to think about what kind of world we live in, how we ought to live and how that affects our families, friends, neighbours and strangers. A measure of civilisation may be observed in how we behave towards those people we don’t know.

In our society, over the past 6 years, some (previously protected) social groups have become politically defined strangers and economic exiles. If you think that’s okay, it’s worth bearing in mind that sooner or later, someone you know well, perhaps one of your loved ones, will be affected by this ongoing process.

When one group are targeted with injustice and inequality, it affects everyone, and other groups soon follow. Historically, we learned that tyrants don’t stick with targeting and persecuting the group you don’t like. You don’t get a choice ultimately. Prejudice tends to multitask very well, and tyrants remain tyrants no matter who you are.

Wilkinson and Pickett’s research on the harmful effects of economic inequality is a challenge for us to ensure that redistribution is the main focus of our political programme. Their research very clearly shows us that if we work towards greater equality, we can ameliorate a wide range of human suffering. Because neoliberal ideology ultimately disconnects us from each other, we really must work hard to seek common ground with the people on the other side of what American sociologist, Arlie Hochschild, calls the “empathy wall” to reach out, communicate to them that “we not only feel their pain, but we share it, and that, in the end, we are all in this together.”

Hochschild’s work has often described the various ways in which we each  becomes a “shock absorber” of larger social, economic and political forces.  She explores the “deep story” of American citizens – a metaphorical expression of the emotions they live by. She recognised that the people she studied may not vote in favour their economic self-interest,  but they often voted for what they felt was their emotional self-interest as members of a group which feels marginalised, scorned  and betrayed by the establishment. This sense of betrayal was utilised by the right, who readily draw on and manipulate the role of emotion in politics.

How much more of the current political-economic just world narrative will people permit to remain largely unchallenged before we all say “enough”?

In democracies, Government’s are elected to represent and serve the needs of the population. Democracy is not only about elections. It is also about distributive and social justice. The quality of the democratic process, including transparent and accountable Government and equality before the law, is crucial to social organisation, yet it seems the moment we become distracted, less attentive and permit inequality to fundamentally divide our society, the essential details and defining features of democracy seem to melt into air. 

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, all citizen’s accounts of the impacts of policies ought to matter.

However, in the UK, the way that policies are justified is being increasingly detached from their aims and consequences, partly because democratic processes and basic human rights are being disassembled or side-stepped, and partly because the government employs the widespread use of linguistic strategies and techniques of persuasion to intentionally divert us from their aims and the consequences of their ideologically (rather than rationally) driven policies. Furthermore, policies have become increasingly depopulated; detached from public interests and needs.

Democracy is not something we have: it’s something we have to DO.

My hope for 2017 is that enough of us will recognise that democratic participation is essential, and that injustice directed against one is injustice ultimately directed against all. 

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All the best for the new year. 

In solidarity.

Related  

The Decline of Empathy and the Appeal of Right-Wing Politics – Michael Bader

Who Believes in a Just World? –  Zick Rubin and Letitia Anne Peplau 

The Stigma Project – Imogen Tyler

The Spirit Level authors: why society is more unequal than ever – Richard Wilkinson and Kate Pickett

The importance of citizen’s qualitative accounts in democratic inclusion and political participation

 


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

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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.

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