Tag: sanctions

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

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Abbie and her late father, James Harrison.

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

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

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

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

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

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

He was clearly not fit for work.

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

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

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

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

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

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

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

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

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

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

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

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

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

The letter was addressed to James’s GP.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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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An example of in-work conditionality: when work doesn’t pay

Tory UK

Under in-work conditionality, those people claiming Universal Credit who are already working up to 35 hours a week – and who may never have been unemployed in their life – are forced to seek more work hours, higher pay, or an extra job as a condition of receiving low-wage top-ups and other benefits, or else face sanctions. 

Low-paid workers put through this process report “dehumanising” and “intimidating” experiences. Following years of government rhetoric about prizing “hardworking people”, suddenly many hard working people have found themselves subject to the same sanctions as out-of-work claimants.

A woman from Barrow described how she was given a benefit sanction after missing a job centre appointment because she took a last-minute offer of extra part-time work.

The punishment is one of three she has received, which she says have left her and her partner on the breadline for a year.

The couple were forced to use Barrow’s foodbank and town community kitchen so they didn’t starve, whilst living without heat or power on occasions when the high tariff pre-payment electricity meter at their rented home ran out of credit.

Hitting out at the unfair sanctions at the heart of the benefit system, the couple say this punitive approach is making them ill.

The woman, who is in her 20s, says she has applied for scores of jobs in a bid to secure full-time work, said: “I was given some extra hours on a Monday morning starting at 7am.

“My job centre appointment was at 9.30am and I didn’t have any credit on my phone. I took the work and called to explain about the appointment the next day but it was a sanction.

“I got another one for missing a workshop about Twitter. I know how to use Twitter but it didn’t make any difference. They’ll sanction you for anything.”

The sanctions have had such a detrimental effect that the couple faced homelessness when they could no longer afford the rent on their two-bedroom home.

They moved into a one-bedroom flat in the town after the landlord offered to accept a deferred deposit.

“We try our hardest,” she told the North West Evening Mail.

“I would love to have a full-time job but we’re really struggling. The stress has made me ill. These sanctions are not fair; they need to be stopped.”

The government claim that sanctions are a method of enforcing “cultural and behavioural change” of people claiming both in-work and out-of-work social security. This of course assumes that people’s behaviours are a problem in the first place. Sanctions don’t address the decision-making of employers – who are ultimately responsible for establishing rates of pay and the hours of work for employees – exploitation, structural problems, such as access to opportunity and resources and labour market constraints. 

Barrow councillor and former job centre employee Michael Cassells said there needed to be more flexibility in the system to ensure sanctions were dished out fairly.

“There’s no doubt sanctions are cruel and causing real hardship and, unfortunately, in most cases, people are not told they can appeal against them, or how to do it.

“We need this system to be looked at so that people are treated with respect and empathy. Otherwise they simply feel they are trying their best but hitting a brick wall with nowhere to turn to for help.”

The government’s Universal Credit legislation has enshrined the principle that working people in receipt of in-work benefits may face benefits sanctions if they are deemed not to be trying hard enough to find higher-paid work. It’s not as if the Conservatives have ever valued legitimate collective wage bargaining. In fact their legislative track record consistently demonstrates that they despise it, prioritising the authority of the state above all else.

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.

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 with consideration of the value and benefit for business and the supply end of the labour market. They want a cheap, disciplined reserve army of  labour 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 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 spiralled 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 the House of Lords have been paying attention to the game.

Benefit sanctions are leaving people almost destitute, with some individuals being pushed toward “survival crime” in order to eat and children missing school because parents can’t pay the bus fare. These are the preliminary findings of a major study into increased restrictions on receiving benefits in the UK welfare system, published in full earlier this year.

The research, led by the University of York, also shows the controversial extension of benefit sanctions to working people on Universal Credit  can produce disincentives to work.

The government clearly intends to continue formulating draconian policies which will punish sick and disabled people, unemployed people, the poorest paid, and part-time workers. Meanwhile, the collective bargaining traditionally afforded us by trade unions has been systematically undermined by successive Conservative governments, showing clearly how the social risks of the labour market are being personalised and redefined as being solely the economic responsibility of individuals rather than the government and profit-driven big business employers.

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Related

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

Nudging conformity and benefit sanctions: a state experiment in behaviour modification

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

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

Exclusive: DWP Admit Using Fake Claimant’s Comments In Benefit Sanctions Leaflet

The politics of punishment and blame: in-work conditionality

Stigmatising unemployment: the government has redefined it as a psychological disorder

 


 

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The Nudge Unit’s u-turn on benefit sanctions indicates the need for even more lucrative nudge interventions, say nudge theorists

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Some context: the new neuroliberalism and “behavioural insights”

The behaviourist turn in government administration – the use of targeted citizen behavioural conditionality in neoliberal policy making –  has expanded globally and is linked to the growth of behavioural economics theory (“nudge”) and a New Right brand of “libertarian paternalism.”  

Reconstructing citizenship as highly conditional stands in sharp contrast to democratic principles, rights-based policies and to policies based on prior financial contribution, as underpinned in the social insurance and social security frameworks that arose from the post-war settlement.

The fact that the poorest citizens are being targeted with behavioural theory “interventions” also indicates discriminatory policy, which reflects traditional Conservative class-based prejudices. It’s an authoritarian approach to poverty which simply strengthens existing power hierarchies, rather than addressing the unequal distribution of power and wealth in the UK.

Some of us have dubbed this trend neuroliberalism because it serves as a justification for enforcing politically defined neoliberal outcomes. A hierarchical socioeconomic organisation is being shaped by increasingly authoritarian policies, placing the responsibility for growing inequality and poverty on individuals, side-stepping the traditional (and very real) structural explanations of social and economic problems.

Such a behavioural approach to poverty also adds a dimension of cognitive prejudice which serves to reinforce and established power relations and inequality. It is assumed that those with power and wealth have cognitive competence and know which specific behaviours and decisions are “best” for poor citizens, who are assumed lack cognitive competence (because they are poor and therefore make “the wrong decisions”). Apparently the theories and “insights” of cognitive bias don’t apply to the theorists applying them to increasingly marginalised social groups. Policy has increasingly extended a neoliberal cognitive competence and decision-making hierarchy. 

It’s very interesting that the Behavioural Insights Team now claim that the state using the threat of benefit sanctions may be “counterproductive”. The idea of increasing welfare conditionality and enlarging the scope and increasing the frequency of benefit sanctions originated from the behavioural economics theories of the Nudge Unit in the first place. 

The increased use and rising severity of benefit sanctions became an integrated part of welfare “conditionality” in the Conservative’s Welfare “reform” Act, 2012. The current sanction regime is based on a principle borrowed from behavioural economics theory – an alleged cognitive bias we have called “loss aversion.”

It refers to the idea that people’s tendency is to strongly prefer avoiding losses to acquiring gains. The idea is embedded in the use of sanctions to “nudge” people towards compliance with welfare rules of conditionality, by using a threat of punitive financial loss, since the longstanding, underpinning Conservative assumption is that people are unemployed because of alleged behavioural deficits and poor decision-making. Hence the need for policies that “rectify ” behaviour.

I’ve argued elsewhere, however, that benefit sanctions are more closely aligned with operant conditioning (behaviourism) than “libertarian paternalism,” since sanctions are a severe punishment intended to modify behaviour and restrict choices to that of compliance and conformity or destitution. At the very least this approach indicates a slippery slope from “arranging choice architecture” in order to “support right decisions” that are felt to benefit people, to downright punitive and coercive policies that entail psycho-compulsion, such as sanctioning and mandatory workfare. 

Psychology is being misused by the government to explain unemployment (it’s claimed to happen because people have the “wrong attitude” for work) and as a means to achieve the “right” attitude for job readiness. Psycho-complulsion is the imposition of often pseudo-psychological explanations of unemployment and justifications of mandatory activities which are aimed at changing beliefs, attitudes and disposition. The Behavioural Insights Team have previously propped up this approach.

The Behavioural Insights Team (BIT) is composed of mostly behavioural economists, who also claim the title of libertarian paternalists (and who have a clear and distinct ideological premise for their behavioural theories, whilst attempting to claim “objectivity”.)

They claim that whilst it is legitimate for government, private and public institutions to affect behaviour the aims should be to ensure that “people should be free to opt out of specified arrangements if they choose to do so.” 

The nudges favoured by libertarian paternalists are also supposed to be “unobtrusive.” That clearly is not the case with the application of coercive, punitive Conservative welfare sanctions.

When it comes to technocratic fads like nudge, it’s worth bearing in mind that truth and ethics quite often have an inversely proportional relationship with the profit motive. It’s a cognitive bias, if you will.

And when one nudge theory fails, there are always lucrative and political opportunities to generate more.

Of course Dr Kizzy Gandy, a leading researcher at the policy unit says: “We are optimistic that behavioural science can help government departments to better design policies to help those who are ‘just managing’ in order to prevent and overcome poverty.”

In a new report released today from the Behavioural Insights Team, the authors say: “There is evidence that welfare conditionality in the UK – mandatory behavior requirements such as attending meetings with work coaches or providing repeated evidence of disability in order to receive benefits – is associated with anxiety and feelings of disempowerment.” 

“However, as far as we know no one has examined whether welfare conditionality has cognitive depleting effects.”

It’s particularly  worrying that there is a proposal in the report for further “experimental” pseudo-psychological approaches to policies aimed at the poorest citizens. The researchers call on the Department for Work and Pensions to conduct experiments into whether welfare conditionality actually had any positive effects and suggested that “self-set” and “enforced goals” might be a better way of “helping people into work.” Although this allows for a little tokenist self determination and permits a little autonomy, it is still an approach ultimately based on enforcement.

There is a clear distinction to be made between “behavioural science” – which is almost entirely about economic outcomes; what is politically deemed “best” for citizens and social conformity, and mainstream psychology – which embraces a much broader and deeper perspective of the complexities of human potential and wellbeing.

For anyone curious as to how such tyrannical behaviour modification techniques like benefit sanctions arose from the bland language, inane, managementspeak acronyms and pseudo-scientific framework of “paternal libertarianism” – nudge – here is an interesting read: Employing BELIEF: Applying behavioural economics to welfare to work, which is focused almost exclusively on New Right small state obsessions. Pay particular attention to the part about the alleged cognitive bias called loss aversion, on page 7.

And this on page 18: The most obvious policy implication arising from loss aversion is that if policy-makers can clearly convey the losses that certain behaviour will incur, it may encourage people not to do it,” and page 46: “Given that, for most people, losses are more important than comparable gains, it is important that potential losses are defined and made explicit to jobseekers (e.g.the sanctions regime).”

The recommendation on that page: We believe the regime is currently too complex and, despite people’s tendency towards loss aversion, the lack of clarity around the sanctions regime can make it ineffective. Complexity prevents claimants from fully appreciating the financial losses they face if they do not comply with the conditions of their benefit.”

The Conservatives duly “simplified” sanctions by extending them in terms of severity and increasing the frequency of use. Sanctions have also been extended to include previously protected social groups, such as lone parents, sick and disabled people. 

The paper was written in November 2010, prior to the Coalition policy of increased “conditionality” and the extended sanctions element of the Tory-led welfare “reforms” in 2012. I wrote about this at length earlier this year, here: Nudging conformity and benefit sanctions: a state experiment in behaviour modification.

The Behavioural Insights Team, (otherwise known as the Nudge Unit) was set up by David Cameron in 2010. In their most recent report called Poverty and decision-making: How behavioural science can improve opportunity in the UK, the nudge researchers now say that burdening unemployed people with responsibilities, using the threat of sanctions might actually be making it harder for them to get jobs.

According to the behavioural economist theorists authoring this highly jargonised report, government policies designed to help people are reducing and impairing people’s so-called cognitive scope and abilities.

However, it’s difficult to imagine how punitive sanctioning, which entails the removal of people’s lifeline income, originally calculated to meet the costs of only basic survival needs, such as for food, fuel and shelter, could ever be seen as “helping people.”

I don’t believe that Orwellian semantic shifts can ever provide a genuine and effective solution to poverty and inequality. 

Some major inconsistencies and incoherences in the report

In the latest BIT report, loss aversion is mentioned again:  “People dislike losses more than they like equivalent gains. Babcock, Congdon, Katz, and Mullainathan (2012) hypothesise that people may experience loss aversion if they consider taking a job paying below past earnings. Therefore, they may stay on unemployment benefits longer than they should. Unrealistic wage expectations may be reinforced when the social status and personal identities of workers are strongly tied to their previous job.” [My boldings]

Note the phrase “unrealistic wage expectations” and later incoherent comments in the report about in-work poverty, which I will highlight.

The summary report states in the introduction: A third of the UK population spent at least one year in relative income poverty between 2011 and 2014.

Traditionally policymakers and anti-poverty organisations such as the Joseph Rowntree Foundation (JRF) have focused on boosting people’s economic capital (e.g., income) and human capital (e.g., educational attainment) to reduce poverty. While investments in these areas have led to important gains in opportunity for many Britons, emerging research from behavioural science shows that other less tangible resources, which derive from psychological, social and cultural processes, significantly influence people’s ability to overcome disadvantage.

BIT was commissioned by JRF to examine the role of individual decisions in shaping people’s experiences of poverty in the UK and to identify the drivers of these decisions. This reflects JRF’s interest in looking beyond traditional, structural drivers of poverty. Our findings, based on a review of the published literature, are presented in a new report, launched today.”

Let’s cut to the chase. The entire document is framed by the use of a distinct and established narrative; it’s composed of a pre-loaded ideological language, references and signposts, using comments and phrases like “[…] we explain some of the ways that cognitive, character and social capital influence social mobility, via decision-making.”  

And a sub-heading:Character capital: Self-efficacy and responsive parenting.” Apparently, “home visits by health workers have had positive effects in preventing intergenerational poverty.” That’s quite a remarkable claim, given that the document acknowledges poverty is actually increasing in the UK.

The whole concept of character capital is itself founded on the notion that people with an “internal locus of control” tend to perform tasks better than those with an “external locus of control.” This is about where people place the responsibility for what they achieve – either “inside” individuals, based solely on notions of merit, specific skills and talents, or external to individuals – “outside” of them, based on environmental conditions such as competition, chance, opportunities, socioeconomic, employment market context and so on. However, the cited evidence to support this theory was later contradicted in the report.

It’s also worrying that it is implied those who believe that achievement is linked with structural conditions are “under-performers.” It reads a little like a Samuel Smiles Victorian treatise on “thrift, character and self-help.”

It’s also an almost subliminal method of dismissing the impact of structural constraints on the opportunities available to individuals. It serves to make invisible what was once a key consideration in public discussions about poverty: the unequal distribution of power, wealth, resources and opportunity.

Also of note: “low levels of financial literacy” was conflated with notions of “human capital”, which “potentially exacerbate the effects of depleted cognitive capital among low income groups when choosing between credit options.”  Nothing to see here, then, regarding the behaviour of lenders. I mean whoever heard of a bank offering an overdraft to people who actually need one. Still, thank goodness there are generous companies like Wonga, always ready to step up to the mark, with eye-watering interest rates to offer those on low incomes.

The research authors seem to think that the only human potential worth recognising is that of our economic decision-making. Yet when people are materially poor, budgeting and decision-making are invariably constrained – that’s intrinsic to the very nature of poverty.

Limited decision-making and reduced available choices don’t cause poverty: they are the subsequent exclusion effects of poverty.

It’s telling that none of the recommendations made in this document actually address the structural causes of material poverty and growing inequality in the UK.

There is a substantial incoherence in some of the claims made, too. For example: “The world of work is possibly the single most important policy area for maximising individual and household resources to prevent and overcome poverty.”

Yet: “Just under half of those in poverty in the UK live in a workless household (Joseph Rowntree Foundation, 2014)”. So work clearly doesn’t pay for over half of those people in poverty. 

In fairness, it is later acknowledged that: “However, simply being in work is not sufficient to prevent or overcome poverty. Nearly two-thirds of children in poverty live in working families.” 

This heavily jargonised rhetoric is, on the whole, about looking for cheap individualist “solutions” to poverty that disregard the need for improving people’s material and financial situations, by extending on an existing neoliberal narrative of alleged individual fault, character deficits, cognitive bias and decision-making flaws. None of this will raise the profile of crucial issues such as the conditions imposed by austerity and neoliberal policies, socioeconomic organisation and political decision-making, that are having a profound impact on growing inequality and increasing poverty in the UK. The persistent use of the word “workless” rather than “unemployed” is another linguistic signpost for neoliberal competitive individualism, too. 

Geographer David Harveydescribes 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. The report does not refer to the mode of political-economic organisation of which growing inequality and poverty are an intrinsic and inevitable feature.

Proposed solutions: more of the same

Summary of recommendations:

MINIMISING COSTS

Consumer credit

1 Make it easier to access low cost credit through extending access to interest-free Budgeting Advances; assisting credit unions to expand online services; and providing tax relief to individuals taking out payroll loans.

2 Further restrict practices by high cost credit providers that play on consumer biases, and test remedies that will improve consumer credit decision-making.

3 Continue to evaluate financial capability programmes through initiatives like the Money Advice Service What Works Fund.

(Access to credit does not alleviate poverty in the long-term.)

Savings

1 Test ways of automating rainy day savings through employer enrolment, default savings accounts with banks, and Universal Credit payments.

2 Evaluate the effectiveness of financial apps for helping people save.

3 Optimise the Help to Save matching scheme, through testing auto-enrolment and prizes for regular saving, to encourage low-income groups to save.

(Poor citizens do not have sufficient funds to make savings. And research shows that absolute poverty is growing in the UK, which means that many people often don’t have sufficient funds for meeting even fundamental survival needs, such as for food and fuel.) 

MAXIMISING RESOURCES

Work

1 Use identity-building activities in Jobcentres to cultivate intrinsic motivation for work in order to improve the quality and sustainability of jobs that people find.

2 Collect longer-term and more holistic outcome measures of labour market interventions to understand their full impact on poverty.

3 Develop a simple tool for Jobcentres to identify capital deficits in order to match interventions to individual job seeker needs.

Entitlements

1 Develop a common “cognitive load stress test”that measures how easy it is for eligible groups to access government entitlements.

2 Use annual entitlement summaries to prompt existing welfare recipients to apply for other assistance they may be eligible for, and to help them budget.

3 Experiment with the design of welfare conditionality to boost cognitive capacity and self-efficacy, such as having claimants set their own payment conditions.

PREVENTING INTERGENERATIONAL POVERTY

Parenting

1 Provide families in or near poverty with free access to evidence-based online parenting programmes.

2 Develop community to strengthen social ties between parents from different backgrounds.

3 Conduct research into whether small and inexpensive adjustments to housing conditions can reduce cognitive load and improve parental decision-making.

Post secondary education

1 Make the application process for post-secondary education as simple as possible, for example, by pre-populating application forms.

2 Use personalised assistance and prompts to encourage students and parents to apply to post-secondary education.

3 Link formal information about returns to post-secondary education with informal information (from peers) about what post-secondary education will be like.

Every single intervention recommendation fails to address the structural causes of poverty, which lie outside of the control of people experiencing poverty. Yet most of these recommendations are aimed at prompting the state to act upon individuals.  

Proposals such as providing access to parenting programmes, “identity-building activities in Jobcentres to cultivate intrinsic motivation for work”, “rainy day savings”, and to “develop a simple tool for Jobcentres to identify capital deficits in order to match interventions to individual job seeker needs” all sound like a New Right blame-storming exercise. Again, the problem of poverty is regarded as being intrinsic to the individual, rather than one that is about material deprivation which arises in a wider political, economic, cultural and social context.

Post secondary education costs money and isn’t supported by the state. The Education Maintenance Award (EMA) was withdrawn by the Conservatives, and the cost of a university education is now far too much for many young people from poorer backgrounds because of the tripling of fees and reduction in maintenance support. It’s the government that need a nudge, here. This is a good example of how opportunities and choices are being limited for poorer citizens by cuts and constraints imposed by the ideologues in office.  

The government never question the decision-making of the powerful and wealthy, yet it certainly wasn’t the poorest citizens that caused the global recession in 2007, nor was it the poorest citizens that imposed damaging austerity policies. The poorest people are burdened with a disproportionate weight of austerity cuts to their support. The wealthiest citizens have meanwhile been gifted with substantial tax cuts. 

Nudge is a state prop for neoliberalism, inequality and social control

Neoliberals argue that public services present moral hazards and perverse incentives. Providing lifeline support to meet basic survival requirements is seen as a barrier to the effort people put into searching for jobs. From this perspective, the social security system, which supports the inevitable casualties of neoliberal free markets, has somehow created those casualties. But we know that external, market competition-driven policies create a few “haves” and many “have-nots.” This is why the  welfare state came into being, after all – because when we allow such competitive economic dogmas to manifest without restraint, we must also concede that there are always ”winners and losers.”

Neoliberalism organises societies into hierarchies. Inequality is therefore an inevitable feature of the UK’s current mode of socioeconomic organisation. 

The UK currently ranks highly among the most unequal countries in the world.

Inequality and poverty are central features of neoliberalism and the causes therefore cannot be located within individuals.  

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.

Shamefully, in a so-called first world, wealthy liberal democracy, othering and outgrouping have become common political practices.  

Replacing spent micro-managementspeak with more micro-managementspeak

The Nudge Unit, which was part-privatised in 2014, have now warned that some Government policies were reducing so-called “cognitive bandwidth” or “headspace” of the people they were designed to help. So more theoretical psychobabble to overwrite the previous psychobabble which didn’t work when applied via policy.

This is bland neoliberal managementspeak at its very worst. The policies are causing profound damage, harm and distress to those they were never actually designed to “help”. Let’s not permit an evading of accountability and techniques of neutralisation: the use of rhetoric to obscure the real intention behind policies, as well as the consequences of them. It’s nothing less than political gaslighting. 

Of course the report attempts to apply “the latest findings from behavioural science to improve government services.” In a neoliberal framework, there are many lucrative opportunities for private companies to experiment in the psychological management of populations who have become the casualties of political decision-making, for political ends. The ethical relativity, moral entrepreneurship and sheer financial opportunism on display here certainly reflect some fundamental neoliberal values and principles. The main one being profit over human need.

Dr Kizzy Gandy proposes that cost-effective “simple tweaks” to services could help improve the way services worked. “Government policies should help people to have less on their mind, not more,” she added. 

However, I propose that government policies in democratic societies should also be designed to meet the public’s needs, including alleviating poverty, rather than being about impoverishing targeted social groups and then undemocratically acting upon individuals, without their consent, directing them how to behave in order to accommodate government ideology and meet politically defined neoliberal outcomes.

Material poverty steals aspiration and motivation from any and every person that is reduced to struggling for basic survival. Abraham Maslow (a real social psychologist) explained that when people struggle to meet their basic physical needs, they cannot be “incentivised” to fulfil higher level psychosocial needs – that includes job seeking.

Further criticism 

Labour Shadow Work and Pensions Secretary, Debbie Abrahams, said: “Even the government’s own Behavioural Insights Team now recognise the mountains of evidence that the widespread use of sanctions is not leading to better outcomes for people seeking work. Indeed, this government team’s report suggests that sanctions may be operating as a barrier to finding a job.

“This government should be ashamed of their persistent failure to act on this issue over many years, after I, and other campaigners, have provided evidence of the devastating impacts of their sanctions policy.  I have committed to putting an end to Tories’ cruel and unnecessary sanctions regime, as part of our work to transform the social security system.” 

In fairness to the BIT, the report does say on page nine, among the listed areas of proposed future research: “A significant portion of behavioural science research focuses on improving the decisions of end-users – in this case people in poverty. But what about the decisions of service providers and policymakers? How can we improve the quality of their decisions to support people escape poverty? And how can we build their empathy with those whose opportunities are at stake?”  

But who is nudging the nudgers?  I would think nudgers are “incentivised” by those providing the contracts that pay their salaries, on the whole. The government part-own the nudge unit.

Researchers from a variety of universities across the UK, using qualitative longitudinal interviews with nine groups of welfare service users from across England and Scotland, aim at determining longer-term effects of sanctions. The first wave findings from this collaborative ongoing study regarding the effects and ethics of welfare conditionality were released last year 

It was found that linking continued receipt of benefit and services to mandatory behavioural requirements has created widespread anxiety and feelings of disempowerment. The impacts of benefit sanctions are universally reported by service users as profoundly negative, having severely detrimental financial, material, emotional, psychological and health impacts. Some individuals disengaged from services, some were even pushed toward “survival crime”.  

The most surprising thing about these findings was the general lack of surprise they raised.

A recurring theme is that sanctions are grossly out of proportion to “offences”, such as being a few minutes late for an appointment. Many reported being sanctioned following administrative mistakes. The Claimant Commitment was criticised for not taking sufficient account of individuals’ capabilities, wider responsibilities and vulnerabilities. Many saw job centres as being primarily concerned with monitoring compliance, imposing discipline and enforcement, rather than providing any meaningful support. 

Power relations, class and economic organisation have now completely disappeared from public conversations about poverty. Neoliberal anti-welfarism, amplified by a corporate media, has aimed at reconstruction of society’s “common sense” assumptions, values and beliefs. Class, disability and race narratives in particular, associated with traditional prejudices and categories from the right wing, have been used to nudge the UK to re-imagine citizenship, human rights and democratic inclusion as highly conditional.  

This is not just about shifting public rational and moral boundaries to de-empathise the electorate to the circumstances of politically defined others. It also obscures the consequences more generally of increasingly non-inclusive, anti-democratic, prejudiced and extremely punitive policies.  

The bottom line is that 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, citizens’ 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: euphemisms, superficial glittering generalities and techniques of persuasion to intentionally divert us from aims and consequences of ideologically (rather than rationally) driven policies. Furthermore, policies have become increasingly detached from public interests and needs. 

For example, the state has depoliticised disadvantage, making it the private responsibility of citizens, whilst at the same time, justifying a psychopolitical approach that encodes a punitive Conservative moral framework. 

According to the behavioural economist theorists, in their highly jargonised and fairly meaningless report, government policies are reducing so-called “cognitive bandwidth” or “headspace” of the people they were designed to help.

That the government imposes additional “cognitive costs”, as well as material and financial ones, on low-income groups, is hardly a groundbreaking revelation. 

I can put it much more plainly, and strip it of neoliberal psychobabbling: imposing sanctions on people who already have very limited resources is not only irrational, it is absurdly unjust, damaging, distressing and spectacularly cruel. 

See also:

Benefit Sanctions Can’t Possibly ‘Incentivise’ People To Work – And Here’s Why

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

Welfare, Conditional Citizenship and the Neuroliberal State – Conference Presentation

 

 

Labour pledge to scrap punitive Tory sanctions and the Work Capability Assessment

Debbie Abrahams MP, Shadow Secretary of State for Work and Pensions, said that she will scrap punitive benefit sanctions and the discredited Work Capability Assessment, at the Labour Party Conference in Liverpool. The pledge was echoed by newly re-elected party leader Jeremy Corbyn in his main speech to the conference. He said a Labour government would be “scrapping the punitive sanctions regime and the degrading work capability assessment.”

Here is a transcript of Debbie’s excellent speech:

“It is a real honour to stand here before you as the Party’s spokesperson for Work and Pensions, my first time on the Conference platform.

Conference, we live in troubling times. Our nation seems more adrift than ever. Our troubles often seem insurmountable.

But when I’m faced with complexity and difficulties, I recall some wise words: “The more complicated something is, the more important it is to define what your simple truths are.”

So, what are my ‘simple truths’? First, I am a socialist. I believe that society is stronger – can achieve more – when we stand together, and that every citizen has an equal stake in our future.

It is to me a simple truth that a nation aspiring to decency and fairness does not punish the disabled and disadvantaged.

It is to me a simple truth that the way a government prioritises finite finances reveals its authentic self.

So when this Tory Government imposes the bedroom tax on disabled people but gives tax breaks to millionaires, then their own simple truths are laid bare.

It is to me a simple truth that where the dignity of rewarding work is deprived to millions through a lack of quality jobs, the rise of zero-hours contracts, and indignities heaped on loyal work forces by the likes of Sports Direct and BHS, then social and economic progress is stunted.

And it is also a simple truth that targeting the most vulnerable in our society damages the least vulnerable, too. If you haven’t already, please read the Richard Wilkinson’s and Kate Pickett’s book, The Spirit Level.

This shows that societies with a wider gap between rich and poor experience higher levels of infant mortality, lower life expectancy, poorer mental health, and less social mobility.

To me, as a former academic, it is a simple truth that evidence-based policy must replace policy-based evidence. That’s why I’m a socialist. Because all the evidence points to another simple truth.

By building a society where the hope of progress is genuine and realistic and not forlorn, where every citizen feels themselves an equal participant in our nation, and where government is seen to be working for everyone, we create a virtuous circle of growth, stability and contentment.

For all the Prime Minister’s warm words, it is by her actions we will judge her. She has been a senior member of a government that has chosen to visit austerity on the most vulnerable in society. She has been a senior member of a government that continues to rain down on our education system ideological reforms with little or no evidentiary justification. And she has been a senior member of a government where the number of foodbanks increased ten-fold in 4 years.

Conference, inequality is not inevitable. We are all here precisely because we know that change is both possible and necessary.

Today there are 3.9 million children living in poverty, and children’s charities are estimating that will be 5 million. Conference, children being in poverty affects not just their childhood but their whole future life chances.

And the five million disabled people living in poverty because of the extra costs that they face associated with their disability, is set to increase as a result of even more cuts in social security support.

While I am proud of the last Labour Government’s success at reducing pensioner poverty, women and the lowest paid remain at high risk of falling into poverty in their retirement.

This injustice is being extended to 2.6 million women born in the 1950s, who have been short-changed by this Government bringing forward their state pension age.

The pensions system that I want to see ensures dignity in retirement, and a proper reflection of the contribution that older people have made, and continue to make, to our society.

This Government has fostered an insidious culture of fear and blame to justify their programme of cuts, deliberately attempting to vilify social security claimants as the new undeserving poor.

I wanted to show you the trailer from Ken Loach’s new film ‘I, Daniel Blake’ as I think it sets out so clearly much of that is wrong with the current social security system.

I believe there is a better way, a fairer way. One where Britain is the centre of a new industrial revolution with industries and technologies as diverse as our people.

To achieve this, we need to invest in our greatest asset – our citizens – nurturing a highly skilled workforce and rebuilding our country.

For too long the labour market has been dominated by poor quality, low paid, insecure jobs resulting in two thirds of children living in poverty coming from working families. Four in every five people working in low paid jobs are still stuck in them ten years later.

For those unable to work through illness or disability, we need to transform our social security system to one that is efficient, responsive, and provides basic support. Time and time again, I hear of how worthless the system makes people feel. For the vast majority of people who have paid into it all their working lives, this is like a slap in the face. People often feel desperate, have been left destitute and have even died.

I want to change the culture of our social security system and how the public see it. I believe that, like the NHS, it is based on principles of inclusion, support and security for all, assuring us of our dignity and the basics of life were we to fall on hard times or become incapacitated, giving us a hand up, not a hand out.

Work should always pay more than being on social security, but being in work shouldn’t mean living in poverty and neither should being on social security.

The Labour Party has already pledged to get rid of the discriminatory and unfair Bedroom Tax. But I want to go further.

I want to scrap the discredited Work Capability Assessment and replace it with a system based on personalised, holistic support, one that provides each individual with a tailored plan, building on their strengths and addressing barriers, whether skills, health, care, transport, or housing-related.

This Government’s punitive sanctions system must go too, so Job Centre Plus and employment support providers’ performance will not just be assessed on how many people they get off their books.

I want to see disabled people better supported into and at work. We will halve the Disability Employment Gap – and when we say it we mean it. And we will tackle other labour market inequalities too.

I believe in a fair and just Britain, where everyone can get on and no-one is left behind.

Labour’s policies will deliver prosperity for all and tackle the inequalities and poverty in Britain today.

I challenge the Government to deliver theirs.”

 


I just wanted to add a note of clarification, as some people are claiming that it isn’t the intention of the Labour party to scrap sanctions entirely. There has always been a degree of benefit conditionality, since the inception of the welfare state. This has not previously been particularly problematic, and a reasonable degree of government accountability and protecting the “public purse” has always been expected from the public.

However, the Conservatives introduced a very harsh and punitive regime in 2012, extending the use of sanctions to include previously protected social groups, such as lone parents and sick and disabled people. The severity and length of the sanctions was also radically increased, and as we know from evidence gathered since 2012, it is these changes that have caused so much hardship and distress for many people.

We also know that sanctions are very often applied unfairly, and that one of the main aims of them is to cut costs and reduce the welfare state. Instead of supporting citizens, our social security is now about coercing citizens into “job seeking” rule-following and conformity, regardless of the employment market conditions and other social and economic constraints.

The Conservatives introduced these changes because they think that coercive “behavioural change” techniques may align citizens’ behaviours with neoliberal outcomes. Their sanction regime is founded on a nudge theory – that we have a “cognitive bias” called loss aversion. The Conservatives expect that by manipulating this alleged bias – using the fear of financial loss – people will comply and get a job. That assumes, of course, that the cause of unemployment is something that happens within an individual, and not because of political decision-making and socioeconomic conditions. 

In this context, sanctions are a punishment for non-compliance with politically defined outcomes, directed entirely by economic dogma. It’s a form of operant conditioning. It does not take into consideration the real structural socioeconomic barriers that people face in finding appropriate work. Instead the individual is held responsible for the failings of a competitive, market-based system.

The stigmatisation of people needing social security – the political and cultural use of dehumanising metaphors and rhetoric – has been used to justify the ideologically-driven dismantling of the welfare state and the other gains of our post-war settlement. The punitive sanction regime is part of this process of political demolition. This is clearly a political misuse of “psychology”. Perhaps it’s more accurate to say it’s a technocratic application of techniques of persuasion: the marketing strategy and packaging for controversial “small state” and authoritarian neoliberal policies.

Debbie acknowledges much of this. She has promised to repeal the Conservative’s punitive sanction regime and the WCA.  Her speech indicates clearly the direction of travel for the Labour party.

I welcome that. I’m certain that many others will. It’s long overdue.

Kitty

Related

Nudging conformity and benefit sanctions: a state experiment in behaviour modification

 


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

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

Photo courtesy of the Manchester Evening News.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Abraham Maslow’s hierarchy of human needs.

Related

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

Nudging conformity and benefit sanctions

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

The Conservative approach to social research – that way madness lies


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Cases of malnutrition continue to soar in the UK

Minnes

The Office of National Statistics (ONS) have released figures that show 391 people died from malnutrition in 2015. There were 746 hospital admissions for malnutrition in just 12 months. The statistics also show two people in the UK are admitted to hospital with the condition every day in what campaigners have called a “national scandal.” 

Health minister Nicola Blackwood confirmed the numbers in a written answer in Parliament.

More than six people a month perish from starvation in England, which is one of the richest nations in the world.  The UK’s biggest food bank network, the Trussell Trust, provided more than a million three-day food packages over the past year, including 415,866 to children.What is worrying is that people may only have this support for a maximum of three days and have to be referred by a professional, such as a doctor or social worker.

Chairman Chris Mould said: It’s a scandal that people living in the sixth largest economy in the world are going hungry, which is why we’re working to engage the public, other charities and politicians from all parties to find solutions to the underlying causes of food poverty.

Our food banks support many thousands of people in various states of hunger.

Some people have been missing meals for days at a time; others have been unable to afford certain food groups or have sacrificed quality for long periods of time to keep costs down.

This, no doubt, has a negative effect on their health – and for people at the extreme end of the scale it will lead to malnutrition.

Every day we meet families across the UK who are struggling to put enough nutritious food on the table and hear from parents who go without food so their children have enough to eat.”

A Department for Work and Pensions spokeswoman said: “We now have record numbers of people in work and wages rising faster than inflation. 

But we need to go further, which is why we’ve committed to increase the National Living Wage, we’re taking the lowest paid out of income tax and our welfare reforms are ensuring it always pays to work.”

However it seems that “making work pay” is a euphemism for punishing those out of work or those in part-time or low-paid work with absolute poverty. In December 2015, I wrote about research from the Child Poverty Action Group, Oxfam, Church of England and the Trussell Trust which found that failures in the social safety net itself are most often the trigger for food bank referrals.

The report said that while money is tight for many reasons, including bereavement, relationship breakdown, illness or job loss, issues such as sanctions, delays in benefits decisions or payments or being declared “fit for work” led people to turn to food banks for support.

  • Around a third of foodbank users in the sample were waiting for a decision on their benefits – and struggling in the meantime
  • Between 20 and 30% more had their household benefits reduced or stopped because of a sanction

Other factors included loss of income due to the “bedroom tax” or the benefit cap. For between half and two-thirds of the people included in this research, the immediate income crisis was linked to the operation of the benefits system (with problems including waiting for benefit payments, sanctions, or reduction in disability benefits) or tax credit payments.

Amongst this group of people are many that are actually in low-paid work, claiming top-up benefits. The remaining number of people needing support from food banks to meet their most basic need are certainly in work, making a complete mockery of the Department for Work and Pension’s statement.

The research used 40 in-depth interviews with food bank users, data from over 900 users at three food banks around the country, and detailed analysis of nearly 200 clients accessing one food bank in Tower Hamlets. Another academic study said the government’s welfare reformsincluding benefit sanctions and the bedroom tax, are a central factor in the explosion in the numbers of impoverished people turning to charity food banks

The study, part of a three-year investigation into emergency food provision, was carried out by Hannah Lambie-Mumford, a Sheffield University researcher who co-authored a recently published government report into the extent of food aid in the UK.

That report concluded there was insufficient evidence to demonstrate a clear causal link between welfare reform and food bank demand in the UK. This is because the government has refused to make that information available by ensuring the reason for food bank referrals are no longer recorded. But Lambie-Mumford’s study says the rise in demand for charity food is a clear signal “of the inadequacy of both social security provision and the processes by which it is delivered”.

In 2015, more than 2,000 cases of patients with malnutrition were recorded by 43 hospital trusts in a single year.

There were 193 “episodes” of malnutrition in 12 months at Salford Royal NHS Foundation Trust alone, according to new figures.

Freedom of Information (FOI) figures show a rise of 259 between the 43 trusts compared with three years previously.

With the more recent introduction of more stringent in-work conditionality, including the extension of sanctions to those in part-time and low-paid work, the Conservative’s coercive psychopolitical approach to poverty will invariably make it even more difficult for many more to meet their basic survival needs.

At the same time, in 2014,  Community Links published a study called Just about Surviving which revealed that far from encouraging people on benefits to move into work, the draconian welfare cuts have pushed many further from employment. The report said that the state has reduced welfare support to the point where it barely enables people to survive.

Overwhelmingly, the reforms have made people “feel insecure and vulnerable to even small fluctuations in their small income or circumstance; continuing to erode their resilience.”

Furthermore, by forcing people into stressful situations where day-to-day survival becomes a pressing priority, the “reforms” (that are, in reality, simply cuts to people’s benefits), which were hailed by the Conservatives as a system of help and incentives – to “nudge” people into changing their behaviour so that they try harder to find work – are in fact eroding people’s motivation. In other words, the reforms have deincentivised and hindered people looking for employment, achieving the very opposite to the intent claimed by the Tories, to justify their draconian policies.

The report states that people are caught between trying to escape welfare reform through poor employment alternatives and feeling trapped in poverty. They move in and out of low paid work and are extremely susceptible to financial shocks and unprepared for the future.

In 2014, Oxfam’s director of campaigns and policy, Ben Phillips, said: “Britain is becoming a deeply divided nation, with a wealthy elite who are seeing their incomes spiral up, while millions of families are struggling to make ends meet.”

“It’s deeply worrying that these extreme levels of wealth inequality exist in Britain today, where just a handful of people have more money than millions struggling to survive on the breadline.”

Diseases associated with malnutrition, which were very common in the Victorian era in the UK, became rare with the advent of our welfare state and universal healthcare, but they are now making a reappearance because of the rise of numbers of people living in absolute poverty.

NHS statistics indicate that the number of cases of gout and scarlet fever have almost doubled within five years, with a rise in other illnesses such as scurvy, cholera, whooping cough and general malnutrition. People are more susceptible to infectious illness if they are under-nourished.

In 2013/14, more than 86,000 hospital admissions involved patients who were diagnosed with gout – an increase of 78 per cent in five years, and of 16 per cent on the year before. Causes of gout include a lack of vitamin C in the diet of people who are susceptible.

The figures from the Health and Social Care Information Centre (HSCIC) show a 71 per cent increase in hospital admissions among patients suffering from malnutrition – from 3,900 admissions in 2009-10 to 6,690 admissions in 2013-14.

Cases of scarlet fever admitted to hospital doubled, from 403 to 845, while the number of hospital patients found to be suffering from scurvy also rose, with 72 cases in 2009/10 rising to 94 cases last year.

The figures also show a steep rise in cases diagnosed with cholera, a water-borne disease which was extremely prevalent in the 19th century, causing nearly 40,000 deaths.

The new in-work conditionality regime may eventually apply to around one million more people.

The quantity of food being bought in food stores is also decreasing. It doesn’t take a genius to work out that repressed, stagnant wages and RISING living costs will result in reduced sale volumes. Survation’s research in March 2014 indicates that only four out of every ten of UK workers believe that the country’s economy is recovering.

But we know that the bulk of the Tory austerity cuts were aimed at those least able to afford any cut to their income.

We really must challenge the Conservative’s use of words such as “encourage” and “support” and generally deceptive language use in the context of what are, after all, extremely punitive, coercive  policies. The government intends to continue formulating policies which will punish sick and disabled people, unemployed people, the poorest paid, and part-time workers.

Meanwhile, the collective bargaining traditionally afforded us by trade unions has been systematically undermined by successive Conservative governments, showing clearly how the social risks of the labour market are being personalised and redefined as being solely the economic responsibility of individuals rather than the government and profit-driven big business employers.

 

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Related

Welfare sanctions cannot possibly incentivise people to work

The Coalition are creating poverty via their policies

Welfare sanctions make vulnerable reliant on food banks, says YMCA

Study finds Need For Food Banks IS Caused By Welfare Cuts

It’s absolute poverty, not “market competition” that has led to a drop in food sales.

Welfare reforms, food banks, malnutrition and the return of Victorian diseases are not coincidental, Mr Cameron

The politics of punishment and blame: in-work conditionality

 

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