The Green Paper on Work and Health

A rights based response

There’s lots to say about the Green Paper on work and health – on how the DWP proposes to improve its employment support offer for disabled people at the same time as a cut in funding for services; on extending conditionality for benefits to groups assessed as being furthest from the labour market.

But this response will consider the implications of the Green Paper for disabled people’s right to independent living. The issue I’m going to take up is the way the Green Paper, as well as some charities response to it, sets up an opposition between full inclusion in society on the one hand and reliance on benefits on the other – a kind of moral dichotomy between inclusion and dependence.

The recent UN report on disability rights in the UK makes clear that this opposition is false.

The right to Independent Living enshrined in Article 19 is inseparable from the right to an adequate standard of living in Article 28 and the right to work in Article 27. The report says, Without an adequate income and standard of living, disabled people risk isolation and segregation from the community.

We might add that, however much choice and control someone has over their care provision, they will never achieve independent living if they are too poor to afford food or fuel.

The Green Paper talks about improving lives and creating a country that works for everyone. But the only gateway to aspiration and equality it offers to disabled people is that of paid employment.

It mentions protecting those who need help the most. But it doesn’t uphold the right to an adequate standard of living as a requirement to full inclusion and participation in the community, set out in the UNCRPD.

As well all know, disabled people’s income has taken a hit through the Bedroom Tax, benefit cap, changes to Housing Benefit and the forthcoming cut to the ESA WRA component.

The Green Paper promises no more cuts to disability benefits. But at the same time DWP has been actively developing ways to restrict entitlement to ESA even further, through measures that haven’t been consulted on, like revising guidance to assessors on interpreting the regulations on risk. So the category of what it calls those “who need help the most” is ever shrinking.

This is where we need to focus our attention in the Green Paper. Sometimes the most toxic cuts come in the form of shrinking eligibility.

The Work Capability Assessment

This is where I’m going to talk about the WCA because I think it’s not well understood by people who haven’t been through it. Its eligibility criteria seem to live in a black box that’s too technical for social policy analysis. Whereas in fact the WCA is pure ideology, there’s nothing technical or even medical about it.

The model of disability developed by Gordon Waddell and Mansell Aylward which underpins the WCA has been a key tool in undermining the rights of disabled people to an adequate standard of living. In a theory that Tom Shakespeare says is neither coherent nor evidence based, it contrasts genuine disease or impairment with so called “common health problems”, everyday aches and pains which, combined with negative attitude and lifestyle choice, create benefit dependency. This is how it creates a distinction between the deserving and the undeserving disabled in order to disqualify, initially, a million people from entitlement to social protection.

It is a pseudo-scientific rationale for denying support to people. And it’s dangerous because it’s legitimacy is almost never called into question by policy makers or the charities who speak to government on behalf of disabled people.

We all need to reject Waddell and Aylward’s version of the Biopsychosocial model outright. The tweaks to the WCA offered by DWP, like the halt to repeated assessments for a small group, are not enough.

We want a new model of work capability. One that is based on disabled people’s accounts and experiences of work and health and the relationship between them; on our own accounts of the barriers we face and the solutions that could remove them.

The Green Paper offers a consultation on the WCA but does not call into question its underlying model of disease and disability, and how it determines who “needs help the most”.

I want to finish with this thought:

Out-of-work disability benefits are not charity or a form of pity; they’re a right for those who face disadvantage in the labour market. DPOs must fight to take ownership of social security policy in the same way they have fought to influence and inform social care. We must fight the idea that financial dependence on the state makes us less than full citizens, in the same way we have fought the idea that dependence on personal assistance gives us less right to control our daily lives.

Catherine Hale.



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