Smokescreen – response to Green Paper

by Caroline Richardson

Spartacus Network this week has produced a response, aptly named Smokescreen, to the Government Green Paper on health and work.  Smokescreen attempts to dig below the soundbites and policy based evidence, and analyse the proposals.

What we found was truly shocking. In a Green Paper, touted as being mitigation for the cuts to the sickness benefit ESA, there was very little evidence that the cuts would be mitigated at all. Instead the Green Paper outlines yet another series of Work Programmes, using many of the familiar Prime Work Programme providers, supported by many of the same community and charity organisations as sub-primes.

What is truly startling though are the numerous hypotheses put forward as facts, supported in part by evidence based on reports written by the DWP or for the DWP, or extremely weak evidence – one survey used only 5 people.  There is a deliberate conflation of sickness and disability – and there is no plan to provide specialist support to those who are healthy and disabled. Instead the DWP has targeted the largest group of ESA claimants by WHO ICD code – Mental and behavioural disorders – regardless of the huge spectrum of conditions this group contains. It also has in its sights the second largest group – musculoskeletal.

Throughout the Green Paper these conditions are suggested to be minor, needed only low level medical interventions to achieve recovery. However these medical interventions are not going to be instigated by the claimant’s GP, but by a Job Centre Employment Advisor rebranded as a Work Coach, one of whose roles is to triage claimants and decide what would be appropriate treatment for them, where treatment consists of a Work Programme.  This triaging will take place at a Health and Work interview whilst the claimant is still in the early stages of ESA, prior to the actual Work Capability Assessment.

What is concerning is that claimants are to be offered treatment as part of their work programme, with provision being via charities, community groups and computers. The emphasis throughout the Green Paper is the coalescing of work and health, as it’s suggested continually that work is not just a health outcome, but also a route to recovery. Obviously if this were true then people wouldn’t leave work due to illness.

No-one is ignored in this Green Paper; the elderly, the unemployed, the sick and carers are all potential units of productivity. The only group exempted are those with disabilities who have good health – for them there is little or no support offered or planned, which is ironic given the Government target of halving the disability employment gap.

This Green Paper should be read with caution; it works excessively hard at not justifying the cut it refuses to mention, and to distract the reader by painting sick people as a hairs-breadth away from recovery – which of course the Government is prepared to supply in the most ‘cost effective’ and consequently ineffective way possible.

Smokescreen can be downloaded here.

Important consultation on a replacement for ESA

ESA needs replacing; there is little disagreement about that. What has not yet been proposed is a system to replace it. Such a system should be designed primarily by the sick and disabled people who will depend upon it.

This is what Ekklesia is proposing to do. In its initial survey, Ekklesia asked respondents about what support they needed in order to be able to work (if work were possible at all) and how the assessment process should occur. The results of this survey have been published in two reports. The first focusses on the support that sick and disabled people say that they need if they are to be able to work. The second report presents a proposal for a new assessment and support process, again based upon the responses to the survey. But there is more work to do.

Ekklesia are asking people to respond to their initial proposal with comments and critique. Their second report is also a consultation document, asking for responses to the proposed system and principles. Twelve weeks have been given to respond to this consultation, which is running from 9th August to 31st October 2016. Ekklesia are particularly keen for responses from people with sensory impairments, spinal or limb injuries, learning disabilities and autism spectrum disorders as these groups were under-represented in the initial survey. However, chronic physical and mental illness continue to be central to the design of a suitable assessment process, especially given their traditional under-assessment in income-replacement and extra-cost benefits.

You can find the first report here, and the second (consultation) report here. The second report is also available in an Easy Read version here. You can respond to the report by emailing your response to ekklesiasurvey@gmail.com or by posting it to Ekklesia Survey c/o Simon Barrow 3/3 Kirk St, Edinburgh, EH6 5EX.
If you prefer, for simplicity, you can answer the consultation questions using a scale of Strongly Disagree / Disagree / Neither Agree nor Disagree / Agree / Strongly Agree.

The report by Ekklesia shows that the government is badly failing its sick and disabled citizens. The government claimed that the Incapacity Benefit system abandoned disabled people to a life on benefits. Yet we are far more abandoned by ESA. Under IB we were given the freedom to live and manage their lives; on ESA WRAG or JSA we are mandated to activities beyond our capabilities without the support we would need to be able to undertake them.

Without this support, any attempts to get us into work are simply doomed to fail. It is a waste of the government’s resources to put money into a scheme that cannot work, and a waste of our health, energy and capacity for social inclusion. The government cannot have it both ways; it cannot refuse to pay the cost of employment support and simultaneously insist that we ‘prepare for’ work that we will never find.

The principles that Ekklesia propose allows the government to make the choice of whether to fully support someone to work, or to support them in a life of independence and social inclusion outside of the workplace. By basing the decision upon what support is needed for an individual to work, we ensure that the decision on capacity for work is tied in to both what support an employer can provide, and what the government is providing. We end the farcical situation where individuals are told by the DWP’s mechanistic system that they are fit for work, when the assessor and employment support worker know that the individual is demonstrably unfit for work. And we ensure that no-one is asked to work before the government has made it possible for them to do so.

Based on the results from the respondents to Ekklesia’s survey, Ekklesia have proposed, as a starting point for this consultation, that a new assessment process should include the following features:

  • Medical evidence should be provided for all individuals; this is a more efficient way to get an accurate medical opinion than having to employ medics who are not involved in the individual’s care.
  • The assessment should be in the format of a discussion taking place over several meetings.
  • Claimants should have the opportunity to comment on the assessor’s report before a decision is made.
  • The assessor should also be the one who makes the decision on fitness for work.
  • Reassessment need only occur for those not in regular contact with a caseworker, and should be light-touch in recognition that these are the people who are least likely to become fit for work.

The criteria of fitness for work should be based on the following:

  • The decision of capacity for work should include labour market competitiveness.
  • The assessment should consider the overall capacity for work, including the need to work at a slower pace or have breaks from work, rather than focussing on isolated activities.
  • The assessment should give direct consideration to the skills that the individual has and whether or not these can be used given the claimant’s health condition.
  • A decision of fit for work should be based upon the ability to identify jobs that that individual could perform.
  • If an individual needs particular forms of support to be able to work, that individual is considered unfit for work unless and until that support is provided.

The underlying policy position, principles and assumptions should recognise that:

  • Individuals contribute to society in a number of ways other than paid work, and the value of these contributions should be recognised.
  • The social security system needs to protect those whose health and quality of life is at risk of being damaged by requirements to engage in work or work-related activity.
  • Voluntary work should be encouraged as a valuable contribution to society and as an acceptable activity for people with chronic illness who claim sickness benefits.
  • The basic rate of benefit should be set at a level that is adequate for long-term living including social participation in society.
  • Sanctions and conditionality are detrimental to health, well-being and financial security. They should not be used for people with chronic illness. Instead, a system of top-ups (above a liveable base-level benefit) could be acceptable to compensate individuals for engagement in activity.
  • A range of areas not well captured by the WCA are key to the understanding and assessment of capacity for work. These include mental health, varying or unpredictable capacity for work, and the accumulation of incapacity from multiple origins.
  • Capacity for work is impacted by the provision of support in areas of life outside of the individual workplace. These can include health care, personal assistance, home help, caring responsibilities, commuting and regulation of the labour market to promote more and better quality jobs.
  • People with chronic illness need a wide range of support if they are to be able to work.
  • People with chronic illness may benefit from re-training, particularly where re-training may allow the individual to use remaining health capacity better or compensate for loss of capacity in a previously trained area.
  • Employers may be reluctant to employ people with chronic illness due to founded or unfounded concerns of associated costs. Employers may need practical advice, support and/or financial assistance to make it viable for them to take on an employee where the any associated costs are uncertain.
  • There is a mismatch between what employers mean and can manage when they refer to flexible working, and what people with chronic illness mean and need when they refer to flexible working.
  • There is a difference between an individual being ‘capable’ of work (which could include working for small units of time at irregular intervals, spread out over a longer period), and an individual being employable or being able to find or sustain work.

 

You can find the first report here, and the second (consultation) report here. You can respond to the report by emailing your response to ekklesiasurvey@gmail.com or by posting it to Ekklesia Survey c/o Simon Barrow 3/3 Kirk St, Edinburgh, EH6 5EX.
If you prefer, for simplicity, you can answer the consultation questions using a scale of Strongly Disagree / Disagree / Neither Agree nor Disagree / Agree / Strongly Agree.
The consultation is running from 9th August to 31st October 2016.

How would cuts to Employment and Support Allowance affect you?

URGENT – YOUR VIEWS ON CUTS TO ESA IN THE WELFARE REFORM BILL NEEDED BY 15TH NOVEMBER

Spartacus produced a briefing when the Chancellor announced his plans this summer to cut £30 per week from the benefits of people in the ESA Work Related Activity Group in order to incentivise them to return to work.

We said that cutting social security for disabled people would place the UK government in breach of its international treaty obligations under the International Covenant on Economic, Social and Cultural Rights as well as the UN Convention on the Rights of Disabled People. What’s more, this plan is based on the false assumption that people in the WRAG have motivational problems, rather than health or labour market barriers.

Now we welcome a parliamentary review led by Lord Low of Dalston in December to give evidence on how these proposed cuts will affect disabled people and their families. A group of disability charities including Mind, MS Society, National Autistic Society, RNIB, Royal Mencap Society and Scope wants to collect your views on this issue if you receive ESA and would be affected by a cut of £30 a week.

Please help them produce a report to submit to this review. Below is the Disability Benefits Consortium’s consultation questions (you can read more here). Please send your response to Natalie.armitage@mencap.org.uk using the subject line ‘Review of reduction to ESA WRAG payment’.

Getting the views of disabled people and their families

We want to hear from you if you are currently in the ESA WRAG and would like you to tell us about what it would mean if you had around £30 less a week to live on. You might want to tell us about your experiences of living day-to-day when you were waiting for your work capability assessment, for example.

We also want to find out about the current effectiveness of support within the ESA-WRAG for disabled people undertaking ‘work related activity’ such as training or support to look for work. Getting this right is important so that those people who can work have the opportunity to do so.

Please answer the below questions. Your answers will be incorporated into the final report. We would like to include quotes in the final report. If you would prefer to remain anonymous then please let us know.

Questions

  1. Tell us about the support you receive from being in ESA WRAG. For example, you can tell us about how you spend the money you receive and/or the support that is offered to you to help you move towards employment.
  1. What would be the impact on your daily life if you did not have this payment of almost £30 per week? Please feel free to draw on your experience of receiving less money when you were waiting for your assessment for ESA (the work capability assessment).
  1. Would there be an impact on your ability to look for work if the amount of money was reduced? What do you think this impact, if any, would be?
  1. How ready for work do you consider yourself to be? Would further support help you to feel ready for work if you do not feel so already? What types of support, if any, would be helpful to you?

Please send your response to Natalie.armitage@mencap.org.uk using the subject line ‘Review of reduction to ESA WRAG payment’.

The consultation will be open until 15 November 2015, midnight.

ESA Myths

Are people in the ESA WRAG nearly fit for work?
The message we often hear from politicians and the media is that people in the ESA “Work Related Activity Group” have only minor ailments or temporary health conditions and therefore could work now or in the near future if they made more effort. The implication is that being in the ESA WRAG is a lifestyle choice.
It’s time to dispel this myth and tell the truth about people in the WRAG. Here are 3 profiles of claimants who would be placed in the WRAG in a Work Capability Assessment.
Do these people have the choice to go out and get a job?
Mike, 40, suffered a stroke two years ago while at working as an engineer which left him with brain injury and epilepsy that his specialist says are unlikely to improve further. Under the Work Capability Assessment he scores points for loss of consciousness due to seizure 2 -3 times a month (6 points); inability to initiate or complete personal action for the majority of time (9 points) and occasionally uncontrollable episodes of aggressive behaviour (9 points).
Mike scores 24 points but doesn’t quality for the Support Group.

Alan, 29 has autism and lives with his parents. Alan enjoys his supported voluntary work in a community farm but he has never been in paid work. Alan has a reduced awareness of hazard which puts him at significant risk of injury to himself or others requiring frequent supervision (9 points). He can’t cope with minor planned changes to his daily routine (9 points). He can’t get around, even to a familiar place without another person to accompany him (9 points) and he experiences significant distress from social contact with an unfamiliar person (9 points)

Alan scores 36 points but doesn’t qualify for the Support Group.

Sheila was diagnosed with multiple sclerosis eight years ago. She carried on working as a sales rep until her symptoms became too severe as the disease progressed. Sheila can’t walk more than 100m due to muscle weakness and balance problems (9 points), (she can’t self-propel a wheelchair because of upper body weakness). She has difficulty controlling her bladder meaning she often needs a change of clothing (6 points). Her co-ordination difficulties mean she can no longer use a keyboard effectively (9 points). Sheila experiences cognitive dysfunction and depression, which has worsened since had to give up work, and as a result she frequently can’t initiate and complete at least 2 personal actions (6 points).
Sheila scores 30 points but doesn’t qualify for the Support Group.

Mike, Alan and Sheila are not real people, but illustrations of how the WCA measures illness, disability and fitness for “work related activity” in a way that has no bearing on either medical reality, or the real world of work. Without financial support to overcome the significant obstacles they face, and without employers prepared to tailor their job conditions considerably, real people like Mike Alan and Sheila don’t have realistic job prospects, now or in the future.

The current work preparation schemes for people in the WRAG provide almost no specialist support for people wanting to move towards work.

These profiles show you can score well over the necessary 15 points in the WCA and still be placed in the WRAG. The WCA takes no account of how multiple symptoms or difficulties decrease someone’s chances of working.

Adapted from the Spartacus ESA Mythbuster by Catherine Hale, Caroline Richardson and Stef Benstead, with contributions from Jane Young and Sam Barnett-Cormack