IDS announces fitness to work U Turn, Choice and Control plunge, Deaths of Benefit claimants data released, NHS caps on continuing healthcare
So how was your summer? The August Bank holiday is done and dusted and youngsters will be back at school within days. It all goes so quickly!
Two things to tell you. First Sue and I visited the Edinburgh Fringe, we drove up in our motorhome and camped, along with many others, on a site in the suburbs. My good friend Simon Minty and his pal Steve Best returned to the Fringe to celebrate the tenth anniversary of Abnormally Funny People (http://www.abnormallyfunnypeople.com/. The show has new acts as well as some from the original 2005 line up, including Liz Carr and Tanyalee Davis. We had a great night with plenty of laughs and not a little angst. Great to see the new acts and remember how it all began.
One major change since the first show in 2005, we travelled to and from our campsite on a fully accessible scheduled Lothian bus! Couldn’t have done that ten years ago! Nice to sit on the bus at midnight surrounded by other bleary eyed Fringe goers, I felt like a proper commuter for once in my life.
The second snippet for you. I’ve just bought a Batec from Cyclone (http://www.cyclonemobility.com/batec) it’s an electric powered wheel which fixes to the front of my manual wheelchair and turns it into a trike, (see picture) which is capable of speeds of up to 20 kilometres an hour. On my first trip out, with our new dog Crumble, I managed to lose the dog and control of the Batec. I attempted to drive the bike up a short muddy incline in pursuit of the dog but only succeeded in turning the whole thing over. I ended up lying on a muddy track with the bike and chair on top of me. Nothing hurt except, of course, my pride.
Fortunately a group of people, out walking their dogs came to my rescue. They produced the classical opening remark, which I’ve heard so many times before and always baffles me, “Are you alright mate?”. I should have said “Yes of course, I love lying face down in the mud with a wheelchair on top of me!” I managed to restrain myself. Their second question was spot on “What would you like us to do?” They lifted me and the chair upright and then gave me a push up the slope. I thanked them for their kindness and then met Sue coming towards me with Crumble who had returned home having decided she was safer there than with me! Quite right too as it turned out!
Have a great week and take a look at this weeks news.
IDS announces ‘fitness for work’ U-turn that was five years in the making
Work and pensions secretary Iain Duncan Smith appears set to scrap the “fitness for work” test championed by successive Labour, coalition and Conservative governments, but there are fears that its replacement could prove even more damaging to disabled people.
Duncan Smith – in comments not included in a written version of a speech reported by mainstream media – said that employment minister Priti Patel would lead a review of the out-of-work benefit, employment and support allowance (ESA).
And he also appeared to promise that the work capability assessment (WCA), the much-criticised eligibility test for ESA, would be scrapped.
He was speaking just three days before his department finally published complex new figures on the number of people who died after being found “fit for work” following a WCA.
Tory, Labour and coalition governments have repeatedly given their support to the ESA system, since it was launched under Labour in 2008.
But Duncan Smith said, in the speech delivered this week to the thinktank Reform, that there was a “fundamental flaw” at the heart of ESA.
He said: “It is a system that decides that you are either capable of work or you are not capable of work.
“Two absolutes equating to one perverse incentive – a person has to be incapable of all work or available for all work.”
He added: “Someone may be able to do some work for some hours, days or weeks, but not what they were doing previously, when they first became ill.”
Duncan Smith said that ESA – and particularly the WCA – was at odds with the government’s new simplified working-age benefit system, universal credit.
He said: “The more personalised approach under universal credit… sits alongside a work capability assessment which sets the wrong incentives.”
He said a new system should be “better geared towards helping people prepare for work they may be capable of, rather than parking them forever beyond work”, and should be “focussed on what a claimant can do and the support that they need to be able to do it – and not just on what they can’t do”.
Duncan Smith’s comments appear to signal a major retreat from his party’s support for ESA and WCA over the last five years.
And they come less than two months after George Osborne announced, in his summer budget, that from April 2017 he was scrapping the extra financial support for new ESA claimants placed in the work-related activity group, a loss of about £1,500 a year per person, as part of measures that would cut £13 billion-a-year from the social security budget by 2020-21.
If Duncan Smith’s comments do mean an end to the WCA, it would mark a victory for disabled activists who have campaigned for five years for the assessment to be scrapped, despite repeated government insistence that it was fit for purpose.
Over the course of five independent reviews aimed at improving the WCA, Tory ministers have insisted that the WCA must stay.
In the government’s response to the second independent review of the WCA, in 2011, employment minister Chris Grayling said they would “make further improvements to the work capability assessment to ensure it continues to be fit for purpose”.
In his response to the third independent review of the WCA, in 2012, employment minister Mark Hoban said the goal was “continuous improvement”, and added: “We agree that the WCA ‘remains a valid concept for assessing… eligibility’ and that there is no evidence to suggest that the system is fundamentally unsound.”
Early in 2014, Mike Penning, then the minister for disabled people, responded to the fourth WCA review by welcoming the conclusion of the independent reviewer, Dr Paul Litchfield, that the WCA did not need to be scrapped.
Penning said: “In line with the government’s view, he has instead reflected that we need to make further changes but that these reflect our strategy of continuous improvement rather than radical overhaul.”
And just three months before May’s general election, responding to the fifth and final review, Mark Harper, Penning’s successor, insisted that the WCA was “integral to the government’s commitment to ensuring that as many people as are able to do so engage in employment and that those who cannot work receive the appropriate support”.
But now, in this week’s speech, Duncan Smith appears to have concluded that his government was wrong all along to support the ESA and WCA system.
He told the Reform event: “I want to place people at the heart of a system, and make the system work around them, rather than the other way round, as has been the case.
“It was this back-to-front approach which we had inherited, a system that people crashed into, and struggled to figure out too often.”
Disabled campaigner and researcher Catherine Hale, who wrote a well-received review on the failure of the ESA system to increase the number of disabled people in paid work, said: “I’ve always welcomed the idea of an assessment geared to what kind of work a person could do and what support they would need to do it, as Labour was promising before the election.
“But it would have to be based on the real world of employment, not the fantasy world of the current WCA, involving moving empty cardboard boxes and picking up pound coins from the floor.
“However, I’ll eat my hat if this government, after all its policies and rhetoric of blame and punishment towards disabled people, actually intends to perform a U-turn and empower us instead.”
Michelle Maher, of the WOWpetition – which calls on the government to assess the overall impact of its cuts to support and social care on disabled people – said she believed Duncan Smith’s speech signified a plan to cut the number of people receiving out-of-work disability benefits.
She said: “I firmly believe they thought the WCA would reduce numbers and that people were fraudulently claiming or making a ‘lifestyle’ choice.”
But when ministers realised this was not the case, she said, they decided to scrap the WCA and replace it with something “innocuous but deadly”, with more sanctions and even more “frightening and stressful” for ESA claimants.
Linda Burnip, co-founder of Disabled People Against Cuts, said: “What Iain Duncan Smith has said is interesting, but the mind boggles about what he is going to replace it with. He is a slimy snake and I wouldn’t trust him.”
He agreed that Duncan Smith appeared to have announced plans to scrap the WCA, but said he had provided no clue as to what he would replace it with.
He said: “I would warmly welcome reform if it was in the right direction.”
But he added: “I think it would be an absolute crying shame for that opportunity to be lost by Iain Duncan Smith spinning forth a load of rhetoric to get people onside and then doing the absolute reverse. That is what I think he will do.”
Dilworth said he believed that Duncan Smith would make it harder for disabled people to enter the support group of ESA – or the equivalent under universal credit – and said: “When he talks about reform, I am all for that, but I just don’t trust him.”
John McArdle, co-founder of Black Triangle, said: “IDS’s latest pronouncements are a signal that a fresh attack on the fundamental human rights of sick and/or disabled people is in the preparatory stages.
“You can’t help disabled people by impoverishing them through brutal austerity cuts as your guiding policy.
“IDS has realised that his disastrous social security cuts have failed to ‘make savings’, even on their own terms, so now he is fumbling around seeking new ways to justify further assaults on our welfare state.
“He’s a proven liar and is both dangerous and breathtakingly incompetent to boot.
“If the UK was still a civilised society – in a week when the DWP has been forced to reveal just how many thousands of sick and/or disabled people have died in abject penury after unjustly being found fit for work – IDS would have been summarily dismissed.
“Dying in poverty and neglect is now just a fact of life in what remains of our social security system, thanks to this man. It is intolerable.”
Disabled activist Caroline Richardson, from the Spartacus online campaigning network, said: “The evolution of universal credit has shown it to be now a system of sanctions, where a person has to continually increase their hours/wages under threat of not just losing the ‘amount a person needs to live on’ but also their housing and other benefits.
“Abolition of ESA reduces the ‘indicator flag’ that clearly differentiates people. I fear that assessments will increase in frequency, and be linked to the number of hours the assessor believes a person could work.
“Anyone with any capacity at all would be effectively on jobseeker’s allowance, even if their claimant commitment obligation for hours to be worked is very low.”
Choice and control have plunged under Tories, say government figures
The government is facing an embarrassing slump in one of the key measures of the success of its disability strategy: the proportion of disabled people who feel they have choice and control in their lives.
The results were included in the latest report from the Office for Disability Issues (ODI) on progress “towards the vision of disabled people living fulfilling lives”, through the Fulfilling Potential disability strategy.
They will be particularly embarrassing for the government, because “choice and control” is one of the strategy’s six major themes.
When the Office for National Statistics began collecting the figures, in 2008 – two years before the Conservative-led coalition came to power – it found that 76 per cent of disabled people said they frequently had choice and control over their lives.
But the new report, published on 21 August by ODI – but not publicised with a press release – showed that figure plunging to just 65 per cent last year, a fall of more than 14 per cent (or 11 percentage points) in just six years.
Three years ago, the government said it wanted its Fulfilling Potential strategy to “tackle barriers to realising aspirations and individual control” for disabled people”.
A progress report published last year said that the proportion of disabled people who believed they frequently had choice and control over their lives had been fairly stable from 2008 until 2012, but started to fall in 2013.
Disability News Service has now asked the Department for Work and Pensions for more detail on how the proportion of people enjoying choice and control changed between 2009 and 2012.
The figures are likely to add fuel to concerns that the Tory austerity programme – including cuts to out-of-work disability benefits, disability living allowance cuts and reforms, the introduction of the bedroom tax, cuts to social care, and the closure of the Independent Living Fund – has damaged disabled people’s chances to achieve independent living.
Other figures in the report will also raise concerns, with the proportion of disabled people who said their employer was very supportive falling from 57 per cent in 2013 to 53 per cent last year.
And the proportion of disabled people who said their work colleagues were very supportive also fell, from 65 per cent in 2013 to 59 per cent in 2014.
Just 40 per cent of disabled people said the protection provided by the Equality Act was effective (a slight rise on the 39 per cent of 2013).
There was also a sharp drop in the proportion of disabled people who said they had no difficulties with public transport, from 74 per cent in 2013, to 67 per cent in the latest report.
Long-awaited deaths stats ‘do not tell the whole story’
The long-delayed release of government figures on the deaths of benefit claimants has added fuel to years of concerns about the impact of aggressive welfare reform on sick and disabled people.
The Department for Work and Pensions (DWP) released two sets of data today (Thursday), one showing mortality statistics for out-of-work disability benefit claimants, and another showing death rates for all out-of-work benefit claimants.
Activists had been calling on DWP to publish updated statistics since November 2012, in an effort to prove that the work capability assessment (WCA), the eligibility test for employment and support allowance (ESA), was so damaging that it was causing deaths.
The information commissioner finally ordered DWP to release the figures after an appeal by Mike Sivier, a freelance journalist and carer who runs the Vox Political blog.
But many activists and commentators warned that the figures released by DWP today “do not tell the whole story”, and would require detailed analysis before any conclusions could be reached.
The figures reveal that, of the two million people who had gone through a work capability assessment and had received an ESA decision between 1 May 2010 and 28 Feb 2013, nearly 41,000 had died within a year of that decision.
The reports also show that, between December 2011 and February 2014, 81,140 people died while claiming ESA or incapacity benefit (IB).
And 2,650 ESA and IB claimants died soon after being found “fit for work” as a result of an assessment.
Another 7,200 died after being placed in the ESA work-related activity group (WRAG), for claimants the government had decided were well enough to move back towards work.
Other figures show age-standardised mortality rates (ASMRs), which allow for comparisons between the proportion of those dying while in different ESA groups and the general population.
These figures show that, in 2012, those placed in the work-related activity group (WRAG) of ESA were more than twice as likely to die (481.1 of every 100,000 people) as the general population (238.5 of every 100,000 people).
The following year, in 2013, the figures were 532.4 per 100,000 people for the WRAG and 240.4 for the general population.
DWP insisted that it was not possible to assume any “causal effect between benefits and mortality” from the “isolated figures” it had published, which “provide limited scope for analysis”.
It insisted that “nothing can be gained from this publication that would allow the reader to form any judgement as to the effects or impacts of the WCA”.
Despite this, work and pensions secretary Iain Duncan Smith had announced – just three days before the figures were published – that he wanted to scrap the WCA, and said there was a “fundamental flaw” at the heart of the ESA system.
Disabled People Against Cuts (DPAC) said the figures showed the WCA was “not fit for purpose”, although it would take time to analyse them properly.
DPAC’s statement said the figures “do not tell the whole story”, as they ignore those disabled people found fit for work but unable to claim jobseeker’s allowance because of its strict conditionality.
DPAC said the figures also ignore the thousands of disabled people sanctioned every month; those disabled people “portrayed as scroungers by the media”; and the “suffering and the humiliation of disabled people who have to prove their impairment/long-term health issues over and over again to DWP staff who don’t believe them”.
The disabled social affairs journalist Frances Ryan wrote in the Guardian that death had become part of Britain’s benefits system.
She said: “That is not hyperbole but the reality that the stress caused by austerity has led us to.
“Shredding the safety net – a mix of sanctions, defective ‘fit for work’ tests, and outright cuts to multiple services – has meant that benefit claimants are dying; through suicide, starvation and even being crushed by a refuse lorry when a 17-week benefit sanction forced a man to scavenge in a bin for food.”
Philip Connolly, policy and development manager of Disability Rights UK, said: “It is not just the charities but the British Medical Association and the Royal College of Nursing who have deplored this medical test for fitness for work.
“Now the evidence of the cruelty and stress involved in this test can be seen by everyone else too and not simply by the families of the dead. We need a completely new approach.
“This time it must be one that starts by supporting those who want to work to exercise their right to work – with encouragement and evidence-based support, not threats of poverty and inadequate programmes.
“And it must be one that disabled people, our representative organisations and health, social care and vocational rehabilitation professionals view as acceptable.
“It must be evidence-based. It must link assessment of needs to support. It must be fair.”
Frank Field, the Labour MP and the new chair of the Commons work and pensions select committee, said the figures were “distressing”, but added: “The key factor is whether the number of deaths are above what would normally be expected from claimants not deemed fit for work.”
He said he had written to Sir Andrew Dilnot, chair of the UK Statistics Authority, to ask if he would answer this and other questions, and “take this analysis further”.
The grassroots campaign group New Approach, which is dedicated to replacing the “toxic” WCA with a fairer system, said it was too early to conclude what the figures really showed, and added: “We will go through today’s figures in detail over the coming weeks and respond to them by issuing a further statement when our findings are complete.”
Among others warning not to read too much into the figures was Ben Goldacre, a doctor, academic, campaigner and writer, whose work focuses on uses and misuses of science and statistics.
He said: “Fit for work assessments may well harm people. These DWP figures do not give us the answer.
“Journalists and politicians claiming they can see any information one way or another in these figures are displaying their ignorance and wishful thinking.”
He said that the figures which could answer this question would be ASMRs for people on IB or severe disablement allowance who had been reassessed through a WCA and found fit for work.
Kate Green, Labour’s shadow minister for disabled people, said ministers had been trying to suppress the figures for more than three years.
She said: “The delay and the lack of transparency in publishing this information is a disgrace and has caused huge distress to the families and friends of those affected.
“These figures should be a wake-up call for the government. Ministers need to focus on sorting out the assessment process so that everyone can have confidence in it, and providing support for disabled people who can work in order to help them do so.”
NHS caps on continuing healthcare pose new threat to former ILF-users
Disabled people with complex health needs are at increasing risk of being forced into nursing homes by cash-strapped NHS commissioners unwilling to fund packages to support them to live independently in their own homes, campaigners fear.
At least two clinical commissioning groups (CCGs) – Mid Essex and Enfield – have already introduced rules that refuse to fund home-based packages of support for those eligible for NHS continuing healthcare if the cost is more than 10 per cent above the cost of a place in a nursing home.
Disability Rights UK (DR UK) has raised concerns that such moves to impose an artificial cap on home support packages could impact on former users of the Independent Living Fund (ILF), which closed at the end of June.
Faced with responsibility for an influx of service-users with high support needs, it is feared that local authorities will argue that many former ILF-users should instead be funded by the NHS.
If CCGs then cap the cost of support packages, it could force some ILF-users into nursing homes.
NHS continuing healthcare was introduced in 2007, and refers to packages of ongoing care for people with complex health needs that are arranged and funded solely by the NHS.
Earlier this month, the board of Mid Essex Clinical Commissioning Group approved new guidelinesthat allow new patients to receive NHS continuing healthcare at home only if that support costs a maximum of 10 per cent more than equivalent care in a nursing home.
A consultation on the plans saw only 22 per cent of 75 respondents backing one of two options to impose a cap.
Responding to the consultation, the user-led Spinal Injuries Association (SIA) warned that such a policy could breach both article eight – the right to a private and family life – of the European Convention on Human Rights (ECHR), and article 19 – on living independently – of the UN Convention on the Rights of Persons with Disabilities (UNCRPD).
SIA said the policy “strongly implies that the individual will be physically placed in a residential care home against their will”, which would be a “fundamental and material interference with their right to a private life”.
It pledged to support members who challenge the policy in the courts.
The SIA response added: “In summary, SIA wishes to make it clear that it rejects as unacceptable the proposals to restrict the cost of ‘care at home’ packages, and will support its members in opposing any attempts to coerce the CCG’s spinal cord injured patients into residential care.”
When asked if the policy would lead to fewer disabled people with high support needs living independently, a Mid Essex spokesman said: “This policy is intended to ensure that NHS continuing healthcare provision in mid Essex is an equitable process for all residents.”
He said Mid Essex had “sought legal advice prior to the consultation taking place to ensure we are meeting our legal obligations”.
Asked if the policy could impact on former ILF-users, he said: “The policy applies to all new patients.”
Enfield CCG has already introduced a similar policy for people assessed as eligible for NHS continuing healthcare, and will now “only consider the provision of ‘care at home’… where the total cost of providing care is within 10 per cent of the equivalent cost of a placement in an establishment”.
Enfield’s policy was introduced in October 2013 and is currently being reviewed.
A spokeswoman for Enfield CCG said that so far the policy had not been invoked, as colleagues had managed to “look at each individual’s needs and have worked the package around what is best for them”.
But she said the policy could still be invoked in the future, because Enfield CCG was a “financially-challenged organisation”.
She said Enfield does not “have any concerns” that its policy could breach the ECHR or the UNCRPD, and believes it is consistent with the government’s framework on NHS continuing healthcare.
But Sue Bott, deputy chief executive of DR UK, said she was “very concerned” that CCGs had begun to introduce such policies.
She said: “I think we will be looking to find out as soon as we can how many CCGs have got this policy.
“It is a direct threat to disabled people and there is a real worry that people could end up in a nursing home against all the principles of independent living.
“It is just not acceptable for people to be institutionalised, which is what it amounts to, in this way against their will.
“We will be campaigning and getting our allies to ask questions in parliament and we will be seeking some reassurance from ministers that disabled people are not going to face this threat.”
Bott said the new policies posed a threat to former ILF-users, as some local authorities were now referring them to CCGs for NHS continuing healthcare because of their own lack of resources.
Linda Burnip, a co-founder of Disabled People Against Cuts, said policies such as those in Enfield and Mid Essex were “very regressive” and were “taking disabled people’s rights to independent living backwards, basing it not on independent living but purely and simply on cost”.
But she said it was very difficult to know what impact these and other such policies would have on people’s care in the future, until the results of the chancellor’s spending review in the autumn.
News provided by John Pring at www.disabilitynewsservice.com