The Smokescreen of the Work, Health and Disability Green Paper

Welfare reform policies, almost without exception, have been based on false assumptions, policy-based evidence, and an astounding ignorance of the lives that will be affected by such reforms. This harmful ignorance has nowhere been more apparent than in policy relating to people who are disabled or who are living with a chronic illness. Indeed, last year the United Nations found that these policies represented a grave and systematic abuse of the human rights of disabled people by the UK government.

Unabashed and undeterred, the government pressed on with its planned cut to Employment and Support Allowance (ESA), the benefit paid to people who have been found unfit to work by the government’s own assessment. Against all logic, the government pronounced that the reason these claimants were not getting a job was because they received £29 a week more than healthy non-disabled Jobseekers. Just to reiterate – these are people who have been found unfit to work by the government. But the government actually said £29 was acting as a “perverse incentive” which deterred such unfit people from working. 

This policy was so blatantly wrong that even some Conservative MPs baulked at voting for it. The government took a two-pronged approach to head off any rebellion.

First, it disingenuously allowed some MPs to believe that because the people affected would be in the Work Related Activity Group (meaning they are unfit to work, but may return to work at some stage in the future) they would actually be fit to work when the cut was applied to them. This was completely false, but appeared to be a common belief amongst Conservative MPs, and the government made no effort to corect it. Secondly, the Secretary of State promised a Green Paper which would offer all kinds of help and support to people affected by the cut. With MPs thus reassured or simply misinformed the government got its way and this large benefit cut for sick and disabled people who make a new claim for ESA will be implemented in April.

In accordance with the government’s promise to MPs, Improving Lives : the Work, Health and Disability Green Paper was published in October 2016. It has been rigorously analysed by the Spartacus Network, a group of experienced researchers who live with severe chronic illness and disability. They have defined it as a smokescreen to obscure the withdrawal of financial support from people who are too ill to work – and an alarming indication of the government’s direction of travel in this area.

The Smokescreen  report responds to the Green Paper paragraph by paragraph, and comprehensively rebuts the false assumptions, conflations and contradictions with which it is littered. I can only mention a few points here, but would urge everyone to take a look at the report and share it with their MP.

Firstly, Smokescreen points out that Jobseekers Allowance was designed as a subsistence amount to tide healthy people over a period of unemployment which may last weeks or months. The government is now expecting people with serious illnesses to survive on this level of income for years.

Smokescreen also questions the government’s definition of the Disability Employment Gap, pointing out that claims regarding the size and cost of this gap are based on dubious figures. 

One of the most fundamental and damaging features of the Green Paper is that it conflates healthy people who have a disability with people who have a severe and disabling chronic illness. This would be like viewing Baroness Tanni Grey-Thompson, a former Paralympic champion and active member of the House of Lords, as being in the same position as someone who is frequently housebound or bedbound through illness. Yet the focus of the Green Paper is not on getting healthy disabled people into work – realistically this could require support such as a Motability car or social care, which are increasingly being withdrawn to save money. Instead the emphasis is on ‘health conditions’, a term used to cover what may be a chronic disabling illness, with no recognition of how serious and incurable those health conditions may be.

The Green Paper implies that many people are on ESA because of preventable illnesses caused by lifestyle choices. The truth, say Spartacus Network, is that, “primarily, people are on ESA because of non-preventable conditions. By defining illness as the result of lifestyle, the government implies that people out of work because of illness are there through their own fault, and can be got back to work through health interventions.”

It is this attempt to inextricably link health and work that is perhaps the most concerning aspect of the Green Paper. Work is seen as a health outcome and a health treatment, with the potential for medically unqualified Work Coaches to get involved in discussing or arranging treatment for people whose conditions they cannot fully understand.  As the report says, “Work Coaches are not trained to know what a person can or cannot do whilst managing or treating their chronic illness…  It  is  dangerous of  the government  to  suggest  that  Work  Coaches  can perform such a highly discretionary role.” Meanwhile the role of the claimant’s own GP is downgraded and claimants could be expected to discuss their condition in a three-way conversation, with a Work Coach and a healthcare professional who has not been involved in their diagnosis or treatment.

Where mental illness is concerned, the government appears at risk of underestimating the seriousness of the conditions claimants are living with. As the report says, “Many people on ESA have ‘uncommon’ mental illnesses such as schizophrenia or schizoid disorders, or personality disorders. ..For someone to receive ESA purely because of anxiety or depression, it must be so crippling that they are essentially unable to look after themselves. This is not ‘common’.”

The Green Paper talks of co-locating employment and therapy services, but Smokescreen warns, “Mentally ill people are rightly wary of coercion and pressure to engage in activity that is beyond their capabilities. Many report that  if  employment  advice  is  co-located  with  their  healthcare,  this  will  make it emotionally difficult for them to access the healthcare they need, risking losing their access altogether.”

Indeed, given the Green Paper’s approach one wonders if its authors are even aware of the most recent NHS Adult Psychiatric Morbidity Report  for England, which says, “it emerged that people in receipt of Employment and Support Allowance (ESA), a benefit aimed at those unable to work due to poor health or disability, were a particularly vulnerable group. .. approaching half had made a suicide attempt at some point”. The potential risks of involving unqualified or inappropriately qualified people here is obvious.

Smokescreen’s authors conclude that, “The Green Paper is a complex and misleading document, and we believe it is deliberately so.” Some MPs may feel that they were misled into voting for the cut to ESA, which will require people with serious illnesses to live on a subsistence income. If they were reassured by government promises of what would be contained in this Green Paper, then they may have been misled yet again.

The authors of the Smokescreen report are Stef Benstead and Caroline Richardson, with contributions from David Gillon, Catherine Hale, and Jonathan Hume.

The report can be read here

More comment on the Health, Work and Disability Green Paper from Ekklesia:

http://www.ekklesia.co.uk/node/23538 and http://www.ekklesia.co.uk/node/23562

* If these issues affect you and you are in distress, please call the Samaritans helpline on 116 123. Calls are FREE and the helpline is open 24 hours a day.

© Bernadette Meaden has written about political, religious and social issues for some years, and is strongly influenced by Christian Socialism, liberation theology and the Catholic Worker movement. She is an Ekklesia associate and regular contributor. You can follow her on Twitter: @BernaMeaden