Purnell’s silly plan for alcoholics


8:20 am - April 17th 2009

by Neil Robertson    


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I don’t know about you, but whenever I hear a new government proposal for reform of the welfare state, I have to pause for a moment and ask: is this a policy or a headline? For example, when Hazel Blears announced that ‘hit squads’ armed with rubber gloves would be banging on parents’ doors to make sure their kids are ready for school, just about every observer – and probably Blears herself – knew it wasn’t going to happen, but made for a nice headline.

So when James Purnell promises/threatens to make unemployed alcoholics seek treatment or lose their benefits, I don’t think it’s unreasonable to ask whether this story falls into the same category.

Because when you think hard about how it would be implemented, you’re left with the irresistible suspicion that it’d either be appallingly intrusive or completely unworkable.

The idea’s apparently been palmed-off to Glasgow University to figure out how it might work, and the first question they’ll face is: how is the state going to define what makes an alcoholic? Are they going to abide by the medical definitions and judge it according to physical & psychological dependency, or will they just pick a number of units drunk per week and define that as the booze barrier? And if they did decide to judge it according to units, how many would you have to drink for the state to label you an alcoholic? Certainly, if they set it as low as the current recommended daily allowance, half the country would end up in A.A. meetings at some point.

Even if they resolve that question, that certainly isn’t the end of their problems. The next difficulty they’ll have is: how is the state going to identify alcoholics? The people who work in job centres are perfectly good at their jobs, but those jobs only involve following pre-approved computer procedures for eight hours a day. None of these people are trained in medicine or psychology, and therefore won’t be qualified to label people as alcoholics, much less terminate their benefits for it.

How does the government get around that? Will they subject every claimant to a full medical? Will they perform breathalyzers on everyone who walks through the door? Or will they be more discreet, and just ask staff walk around council estates with clip boards and ask them to count how many cans of Special Brew are left in recycling bins?

I suppose you could ask them whether they’re alcoholics, but how many people who are ever answer affirmitively? If you deny your addiction to your friends, your family and even yourself, you’re hardly going to open up to someone you only see once a fortnight and who only knows you as a name on a computer. And before we start going down the lie detector test route, we should note that this has already been torn to shreds.

Lastly, if you’re going to do something as serious as terminating someone’s benefits for not attending treatment, you better make sure that you’re offering the best treatment possible. Addiction is an incredibly tough thing to overcome; failures happen regularly, and often to people much better off than the unemployed. We have to realise, too, that alcoholism doesn’t simply happen out of idleness, and that it’s often intertwined with other factors: depression & other mental illnesses, low self-esteem, learning difficulties, social exclusion & sometimes even disability. If these people need help, then it’s in society’s interest to provide that help, but nobody should lose their benefits because the treatment programme they were ordered on was ineffective.

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BMJ Medical Ethics blog – The Benefits of not being an Alcoholic

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About the author
Neil Robertson is a regular contributor to Liberal Conspiracy. He was born in Barnsley in 1984, and through a mixture of good luck and circumstance he ended up passing through Cambridge, Sheffield and Coventry before finally landing in London, where he works in education. His writing often focuses on social policy or international relations, because that's what all the Cool Kids write about. He mostly blogs at: The Bleeding Heart Show.
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Reader comments


1. Shatterface

Alcoholics should have the same rights to benefits as diisabled people, which is that they should be expected to look for work within their capabilities. Most alcoholics are perfectly functional, as are most drug users.

I don’t see any benefit in abandoning anyone to a lifetime of benefits, especially where that means further decent into mental and physical illness and an early death. A society which does so is enacting a form of eugenics.

If they fail to disclose their illness then they cannot fall back on this as mitigation for their failure to look for work.

The left seems rather attached to ‘….to each according to his abilities’ but happy to skip ‘from each according to his abilities…’

2. Shatterface

Bugger: ‘…to each according to his needs’

Yeah, let’s let them rot to death, eh Shat, that’ll teach them to fall onto the wrong side of the tracks!

Surely he must have been p*ssed when he thought of such a policy.

Maybe he could start with alcoholics in parliament first before starting to preach on his high horse to others.

Shatterface does have a point. Many, many alcoholics work effectively.

Also, alcoholism isn’t necessarily the cause of unemployment, but as likely a symptom.

“Because when you think hard about how it would be implemented, you’re left with the irresistible suspicion that it’d either be appallingly intrusive or completely unworkable.”

Don’t have to think very hard.

Churchill was an alcoholic wasn’t he?

I find this idea offensive, up there with the “we’ll take your homes if you don’t look for work” idea that even the Daily Mail said was going too far.

But as you said, I think it’s all about headlines rather than policy.

7. Mike Killingworth

Well, in one sense, since addiction is addiction, there’s no logical case for treating people addicting to skunk or cocaine with one set of rules and those addicted to alcohol (or nicotine, come to that) with another.

As to prevalence of alcoholism, this is not a term used by the report “Statistics on Alcohol: England, 2007”) which identifies “hazardous”, “harmful” and “dependent” drinking – the last category being those drinking above ‘sensible’ levels and experiencing harm and also showing symptoms of dependence where “harm” may be physical or psychosocial. These categories are taken from a WHO report.

Alcohol “treatment” programmes as such largely focus on “dependent” drinkers (for & by whom AA was founded) for whom recovery requires total abstinence. This in turn requires the willingness of the alcohol-dependent individual to abstain, an effort which typically requires prioritising it over all other commitments, including those to work and family. It is therefore perhaps unsurprising that the relapse rate is about 95% at any given time.

The WHO report promoted interventions among “harmful” drinkers, for whom presumably – since they are not neurochemically dependent on alcohol – a drink reduction programme might work.

If you are sceptical of this convenient typology, I don’t blame you in the least. It has always been a habit of the medical profession to label what it doesn’t understand and it has no particular understanding of addiction. Most treatment centres use medically qualified staff only in the “detox” stage, i.e. to deal with physiological “withdrawal” symptoms.

Recovery programmes that have any success at all have the following basic features:

(1) they make no distinction between the different substances to which people become addicted, but focus on the addiction (“dependence” in WHO language) itself; and they actively seek to mix customers from the widest variety of social backgrounds (in order to focus their attention on their addiction rather than anything else). This would suggest that setting up programmes on “sink” estates – if the government has such a thing in mind – is unlikely to work;

– they are ongoing maintenance programmes rather than the kind of time-limited intervention such as CBT (cognitive behavioural therapy) so beloved of governments: this means in practice that at least after the initial stages they need, for cost reasons, to be self-help programmes – again this implies a high degree of motivation on the part of the participants, which can surely only come from within themselves, not from outside;

– they require the addict – to nutshell their content – to replace the pursuit of pleasure with the pursuit of happiness. This is extremely difficult (hence the low success rate) for two main reasons – first, that our society is dedicated to the former rather than the latter (money can buy you love and fame is even better) and second because all addicts come from more or less dysfunctional families (by which I mean that at least one of their parents either perpetrated or was the victim of physical, sexual or psychological abuse) – they are not alone in this, of course, and drug/alcohol abuse is in one sense a rational reaction to such an upbringing. They have thus no idea of what “happiness” is and no way to tell the good from the bad from the ugly when it comes to those offering to teach them.

Why an employer would wish to take on someone whose value-system is at odds with that of society at large and by implication with that of his/her colleagues – so that they are not likely to make a very good team player – and the materialist goals of the organisation itself is a very good question. Based on an experience of over ten years, I would say that educated addicts (including alcoholics) in stable recovery (usually measured as being of over a year’s duration) are capable of self-employment and uneducated ones of voluntary work.

Aaron @5:

Many of them, indeed, work in Westminster.

Shatterface @1:

The situation is a little more complex than Purnell is trying to present. Realistically, if you want a sociological model for alcoholism among the unemployed in ex-industrial areas that have been wholesale abandoned (of which we have quite a few, mostly abandoned in the 80s and in the north), you’re looking at the model of alcoholism among indigenous peoples in Canada and Australia, or (and better) at what happened to Newfoundland after the changes in North Atlantic fishing regulations.

Purnell does not want people drawing that comparison, because the only thing that ever worked with those cases was massive, massive investments in education and infrastructure, and then only if the uses of the money are left entirely in the hands of local government.

Secondly, this isn’t a bad idea, in that what Purnell is thinking is, let’s get all the 20-yr-old council lager louts off benefits because they’re violent drunks.

What he’s actually going to get is a system that doesn’t work and primarily screws the legitimate strugglers who desperately need their benefits to have any hope of getting their life stable; the professional benefits scroungers (less than 2% of the total, according to his own numbers) are the only ones who understand the system well enough to play it. Just like the current attempt to redefine anyone on DLA with a mental illness as not disabled, Labour’s own Chuck the Nutter in the Gutter plan.

Mike @7:

addicts come from more or less dysfunctional families (by which I mean that at least one of their parents either perpetrated or was the victim of physical, sexual or psychological abuse).

Er, could you source that please? Not only am I, from personal experience, certain that this statement is not true as written, but it seems to me that you’re committing a post hoc, ergo propter hoc error which was very popular in the 80s. There’s correlative data between poverty, familial abuse and chemical dependency which strikes me as common sense; some people, a lot of people even, get dependent on drugs (including alcohol) to escape a bad situation. But it certainly isn’t absolute that their parents were abused or abusers: and it surely isn’t absolute that the only cause of addiction, ever, is familial abuse, which seems to be what you’re saying here?

Alternatively, if you consider maternal guilt trips to be psychological abuse, a view for which there is considerable precedent and evidence: and if you consider corporal punishment administered in the 1940s or 50s to be physical abuse (which is how it would be categorised now), then virtually every adult my age or older has parents who fit your description, which diminishes the utility of it…

We have to realise, too, that alcoholism doesn’t simply happen out of idleness, and that it’s often intertwined with other factors: depression & other mental illnesses, low self-esteem, learning difficulties, social exclusion & sometimes even disability

…and sometimes the result of being sacked or being unemployed.

John Q Publican: Secondly, this isn’t a bad idea, in that what Purnell is thinking is, let’s get all the 20-yr-old council lager louts off benefits because they’re violent drunks. – only ‘being a violent drunk’ isn’t the same as an alcoholic (as usefully explained by Mike Skinner here). But then if Purnell is simply extending New Labour’s vendetta against the ‘undeserving poor’ into new areas, it makes perfect sense: I await the next phase – the pursuit of the ‘clinically obese’ – with interest.

Sadly I’m inclined to take any ideas Purnell floats as serious attempts to see if he can get away with it; to test just how right-wing he’s allowed to be. He’d implement them if he could. Same with Caroline Flint, who I’m immensely relieved is no longer Housing Minister so she can’t agree with any of the ludicrous Conservative Housing Paper.

#1, I agree completely that “from each according to her ability” is just as important as “to each according to her needs”, I’m just not convinced that conditionality is usually the best way to achieve it.

Redpesto @10:

yes, I know. Purnell possibly doesn’t.

What he wants is, in a way, not a bad thing; there are people who game the system, and there are people who (often for reasons a generation beyond their control) are stuck in a pit of dependency they can’t climb out of. Very occasionally they’re the same people. The ones who game the system need to be stopped: the ones who can’t climb out need to be helped out. Purnell wants to do the opposite because there’s more of them in category two. It is therefore cheaper for him, since very few of the people in category two are going to be people he cares about.

13. vulpus_rex

James Purnell gets my vote as the most likely Labour MP to defect to the Tory party in the chicken run before the rout next year.

I doubt it, although many Labour members would be secretly pleased. I don’t think there’ll be any defections, though if there were I’d count Kate Hoey as most likely.

I found the story strange, too. See http://nodeinthenoosphere.blogspot.com/2009/04/is-addiction-disease.html, if anyone is interested.

Frank Field might have jumped ship by now, but I suspect he’d be toast when it came to defending his seat in Birkenhead.

Purnell will hold on and try to maneuver himself into a position of leadership whilst Labour are in opposition. None of the top ranking Labour scum can defect unless they are sacked from the cabinet/ministerial office. They’ve tied themselves to the mast too much to jump off the sinking ship now.

18. Shatterface

Delboy (3): yeah, that’s right I want alcoholics to rot in the gutter, along with the disabled and single parents.

Learn to fucking read.

Flawed though Purnell’s plans are, it’s those who think leaving alcoholics untreated is an acceptable alternative who are letting them rot.

“… since addiction is addiction…” – I am far from convinced it is. Of course, there is a family resemblance between what we call addictions but that is far from saying they are the same thing, or should be treated in the same way. Also because different substances have different implications for longterm health and prosperity.

Thanks for the comments, everyone; they’ve made a really good read.

Shatterface,

Like you, I don’t believe in abandoning anyone to a life on benefits, and would support any reforms which might offer better training, education, voluntary work or help resolving pre-existing social/mental problems which might make people less likely to languish on the dole. I’d support an involved and proactive jobs service, should one ever come to pass. But what I fear (and this is based partly on the reading I did when the welfare white paper came out, and partly from the few months I was unemployed towards the tail end of last year) is that the current welfare system is too bureaucratic and mechanistic to make a policy like this work. Even if Purnell’s plan is devised with the noblest of intentions (and, frankly, he could’ve sold it better), I’m still not sure the current system – nor the reform proposed in the DWP’s white paper – will be able to do what he’s intending. For that reason, if I was given only the two options, I would rather the government keep things as they are than implement a deeply flawed alternative which would end up unfairly stripping people of their benefits.

Like I said in the piece, I could be proved wrong. But I doubt it.

What happened to common sense?

I don’t see any benefit in abandoning anyone to a lifetime of benefits

God forbid we give benefits to alcoholics, the poor, single mothers. Oh no, let’s not abandon them to the awful fate of having a bit more money than the market would give them. Perish the thought.

Learn to have a fucking conscience.

23. vulpus_rex

15. Kate Hoey is, from what I can gather, a conviction politician who is unlikey to suddenly become right wing.

James Purnell on the other hand strikes me as having decided he wanted a career in politics, looked about for the party most likely to get him elected and then adopted his principles accordingly.

He might prefer defection to a generation in opposition with little real chance of a ministerial position again.

It sort of worked for Shaun Woodward though his limited rewards for his act of treachary is some testament to what a piss-poor politician he his.

Shatterface: Flawed though Purnell’s plans are, it’s those who think leaving alcoholics untreated is an acceptable alternative who are letting them rot.

Well, you could provide treatment via the NHS – but where are the headlines in that? In any case, Purnell can’t ‘sell’ it better because selling on the basis of threats is the whole point – it’s just that when you call him on it, he starts whining about how you really don’t care about the unemployed like he does.

How many unemployed are there in the UK now? 3 million – and this – well call him what you will – says that a person on dependency of some substance should be forced to get help? All this for 45 quid a week?

And they wonder why people take the piss out of them.

*Wide-eyed and dumbfounded*

Purnell is appealing, in the time dishonoured New Labour fashion, for the Daily Mail reader mentality. This current recession is hitting people at all social levels, and there will be some who, after being made redundant in, say, an expensive management job, will want to know why some boozer or junky is getting money from the Social to feed his habit when all he, the ex-manager, gets is the measly job-seekers’ allowance. That’s Purnell’s target audience.

How is cutting off Social money to Junkies or boozers going to help? How will they purchase their necessities, except by committing crimes, and thus cause more social problems? Many, if not most, addicts use drugs to escape from a world that they find intolerable. Unless they can see the possibility of a better life, they will wish to remain in the oblivion of addiction than face an unpleasant reality. This recession is bound to increase feelings of hopelessness, and will almost certainly lead to an increase in drunkenness and drug use, as people try to hide from the increasingly miserable and harsh world by drinking or using drugs. Purnell’s suggestions are cheap politics; something in which New Labour revels.

I could see Purnell and many other of his ilk defecting from New Labour, if they feel that another party can help them with their authoritarian ambitions. Perhaps the Tories, but they seem to be projecting a more ‘understanding’ image for these hard guys. If a new brand of right-wing authoritarian politics takes off — not a re-run of traditional fascism, but something quite different (for example, much less racially-oriented) — the Purnells of this world will be amongst the first to join — and then to lead — it.

27. Shatterface

The point of ‘forcing them to get help’ isn’t to give them £45 per week, it’s to get them off £45 a week and into paid employment. That’s not going to happen if they are pissed up at breakfast time. I don’t buy into a triage system whereby we should concentrate our effort on getting people into work who find it easiest to find work for themselves.

I detest New Labour as much as the next person because they are keen on inventing solutions to problems which don’t exist (e.g. ID cards and their associated database) but the association of alcoholism and unemployment is real and simply ignoring it won’t make it go away.

We should be attempting to work out a solution to the problem, not denying it.

Shatterface @28:

Yes, but again, post hoc, ergo propter hoc. The correlation is real. The causality analysis is considerably more complex than Purnell wants to imply.

This a great idea, but we will need some consistency, so I propose that……….

Alcoholic and drunken farmers will have their subsidies taken away from them.
Members of the Royal family who get drunk regularly should be booted off the civil list.
Members of the armed services who get drunk all the time should lose their pensions.
Judges and Policeman seen coming out of pubs and clubs should be followed to ascertain if they are drunks and then should be fired, with loss of pension..
Members of Parliament who get drunk should lose their salaries, and pensions.

Oh dear, does not seem such a good idea after all.

30. Shatterface

Sally, the Royal family can go fuck themselves but the police, judges and MP’s are employed by definition. If they can perform their jobs despite being alcoholics, good luck to them. As noted above, Churchill was an alcoholic.

The issue is with people who find alcoholism a barrier to work. So far I’m not seeing any alternatives more coherent than ‘OOH, YOU’RE SO MEAN!’

A few weeks back most people here argued that alcoholics are incapable of consenting to sex, now apparently they’re happy to be the way they are.

Shatterface –

I can’t say that those who are alcoholic really like being that way – most know they have a problem. But what I can tell you is for those who have sought help most come to the same conclusion – there just isn’t enough spaces in the programs, so, believe it or not, they are told to wait until an opening comes up and that someone will be in touch.

So, if this dipstick wishes to bring about this legislation then I presume he is going to fund the AA 300% and put them and the organisation on the payroll. Now – if he were to do that to give the people the help they need – so be it, I wouldn’t mind – but you can bet your last quid that as soon as that is funded the Tories would be on to it like a shot!

If you take away the 45 quid, then how do the addicts get his/her fix?

Does Sally have a point? I believe so – because the people she mentioned are all on the public payroll – private companies can ask you to take sobriety test, can public bodies? If they can then those people who are pissed or has a joint should come under the same scrutiny as those who are on a piss poor benefit.

This is Purnell’s and New Labour’s attack on the poor – again!

If, as I say, the government wants to fund rehab clinics, go for it. If not, then leave people alone and provide what they can with the help of the general public.

32. Shatterface

Will, I have no issue with those who seek help but can’t find it. Under the current system all jobseekers are expected to look for work. They won’t get sanctioned for failing to find work but they will be sanctioned if they are not looking.

Exemptions to this include for those who are on training courses because while this is not strictly speaking looking for work it is improving their chances of finding employment. I see no reason why treatment for alcoholism – or at least looking for treatment – would not fall into this category.

And no, Sally does not have a point. Jobseekers aren’t going to be arbitrarily tested for alcoholism, alcoholism is only an issue where it is preventing them from looking for work.

The majority of alcoholics, like the majority of drug users are functional: they might not be suitable for positions as surgeons but that is not to say they are incapable of any work at all. For the worst cases alcoholism IS a barrier to employment and ‘leave them alone’ might sound like a liberal response but we do not ‘leave them alone’, we feed their habit.

Shatterface –

Would you really mind if I called you Shatter, or SF – Shatterface just seems so aggressive a name to me?

Jobseekers aren’t going to be arbitrarily tested for alcoholism, alcoholism is only an issue where it is preventing them from looking for work.

This is where you have the crux of the whole problem. Who defines what, or who is, an alcoholic? What test is to be done to stipulate anything? Drug user or dependent on booze, you come back to more employed doctor of – well not so much good reputation – who will do the testing.

People want to work, all they need is the jobs to fill – millions are waiting for those jobs, literally.

As one who has used the benefit system in the UK, I am registered disabled, but I won’t go into that here – I know how bad it is for disabled people to even try to get the help you need. I didn’t want, in fact I hated, getting benefits! And wheter people agree with me or not, drink dependency is an illness and needs to be treated in what way it helps the person.

Purnell does not care one jot about the person – only his attack, in response to the Tory attack, on those who are poor and cannot look after themselves.

WTF is 45 quid a week when you have CEOs of councils scamming council tax for 1/4 of a million a year?

The priorities of people are simply fucked up – big style.

34. Mike Killingworth

[32] AA’s constitution precludes it from taking money from outside bodies, government or anyone else.

I suspect that rather a lot of alcoholics are no strangers to paid work, and have spent many years contributing to the welfare state. Just as many pot smokers are. It may be the case that a high proportion of the unemployed are alcoholics. But that does not mean that alcoholism leads to unemployment. People compartmentalise their lives.

Surely the job of the state is to ensure that recipients of benefits are making reasonable efforts to re-establish their self sufficiency, not just casting around for an excuse to withhold benefits from those who have a sound track record of contributions. Perhaps we should sack the state, and appoint someone more competent.

36. Shatterface

Enrolling in a programme to get off alcohol would constitute ‘re-establishing their self sufficiency’. Simply waiting for their next payment would not.

And people who have paid contributions get contributions based benefits, those who have not, or have exhausted their contributions, get income based benefits. Those on contributions based benefits can do what the fuck they want.

Pot smoking is not an addiction: you don’t need help to stop, you just quit. Nicotine withdrawal is a different matter but I’ve yet to encounter someone whose nicotine addiction prevents them from work.


Reactions: Twitter, blogs
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