How the cuts will destroy lives of people like Sue Marsh, and encourage divorce


9:05 am - October 21st 2010

by Sunny Hundal    


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Hidden in the mass of detail rushed out yesterday was a key change that will cause untold misery and destroy lives.

You think I’m exaggerating? Here’s one example where it is happening already, and it makes me angry.

First, the explanation. George Osborne said that the Employment and Support Allowance (ESA) would be limited for a year. This used to be called Incapacity Benefit.

Tom Clark at the Guardian says this means a disabled or seriously sick person who has a working spouse, however low-paid their job may be, will lose their personal entitlement to benefits after a year.

Furthermore, while single people will be able to fall back on a (harsh) means-tested ‘safety net’, everyone else will be forced to rely on their partner. We’re not talking about middle-income people here – we are talking about people who already can’t work or face daily problems because of incapacity.

In many cases – they might simply decide that divorce is the only option for them to survive, or else both will face deep financial difficulty.

Sue Marsh is one of those people who will be hit very badly by this change. Sue has a rare form of Crohn’s Disease which was diagnosed 21 years ago. She suffers daily pain, often vomiting, malnourished and weak.

This is what she wrote yesterday on her blog:

My husband who works two hours overtime every day to make ends meet, has to look after and care for me, has taken a less responsible and lower paid job to enable him to get time off at short notice, takes over entirely the child care for our two children as soon as he walks in the door now has to support me in every way too.

I’m worth nothing, I get no help at all, no matter what my condition? We simply won’t survive and that’s that.

I thought this blog would allow me to talk you through just why we need extra money and the assessment process, but now it looks like there won’t even be one . I’m a chattel, totally dependent on my husband for anything and everything.

I write this, with tears streaming down my cheeks in desperation.

Sue says she has to take very strong medications every day, including chemo-style immuno-suppressants, opiates and anti-sickness injections. And now this.

Cutting ESA for those with a working partner, says Sue, is equivalent to a cut of £5107.20 per year for the most vulnerable families in the UK.

George Osborne has caused this – no one else. Rather than look to raise taxes on the super-rich or cut empty aircraft carriers, he has deliberately cut welfare benefits for the most vulnerable in society.

I rarely feel anger when discussing politics, but this makes me enraged. It’s a fucking travesty and there’s only one man responsible. We have to get mobilised and we have to take action.

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About the author
Sunny Hundal is editor of LC. Also: on Twitter, at Pickled Politics and Guardian CIF.
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Story Filed Under: Blog ,Equality ,Fight the cuts

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Reader comments


“George Osborne has caused this – no one else.”

— That’s just not true.

David Cameron has caused this; Nick Clegg has caused this; Danny Alexander and David Laws and Vince Cable have caused this; Eric Pickles has caused this; the rest of the Coalition Cabinet has caused this; the men and women who stood as Tory and Lib Dem candidates at the election have caused this; the right-wing press has caused this; chunks of the liberal press — by calling for a vote for the Lib Dems — have caused this; the various Lib Dems on the federal executive and at the party’s special conference who chose to back the Coalition have caused this.

My goodness, there’s a lot of blame to go round, and while it’s fun to personalise it and direct it against the peculiarly obnoxious George Osborne, we really shouldn’t let the others off the hook.

2. the a&e charge nurse

“George Osborne has caused this” – well Nick “bar of rock’ Clegg seems to be right behind the cuts as well, while it goes without saying quite a few people voted for the tories knowing they were unlikely to be sympathetic to the welfare state.

I very much agree though that this is a heartbreaking story – Crohn’s can be a particularly ferocious type of inflammatory bowel disease.

3. Luis Enrique

Is this the kind of thing that could be feasibly over-turned? I mean there cannot be that many people in Sue’s position … my point being that this act of careless cruelty isn’t even saving the taxpayer much money.

If I understand this correctly, this applies to people who cannot work but have a partner who does, and are henceforth disqualified from incapacity benefit. The easiest solution would just be to reverse this rule change, but if the govt is worried there are too many wealthy in this position, surely they can just means-test household income and pay incapacity benefit up to that limit.

Well, the right-wing press can give themselves a great big pat on the back. They’ve got the country so convinced that welfare payments are all frittered away on scroungers and malingerers that he can now get away with tipping disabled people out of their wheelchairs into the street and telling them to drag themselves off and get a job.

Over to Labour now to say which of the Government’s welfare changes they’ll be supporting.

Oh, and would it be too much to ask that the mainstream media start bringing to people’s attention what changes in disability benefits actually mean to disabled people and their families?

Utterly disgraceful, I was quite numb to the cuts until this, I’ve been busy and I know they’ve been awful in the abstract, but this has brought it home.

If I understand this correctly, this applies to people who cannot work but have a partner who does, and are henceforth disqualified from incapacity benefit. The easiest solution would just be to reverse this rule change, but if the govt is worried there are too many wealthy in this position, surely they can just means-test household income and pay incapacity benefit up to that limit.

If they want wealthy people to have less money, they could just tax them ever so slightly more rather than build cut offs and means tests into otherwise workable policies.

I think this Ben Goldacre article will be increasingly important over the next parliament. We need to humanise and individualise the cuts, the raw statistics won’t affect anyone like the above story will.

When he appeared on Desert Island Discs, Rolf Harris chose to take his own song “Two Little Boys” with him. When war broke out, Rolf explained, his father and uncle had both joined up, his father lying about his younger brother’s age so they could both join the fight. But their mother found out and dobbed them in, because she couldn’t bear the thought of losing both her sons so young. Rolf’s uncle joined up 2 years later when he came of age, was injured, and died on the front. Rolf’s dad was beside himself, and for the rest of his life he believed that no matter what the risks, if he had been in the same infantry, he could have crawled out and saved his younger brother, just like in the song. Rolf played “Two Little Boys” to his grandmother just once. She sat through it quietly, took it off at the end, and said quietly: “please don’t ever play that to me again”.

This story always makes me cry a little bit. 2 million people die of Aids every year. It never has the same effect.

People can’t emphasise with statistics, but these stories show what these cuts will do.

Have you not noticed how the outrage you want to whip up is just not out there? I recall welll the genuine and immediate outrage felt at the early budgets of the first Thatcher government. I also recall the oodium heaped on the Major government. What is very noticable this time round is that the public do seem to be very sure that what is being done now is sorting out the mess from the last lot. Hence the lack ot outrage at this lot.

I am sure there will be plenty of examples of unfairnessess in the months to come. I am sure there will be elements that attract genuine opposition. There always are in changes this large. But what I dont see is this turning this into a mass movement of revolution against the generality of this CSR. Apart from anything else it is hard to do that when the Labour opposition agree that the deficit has to be cut, agree that welfare reform has to happen and agree with many of the changes the Chancellor is proposing. They complain about the degree, that is all.

7. Luis Enrique

why did they do this? do they think that there are lots of people with far less serious ailments and working partners who are being given too much money? An important part of Sue’s story is that her condition is so serious that her husband has to care for her and his earnings are thus low. Would the Conservatives say this is atypical? But why can’t the State identify people with conditions that are so bad their partners have to act as carers?

There is in fact an update, the Guardian were a little off with the facts. Whilst it is true that ESA will now be limited to a year, that is for those who have been “assessed to be capable of some kind of work”. If they haven’t found a job within a year, their benefits will stop if the they have a partner to support them.

Osborne still thinks he can get 1.5 MILLION people off ESA, so one can only assume the assessments will decide that many disabled people are suddenly fit for work, but at least there isn’t a sudden blanket cut in benefits that would affect everyone.

Watch this space for updates, It’s still dreadful, but not quite as dreadful as The Guardian and ITV news reported.

http://diaryofabenefitscrounger.blogspot.com/2010/10/esa-to-be-limited-for-one-year.html

“but if the govt is worried there are too many wealthy in this position,”

But they’ve already announced that no household will be able to claim more than the median wage in benefits, so they’ve already addressed this.

TBH this is a change that not even I thought they would do – particualrly given Cameron’s family history with disability. Which means one of three things; (1) we are wrong and the change doesn’t have the implications we think it does, or (2) they really haven’t thought this through and thus may well be persuaded to change it, or (3) it is a deliberate measure intended to make disabled people destitute.

So lets figure out which one it is quickly, and then react accordingly.

10. the a&e charge nurse

[6] “What is very noticable this time round is that the public do seem to be very sure that what is being done now is sorting out the mess from the last lot. Hence the lack ot outrage at this lot” – your complacency is staggering.

“Most people will keep their jobs, enjoy low interest rates and wonder what the fuss about cuts was all about – at first. That is the coalition bet: people just won’t know or care about the struggling third of their fellow citizens who lose out right away”.
http://www.guardian.co.uk/commentisfree/2010/oct/20/spending-review-fuss-polly-toynbee

At least we can say that the battle lines are clearly drawn?

Thanks Sue for the clarrification.

It does make a bit more sense now, but still leaves us with the likelyhood that people are going to be assessed as capable for work when they clearly are not, and also penalises marriage. All in all it is still a vile reform.

12. Luis Enrique

Sue,

glad to hear at least that.

something I don’t understand – obviously nobody should get a disability allowance unless they have a disability that prevents them from earning their own living.
How does “being assessed as capable of working” differ from (the inverse of) being categorized as disabled to receive incapacity benefit in the first place? How does this differ from saying: you will receive incapacity benefit until you are no longer incapacitated?

I (think) I know I must be missing something, because if the above was all there is to it, partner’s income shouldn’t be relevant. It’s not as if not-incapacitated single people should be on incapacity benefit.

13. Luis Enrique

sorry I should qualify above – clearly there is room for income supplements if somebody is only capable of earning a low wage.

Here is a description, from someone who actually worked in ESA of what happens to claimants and how only 9% are considered disabled enough to get support.

How are the Coalition going to take even more people off ESA/Incapacity Benefit?
For those who don’t know, Incapacity Benefit no longer exists for new claimants and hasn’t done since October 2009.

They now need to claim Employment Support Allowance, which is a whole new ball game.

I worked for two years in this field and so know a little bit about it.

When you first apply for ESA, you need to submit a medical certificate from your GP, as well as fill in a very detailed questionnaire about your illness/symptoms. You will be awarded a basic rate of JSA (£60 per week or thereabouts) for the first few weeks, upon which you will be called to an assessment with a doctor who works for the DWP (currently contracted to a company named Atos Origin). The Doctor will assess your SYMPTOMS (ie not to decide whether you are actually ill or not) and what – if any – impact they would have on your ability to work. You are awarded points for every aspect of your condition/symptoms which limits your ability to work.

At this point around 40% of applicants are told that they have no accrued enough “points” to claim ESA and their claim stops, ie they get no more money. They have to claim JSA and look for work like any other unemployed person.

The remainder, whose symptoms are more severe, will either be placed into the “Work Related Activity Group” which means that they receive a lower amount of ESA, but at the same time are expected to look for work which the DWP doctor feels they COULD do (ie bad back = you can’t do manual work but could do office work) with the help of a personal advisor at the Jobcentre. The most severely affected will be placed in the Support Group.

Only around 9% of claimants are placed in the “Support Group” which means they get a higher rate of ESA and are not expected to look for work. These are usually people with the most severe disabilities.

I often see questions on here talking about how the new Government are going to tackle the “scroungers” with pretend “bad backs/depression” etc – but having explained that the system already works this way – with only a very few people allowed to claim higher rate ESA without looking for work, how exactly are they planning to cut this down even further? Its pretty impossible to blag your way onto ESA with a pretend “bad back” or depression, believe me!!!

The only way I can see they could do this is to stop Incapacity Benefit completely and put EVERYONE on ESA. Right now, those who’ve been claiming for a while will still be on Incapacity Benefit, with the old rules, which were slightly more lax. Putting everyone on ESA and making them all subject to the same assessments would cut down the number of claimants.

But as for ESA it honestly couldn’t be tightened up anymore than it has been. There are already thousands of people struggling with quite severe and debilitating conditions who’ve been declared “fit for work” by the DWP (on the advice of a doctor who saw them for 20 mins and sometimes has a limited level of English or misunderstood the things they said. Migrant worker doctors are heavily relied on)

The following article outlines just how many people were wrongly assessed already

http://www.disabledgo.com/blog/2010/07/leap-in-esa-appeals-%E2%80%98exposes-flaws-in-system%E2%80%99/

Luis, I think (and am not sure) it means that the system regards you as having some form of disability, but that disability doesn’t prevent you from working. To use an obvious example, somebody in a wheelchair clearly can’t work on a building site, but there is no reason why that person couldn’t get a job in an office sitting by a PC all day (assuming the office has ramps etc). So those on the work related ESA are supposed to get support in finding suitable work, which may involve training, and DWP staff re-assuring employers about the condition and making work accessible (putting in ramps, tackling prejudice etc). In practice it probably means vulnerable people getting bulllied and threatened into taking unsuitable jobs.

10 – Taking Polly as your augur is, well to be honest, quite funny. The Tuscan sage who was on an off Gordon Brown more often than a Routemaster does not have the best track record as a futurologist.

Anyhow you miss my meaning.I am not at all saying that there is not trouble ahead. I am sure there will be lots. (e.g. quite obviously I am sure millions of people on welfare will complain bitterly about being on less welfare.) What is absent from the scene (and disappeared rather wuickly in 2008-9) is the consensus that welfare in its current form was affordable and worth paying for. Taxpayers (mostly working people in terms of numbers of voters) as a whole bought in (literally) to that notion in 97-2005. That has changed. We are in retrenchment period now. Stories of suffering, however heart rending are more likely to fall on deaf ears, especially if peoplefeel that they are all suffering to some greater or lesser extent. (Thats why the Child Benefit change is so important in the governments plans)

17. Luis Enrique

Sue, Planeshift, thank you both.

18. the a&e charge nurse

[16] “What is absent from the scene is the consensus that welfare in its current form was affordable and worth paying for” – yes, the drip, drip smearing of ‘scroungers’ by the right wing press proved most effective, and now these messages are implicitly reinforced by wealthy teddy boys like Dave, George & Nick.

BTW Toynbee might be a champagne socialist but that doesn’t mean she gets it wrong all the time.

Winter is coming – don’t be surprised if a mood of resignation soon gives way to one of anger and resentment?

I rarely feel anger when discussing politics, but this makes me enraged. It’s a fucking travesty and there’s only one man responsible. We have to get mobilised and we have to take action.

Given Sue’s explanation of how this will actually work, don’t you think an update is required?

I’ve taken this quote from the main article:

“single people will be able to fall back on a (harsh) means-tested ‘safety net’,”

Anyone know what actual criteria is for these means tests ? I suspect shifting of goal posts again – just like Labour did about 4 years back.

“Given Sue’s explanation of how this will actually work,”

Given Sues explanation of how ESA works in practice already, I think the conclusion remains valid.

22. Luis Enrique

Planeshift are you sure? The OP says Sue will lose her benefits, now we know she only will if assessed capable of work, which unless there is some outrageous transgression, she won’t be. The information that 40% of initial claimants don’t get ESA and only 9% get put on the “totally incapable of work” list, does not, I hope, tell us that Sue is likely to find herself judged capable of work.

Sue herself thought a correction was in order, so updating the OP prob is – if only with a reference down to Sue’s first comment.

“, does not, I hope, tell us that Sue is likely to find herself judged capable of work. ”

I’d say her own story of how ESA is assessed suggests it is a reasonable possibility. Luis, in my own job I’ve come accross Cancer Charities who have had clients with terminal illnesses being assessed as capable of work. Virtually every health related charity has submitted evidence of how the work related assesments have been unfit (no pun intended) for purpose.

“Furthermore, while single people will be able to fall back on a (harsh) means-tested ‘safety net’, everyone else will be forced to rely on their partner.”

Certainly puts some force back into the marriage vows doesn’t it?

“I thee with my worldly goods endow”….”in sickness and in health”

25. the a&e charge nurse

[22] “The OP says Sue will lose her benefits, now we know she only will if assessed capable of work” – who will do the assessing – will it be an outsourced medical service provided the likes of Care UK?
http://www.timesonline.co.uk/tol/news/politics/article6989004.ece

How will the ‘assessors’ call it when it comes to a medical condition that follows a pattern of relapse and remission – perhaps it will be assumed that if you are not suffering acute symptoms then you a well enough to work?

Sue herself thought a correction was in order, so updating the OP prob is – if only with a reference down to Sue’s first comment.

Even I was outraged by this story as first outlined.

Now the details have emerged it does look rather different.

“Certainly puts some force back into the marriage vows doesn’t it?”

No it doesn’t. It creates a financial incentive for families to split, as single people will get more.

Incentives matter.

28. Luis Enrique

hang on a minute – you cannot have a system of incapacity benefits with out some assessment of who is incapacitated. When this system involves thousands of doctors making thousands of decisions, I’m not surprised if there are some outrageously bad decisions made, and there should be a system in place to get those bad decisions overturned and the decision maker re-trained/fired whatever.

a&e you are no doubt right these decisions are difficult to make, but these difficulties cannot be avoided.

am I really to believe that the guidelines the assessors are working under, or the assessors themselves are such psychopaths, that somebody who has to take a cocktail of aggressive drugs and suffers daily pain, often vomiting, is malnourished and weak, is going to be assessed fit for work?

Is there evidence – and I mean real evidence as opposed to a collection of examples of bad decisions – that the system is systematically classifying people unfit to work as fit? If so, obviously that’s a great scandal.

Whether or not we should be totally outraged about this depends on what “being capable of some kind of work” is judged to mean. If they take the Nadine Dorries approach – “You can blog, therefore you can work” – that’s going to leave a lot of people, Sue included, on the wrong side of any assessment, regardless of whether or not they are realistically capable of working.

“You can blog, therefore you can work”

Well, that is actually true. There are people out there who will pay for writing to a standard similar to that of a blog post. I even do it myself. I don’t say it’s exciting or even all that rewarding but:

http://www.ehow.com/facts_6148458_difference-assistant-nurse-assistant-ii_.html

I was paid £10 for that. OK, I type pretty quickly, know my Google, but seriously, if you’re literate enough to blog, have access to the computer etc at home (ie, not in a library etc) you should be able to crank out one of those an hour (as opposed to the two or three that I do).

They currently have 133,000 such assignments waiting to be done.

Sure, of course, this isn’t the solution for 2.5 million people. But it is still true that if you can blog then you can work.

32. Luis Enrique

oh come on Tim – if you can write quickly enough and for a sufficient number of hours a day to earn a living, then you can, if you can only manage a few minutes in at the computer before needing to sleep for an hour, not so much. The statement “if you can blog you can work” is false. I submit as evidence a man who blogs extremely slowly by moving his eyelid.

@28 Atos staff are not medically qualified. They have targets for denying eligibility and are rewarded for doing so. Under trials of the new regime in Scotland (to be rolled out nationally irrespective of success or failure) there have been over 20 suicide attempts. Appeals against the decisions are 40% successful, rising to 70% if the person is represented at the hearing. It already IS a national scandal but the media don’t give a damn as it doesn’t affect middle class journalists or billionaire proprietors. The most disgusting thing this vicious prat did yesterday was to cut the mobility allowance for those in residential care. Osborne is filth incarnate, a mediocrity (a 2:1 in Modern History), never done a days real work and never going to need to with a fortune and a baronetcy coming his way, totally immune from the consequences of his own actions, he embodies the very worst aspects of the nasty party.

What the OP and ensuing thread reveal is that shroud waving can be a risky campaigning tactic unless you are absolutely sure of all the facts.

35. James from Durham

Despite the lack of clarity about how this is going to work, it underlines the real financial anxiety that disabled people and their partners have to live with. Announcements like these can only exacerbate the emotional stress these people live with. Sue will already live with constant anxiety about her ability to care for her two kids, which those who don’t deal with this kind of thing can hardly imagine.

Sue – You have probably already looked into this, I’m sure, but have you considered DLA? Not easy to claim, either and you have to accept that you will probably need to appeal against any decision, but just a thought.

36. Luis Enrique

dear god, can anybody really have designed an incentive system for those assessing disability that gives them more money the more they disqualify?

[if anybody thinks this is “straight out of the neoclassical economics playbook” I should point out that it is not. The economics playbook involves thinking about the outcome you want to encourage – accurate identification of disability – and how to provide incentives for that. If people want to encourage cutting disability spending regardless of screwing over the genuinely disabled, they’ve chosen the right system but having that goal has nothing to do with economics]

37. the a&e charge nurse

[28] “am I really to believe that the guidelines the assessors are working under, or the assessors themselves are such psychopaths, that somebody who has to take a cocktail of aggressive drugs and suffers daily pain, often vomiting, is malnourished and weak, is going to be assessed fit for work” – if medical “assessments” are driven by targets then we should always beware the law of unintended consequences”.

I suspect it will be those suffering back problems or low mood who will be scrutinised first?

As an aside I understand there is no shortage of doctors willing to carry out surgical procedures on drug addicts who have been paid £200?
http://www.telegraph.co.uk/health/healthnews/8069697/First-drug-addict-sterilised-under-cash-for-vasectomy-offer.html

Perhaps the moral of the story is that medical ethics can be compromised once financial incentives are added to the equation?

The comment thread seems to be better informed than the post, not for the first time. Sunny’s right that the devil will be in the detail, though – a little wrinkle Osborne picked up from one Gordon Brown.

How about this, from FT Alphaville :

“The huge cuts in govt funding of local councils and the devolution of financial controls to council, while increasing the cost of Public Loan Works Board to Gilts plus 1 pct, meant that once the 2011-12 council tax freeze has passed, there will have to be large increases in council tax, and sharp rises in the cost of other services, e.g. parking licenses, etc, and a lot of non-health/schools related services may face the chop. Councils will be able to borrow against a proportion prospective revenues, in effect shifting some Gilt issuance to local authority bonds, which could perhaps harshly be construed as a ’smoke and mirrors’ trick…”

“the PWLB move is a shrewd political move (but wrong IMHO) as the general public won’t realise the effect it has on them. it will affect everyone.

the irony of course is that this will force more LAs to borrow from banks, and since the financial crisis, there is only one bank operating in that area….and it is 84% owned by the very state that wants it to lend! “

Another commenter points out that while pension and other increases will be linked to (lower) CPI, the formula for rail fare increases is linked to (higher) RPI !

Ted – Actually the criteria are quite detailed. Labour bought in ESA and I thought it was the most disgraceful thing they did in power. I lobbied for months about it. The problem I think, is in the assessors. They are a private company (ATOS) and as I understand it are only paid on the number of people taken off benefits. If, for example you suffer from incontinence, you immediately get the full 15 points you need to qualify for ESA, yet there are stories of incontinent people being turned down.

Don’tmindme – I’m not always a fan of Polly, but I thought her article yesterday was the best I’ve seen. Full of passion.

Tim Worstall/A&E Chargenurse – The problem with long term variable conditions is reliability. I could never guarantee WHEN I could do some work. One day I might manage perfectly well, the next three days I wouldn’t. I tried every form of work for the 9 years before I had to give in and accept I couldn’t do it – first full time, then part time, then part time on later shifts. (I’m always at my worst in the mornings) I do have a suggestion for this though, that I’ll be blogging about soon. Maybe the government will like it and take it forward. Even if I could work, most employers simply won’t take me on as I’m too unreliable and, often, their insurance won’t cover me.

dear god, can anybody really have designed an incentive system for those assessing disability that gives them more money the more they disqualify?

Yes, of course they bloody can. What sort of rock have you been living under for the past few years, and which planet what it on?

Luis Enrique – “hang on a minute – you cannot have a system of incapacity benefits with out some assessment of who is incapacitated. When this system involves thousands of doctors making thousands of decisions,”

I blogged an alternative a few days ago Luis.

http://diaryofabenefitscrounger.blogspot.com/2010/10/how-sick-is-sick-enough.html

I think perhaps the biggest problem is that the assessors are often not doctors at all.

James from Durham. Thanks for your very insightful comment.
I used to claim DLA, but I stopped, because it was just so depressing to claim, I decided it wasn’t worth the anxiety.
I may have to reconsider now though, as it seems as though the coalition have much more compassion towards those who claim DLA. I think a lot of sick people will end up doing this, as they would also be excluded from the benefit “cap” – DLA claimants are exempt from e cap.

It’s a fucking travesty

Travesty- a literary or artistic burlesque of a serious work or subject, characterized by grotesque or ludicrous incongruity of style, treatment, or subject matter.

Rather sums up this post.

and there’s only one man responsible.

Hmmm

44. Luis Enrique

Sue

Yes, your suggestion of getting the same consultant who diagnoses and treats you to testify to your incapacity seems very sensible. In fact having a separate assessment by somebody less qualified looks like insane inferior duplication of effort. I know nobody likes IT in healthcare, but this really would just be a matter of them clicking a box on a page that links into the benefits system.

Dunc,

under my rock, I hadn’t realized incentives system in areas such as that would be quite so criminally stupid. Even now I wouldn’t be surprised to discover that the way Atos pays its assessors is a somewhat cleverer than that.

Shorter tory trolls “I hope the sick die quickly then we won’t have to pay them any benefit.”

Never again do we want to hear about civility and morality form Tim Jerk and all the other brownshirts who come on here daily to defend the rich and the wealthy. Today we see that they are brownshirts. They have no compassion except for rich people and they would be glad if all the sick could be rounded up and put in a concentration camp and then dealt with in a final solution.

I hope with all my heart that some of you trolls get really sick and die a slow death.

46. Shatterface

‘Ted – Actually the criteria are quite detailed. Labour bought in ESA and I thought it was the most disgraceful thing they did in power. I lobbied for months about it. The problem I think, is in the assessors. They are a private company (ATOS) and as I understand it are only paid on the number of people taken off benefits. If, for example you suffer from incontinence, you immediately get the full 15 points you need to qualify for ESA, yet there are stories of incontinent people being turned down.’

These are the big issues: that (a) people without medical qualifications are (b) incentivised for taking people off benefits.

The idea that people who CAN work SHOULD LOOK for work isn’t unreasonable, especially if they are given help to find work and employers are given help and incentives to take them on. But that requires assessment by REAL doctors specialising in particular conditions and organisations which represent those with those conditions.

It’s all stick and no carrot.

under my rock, I hadn’t realized incentives system in areas such as that would be quite so criminally stupid.

That was the whole fucking point. The government at the time even told us exactly how many people they expected to move off IB/ESA when they introduced the new assessment system.

It’s not that the incentives are criminally stupid, it’s that the objective was to get a certain number of people off IB/ESA no matter what. The incentives are perfectly matched to the actual objectives.

Is there evidence – and I mean real evidence as opposed to a collection of examples of bad decisions – that the system is systematically classifying people unfit to work as fit? If so, obviously that’s a great scandal.

New benefit system labelled unfit:

“A BBC Scotland investigation found that under ESA, more than two thirds of claimants are being found fit to work, almost 20% more than the government had planned.

A BBC freedom of information request revealed there are eight thousand ESA appeals heard every month. This is double the number of the next most appealed benefit, disability living allowance, which has seven times more claimants than ESA.

And around 40% of ESA appeals find in favour of the claimant.”

Does that sound like evidence of systematic bias to you?

48. Luis Enrique

Dunc

yes, yes it does.

What percentage of claims go to appeal?

39 Sue Marsh “I’m not always a fan of Polly, but I thought her article yesterday was the best I’ve seen. Full of passion”

I understand what you say, but Polly is already and always was, and known to be passionately anti Tory. (probably quite passionately anti LibDem these days…). So her views are likley to be discounted by the small community of interested voters on the basis of their own political prejudice.

But the passion of diehard politicos is no guide to how that will translate into the passions of the far greater group of disinterested voters, the vast majority of whom get their news from the BBC and/or from the red tops.

It is the likelyhood of a translation of opposition from the activist minority to the general populous that I am questioning.

51. James from Durham

I understand that with DLA it is almost the norm for claims to go to appeal. Ths might seem inefficient since it means that tribunals have to convene and be paid. Claimants may get assistance at the hearing at govt expense. However, it serves to weed out those who are less determined (who may paradoxically be more in need of help).

I thought Cameron pledged to abolish the so-called ‘couple penalty’; instead his government extends it.

@ Dunc

The government at the time even told us exactly how many people they expected to move off IB/ESA when they introduced the new assessment system………………..A BBC Scotland investigation found that under ESA, more than two thirds of claimants are being found fit to work, almost 20% more than the government had planned.

Do you see my point?

The fact that more people than expected were fit to work (if true)- is that not a GOOD THING?

Sue Marsh said “I blogged an alternative a few days ago Luis.
http://diaryofabenefitscrounger.blogspot.com/2010/10/how-sick-is-sick-enough.html

and Luis said “Yes, your suggestion of getting the same consultant who diagnoses and treats you to testify to your incapacity seems very sensible.”

It would seem very sensible, if it weren’t for the fact that the NHS makes it incredibly difficult to see consultants.

Example – My hands and wrists ballooned, I could barely move my arms let alone my fingers, and I was in extreme agony. My gp gave me ibuprofen. It didnt help. I went back. He said keep taking the ibuprofen, we’ll keep an eye on it and see what happens.

A few prescriptions later, I was still unable to hold a pen, a mug, a knife, a fork, or pick up my baby (and I was still breastfeeding), so he referred me to the local hospital. About eight weeks later I had my appointment. The guy spoke at me for a couple of minutes, he didn’t even look at my hands, which really took me aback – and yes I did try to show him. He told me to “avoid using” my hands (!) and sent me away with some extremely uncomfortable splints to wear, with the advice to ‘keep an eye on it’.

So after a few weeks of splint wearing and no improvement I went back to my gp, who referred me back to the hospital, and I yo-yod back and forth for more than two years, with each referral and appointment taking at least six weeks, usually more than three months, and once more than six. I had blood tests, carpal tunnel tests, x-rays, ultrasounds, and more two minute appointments with doctors who didnt even look at me. I was taking ibuprofen and painkillers the whole time and wearing splints most days, still in pain every day, swelling going up and down. After all this, I was still none the wiser on what was wrong, or how to make it better.

Finally I got referred to the Occupational Therapy department. The doctor there was fantastic – she gave me a photocopy of exercises to do every day, special ‘complete rest’ splints she moulded to my arms while I was there, as well as two sets of shorter, much more comfortable daytime splints that allowed me some movement (the set I’d been using were terrible, and she expressed surprise that the hospital was still using them). On top of this, she referred me to yet another person who was able to prescribe me much better painkillers and anti inflammatories. And she gave me a name for what was wrong – tendonitis – and told me to expect to always have it, that it might go away sometimes, but it’ll probably come back. But its a bit of a nothing word, tendonitis – when I tell people I have it they respond like its similar to a temporary sprain or something – not something that I live with permanently and gives me pain and restriction every day. Even on good weeks I have to be really careful not to aggravate it. Ive had to relearn how to do basic things in new ways, and Ive had to give up hobbies and interests that I miss desperately.

So thats what it was like, trying to see a consultant and get a diagnosis, when I was dealing with constant physical pain and an inability to do even really simple things (doing up a button, etc etc) with my hands, and despite being very obviously swollen, so I couldnt’ have been making it up.

Now think about how difficult it is to get a ‘consultant’ or a diagnosis or any help whatsoever with mental health problems that ‘they’ cant see. I have had them my whole life, yet Im in my thirties now and Im still struggling to be seen by a specialist that actually listens to me and provides actual help. You have to fight the NHS to be taken seriously and for years I didnt have the strength, or like when I was a kid, I just gave up and got into fucked up things to cope. Ive been given different labels by different ‘specialists’ – but there are very short time limits on the care they can give (we’re talking single figure weeks) and no time limits on waiting for referrals. Im on a waiting list at the moment to see another, different, specialist – Ive been told the waiting list is over a year long already, and as I’m an out of area referral (there isnt a single specialist locally) it could take longer because their locals take priority. I use my DLA to fund biweekly visits to a clinical psychiatrist because there is no NHS budget for it. I dont even feel he is helping me, but its literally all I can get – he’s the only person round here that will give me a discount on account of income, and most of the time I feel like his guinea pig.

So having consultants confirm conditions would only work if we all had access to consultants – but we dont. If I had money I could see a private specialist in November, not in 12months plus. But while we’re relying on the NHS you need to trust the word of our GPs, because most people dont have a single consultant – they have a series of people they see once or twice each after ridiculous waiting times in between, and very few consultants they are allowed to see more than three-six times because the PCT simply will not pay for it.

This was very long but I hope it demonstrates how boring and endless and depressing waiting to see a consultant or get any care or a diagnosis on the NHS can be.

This is not, btw, an argument for ATOS.

The fact that more people than expected were fit to work (if true)- is that not a GOOD THING?

If it were true, then, yes, that would be a good thing. Unfortunately, all of the available evidence suggests that it’s not true, and that the truth of the matter is simply that they managed to screw even more people than they initially hoped to.

@Pagar, no it isn’t good, because being ‘capable of work’ under the test doesn’t mean you are able to work.

Being ‘capable of work’ means you scored fewer than 15 points from the pre-determined criteria: http://www.benefitsnow.co.uk/esa/limitedcapability.asp

Some who “Cannot cope with expected changes in routine (such as a pre-arranged permanent change to the routine time scheduled for a lunch break), to the extent that overall day to day life is made significantly more difficult.” would only score 9 points and be ‘capable of work’, even though in practice they would be unemployable in the modern world.

btw, the 15 points is just to be able to receive ESA at all. To be in the ‘support group’ (more seriously ill), you have to additionally meet one of the tests from this list: http://www.benefitsnow.co.uk/esa/workrelated.asp

Being in the support group is somethimes referred to as being ‘completely’ incapable of work, but actually much more is needed. Being completely incapable of work will usually still only get you into the general group (part of the definition of ESA in the parent Act is that to receive it you must be unable to work.) For the support group it must be a much more severe disability, but the reverse does not hold: severe disability does not guarantee being in the support group.

58. Luis Enrique

mhi,

blimey. I didn’t use the word “consultant” very deliberately – just because Sue did – I was going to say it needn’t be a consult, merely that “whomever you see at GP/hospital who diagnoses and treats you could also testify to your ability to work” but after reading about your experience maybe they’d not perform much better than ATOS. Still I’m surprised they didn’t try to make the NHS do it, for cost saving alone.

The story at 54 reminds me why I like the US medical system so much.

If you look at the WHO evaluations of the different health care systems around the world you see that the NHS scores quite well. When you dig down into those figures you find that much of the way the score is calculated is about equity of access, about equity of financing and so on.

There is one though: responsiveness. How quickly do you get seen by the right person and your treatment started?

The US system is number 1 there: the NHS position, for anything other than emergency care is, as @54 shows us, somewhat less perfect.

“How quickly do you get seen by the right person”

In the US, never if you don’t have insurance or made a typo on your form. Although in fairness, Obama has now stopped providers refusing treatment on the basis of typos. Which apparently is socialism.

61. the a&e charge nurse

[59] well I never, TW arguing that the UK should be spending 17% (rather than 9%) of GDP on health.

Perhaps that why 60% of bankruptcies in the States are related to unpaid health bills?
http://edition.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/

It takes either a brave man or a fool to defend the American system?

“TW arguing that the UK should be spending 17% (rather than 9%)”

I’d be entirely happy if 17% of GDP was spent on health care: as long as the spending is being done by those who want to do it.

I’m a liberal, remember? I’m one of the people saying that people really should be allowed to spend their own money as they wish. If that means they want to spend it on toot that’s just fine with me: if they want to spend it on health care that’s also just fine with me. Their money, their choice.

And, given that health care really does seem to be a superior good, that as we get richer we spend a larger portion of our income on it, it doesn’t surprise me either.

Of course, I wouldn’t be happy if 17% of GDP was taxed off us to provide health care as the bureaucracy desires to deliver health care to us…..but the level of spending, if freely arrived at, doesn’t bother me in the slightest.

“Perhaps that why 60% of bankruptcies in the States are related to unpaid health bills?”

Be very, very, careful with that number. It isn’t telling us that unpaid medical bills cause 60% of bankruptcies. It’s telling us that 60% of people who go bankrupt have unpaid medical bills.

And the reason you want to be careful about it is that I’m willing to bet that 100% of those going bankrupt have unpaid tax bills: meaning, that if I userd your logic I could say that taxes cause 100% of bankruptcies.

Be very, very, careful with that number. It isn’t telling us that unpaid medical bills cause 60% of bankruptcies. It’s telling us that 60% of people who go bankrupt have unpaid medical bills.

And the study, if I remember correctly, was timed immediately after a change in US bankruptcy law making it considerably easier to declare oneself bankrupt. I don’t think it should be treated as unchallengeable gospel.

“It takes either a brave man or a fool to defend the American system”

No, just a public school education. Which incidently is also the qualification for membership of the cabinet.

Off Topic – this amused me greatly http://www.bbc.co.uk/news/uk-politics-11597664

65. Luis Enrique

it’s hardly controversial to suggest that a system that involves a lot more expenditure and medics trying to make money out of you, is better at getting you in front of a specialist and getting you treated quickly (if you can pay / have insurance) and it’s not unreasonable to compare that to the NHS’s somewhat less impressive performance along that dimension. Why deny that the US system is better in some respects? That doesn’t mean this one aspect outweighs the problem of the uninsured, nor that we don’t get a better deal from our cheaper, universal but not as good NHS. In fact one of the main arguments against the US system, which I am surprised Tim W does not show more interest in despite the attractive points from a voluntary-not-compulsory point of view, is that the US system is very inefficient, involves lots of unnecessary treatment and other pudding over egging.

66. the a&e charge nurse

OK quibble about the extortionate cost of American health care (and rates of bankruptcy) even it is impossible to equate the NHS with this sort of financial misery but surely these stats would even worry somebody like Daniel Hannan?
http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aicuTZz3sykc

According to this report – “More than 100,000 Americans die each year from lack of timely, effective medical care, according to a study that found the U.S. has the highest rate of preventable deaths among 19 industrialized nations” – while “the biggest improvements in preventable death rates were found in Ireland, the U.K. and Austria’.

“According to this report – “More than 100,000 Americans die each year from lack of timely, effective medical care, according to a study that found the U.S. has the highest rate of preventable deaths among 19 industrialized nations” – while “the biggest improvements in preventable death rates were found in Ireland, the U.K. and Austria’.”

Any set of statistics which use one absolute number for one system and then rates of improvement for others is, I’m afraid entirely suspect.

We can either talk about changes in the level of preventable deaths for everyone or the absolute level of preventable deaths for everyone: but doing one for one group and another for the other is, at best, obfuscation, at worst, lying with statistics.

68. the a&e charge nurse

[67] OK you won’t accept the bankruptcy or preventable mortality figures – so what about the huge swathes of the population who cannot secure proper access health care?
http://www.healthpaconline.net/health-care-issues.htm

According to this item – “More than 47 million people in the United States do not have health insurance and about 9 million of them are children. Over 40 million people a year do not get medical care when they need it, even if insured, because they can’t afford it. More than 8 out of 10 uninsured people are from working families. Thousands of deaths every year are attributed to lack of health insurance”.

What is there not to like?

@ 62 & 67 Tim

Whilst you may cavil at the precise figures, it is undeniable that many oridinary people in the USA (even those who are relatively affluent) live in fear of the financial effects of a major illness in their family.

Whilst it may be anecdotal, I’ve spent a large part of my career working for US companies, visiting there for work and training purposes. In discussions with US colleagues it is quite common to hear them talk about what a nightmare it would be if you or a family member had a serious illness, as even WITH insurance it has the potential to bankrupt you, or at least have fairly catastrophic financial implications short of actual bankruptcy.

Hey, I’m not trying to claim that the US medical system is perfect. And as @54 has told us, nor is the NHS.

(BTW, that number for uninsured in the US is also wrong. It includes those who could be insured by Medicaid, the insurance system for the poor, but who haven’t bothered to sign up).

What I do want to point out though is that each fail in different ways. Private insurance does indeed leave those gaps: and adverse selection problems will mean that such private insurance probably always will, especially for pre-existing conditions.

Similarly, I’m personally convinced that direct government procision of health care, as in the NHS, is always going to suffer from the problems @54 describes. No markets means no competition and tus no pressure to make things better/more efficient.

I can think of systems which would sidestep both sets of problems. State financed (or at least state collected) insurance, perhaps with the ability to top up that if one wished, with suppliers competing among each other for access to that finance. Money follows the patient sort of thing perhaps.

You know, like the French, German, Swiss systems maybe? You know, those systems which are regularly cited as being better than either the US or the NHS?

Heck, I’m even tempted by the Singapore system: better and cheaper.

There are better systems than the NHS in Europe and Asia. However, the US system manages to combine the worst of all systems.

Always a funny chart
http://pjep.org/uploads/resources/1262014762.jpeg

We know the costs are not all down to the private sector. The government and regulations preventing insurance across state borders manages to make a costly system even worse. Sure they have some great care but if you are spending twice what we spend then you should have great facilities. They do not appear to get much benefit from the spending with the worst infant mortality in the G7. The lowest life expectancy in the G7. The US Right used to try to explain away by saying they have car crashes in the US. Obviously must believe nowhere else has cars. They have murders in the US. Like nowhere else has murders.

If you look at life expectancy at 65 they are still at the bottom of the heap
http://yglesias.thinkprogress.org/wp-content/uploads/theincidentaleconomist.jpeg

http://yglesias.thinkprogress.org/wp-content/uploads/theincidentaleconomist1.jpeg

I’m disabled with a spinal injury, in my twenty years of disability after an accident at work, I’ve been through nine medical to get IB and DLA. Each year I had to have a medical called a PCA every three years i had a full medical.

Each time I was seen by a doctor or a highly trained nurse, they asked you question talk to you and I’d be told obviously your disabled.

Now then New labour brought in a New PCA and medical to get 2 million people back to work, the medical is not done by a doctor but some nerd who is under 25 so he does not get paid the full min wage, he is told a set of question which are aimed of making you fail. To date 80% of the people who fail these new medicals are appealing and winning, the rest are putting in to have new medicals.

Of course ATOS is falling over it’s self because each new medical it gets an extra £1700 to add to it’s multi billion profits.

Yes the Tories are adding to the problems but those new medical which are causing so much trouble are in fact from Brown.

So lets not just blame the Tories, and before you call me a Tory I joined labour in 1966, left in 2005 after going through a ESA medical in a trial, I can tell you now this is not in any way shape of form a medical.

In the comments above it’s really easy to spot those who have experience of the benefits system and those who don’t.

Best never get ill. This amounts to “get a job in 1 year, die, or rot on basic JSA”.

Wake me up when the magical free market fairy has created those replacement jobs.

http://www.youtube.com/watch?v=8qagXyuEZaE

This video by blogger “Benefit Scrounging Scum” aka BendyGirl on twitter should be required viewing for all members of the coalition.

How cuts to DLA for those in care homes will severely impact their ability to buy wheelchairs.

Any one daft enough ..that suggested voting Lib Dem at the last election is responsible for this …( ahem )


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