A DWP funded study published in 2006 reached a clear conclusion: “there is little direct reference or linkage to scientific evidence on the physical or mental health benefits of (early) (return to) work for sick or disabled people.”
This is quickly qualified by the researchers, who are no doubt aware that you don’t get cushy jobs writing reports for the government by telling them things they don’t want to know. So the study claims that there is a ‘a broad consensus’ that work is good for the health of sick or disabled people “across multiple disciplines and also, importantly, among disability groups, employers, unions, insurers, and the main political parties”. In other words if enough important people say something is true then it must be true, despite the lack of evidence. That’s science folks.
The tragedy is that this ‘broad consensus’ has manifested in a horrifying regime for disabled people or those out of work with a long term health condition. Every benefit sanction, work capability assessment and forced unpaid work placement that has been inflicted on sickness benefit claimants can be traced back to this invented consensus. So far has it gone that even the recent Mental Health Taskforce report – which highlighted the shameful lack of funding for mental health treatment – called for employment to be viewed as a clinical outcome. In some parts of the UK trials are being established to put DWP funded ‘work coaches’ in GP surgeries. Mental health treatment ‘hubs’ are being sited in buildings alongside Jobcentres. A new Health and Work Programme is on the way aiming to strip benefit from up to one million claimants of Employment Support Allowance – the main out of work sickness and disability benefit. All of this is being justified by the belief that work is good for the health of sick and disabled people based on the 2006 report which says there is no scientific evidence for this claim.
The study called ‘Is Work Good For Your Health And Well-Being’ was authored by Gordon Waddell and A Kim Burton, two specialists in back pain from Cardiff University. It features a review of over 350 scientific publications examining the relationship between health and work. The focus of the study is largely those who are non-disabled, healthy, or have mild to moderate health conditions. What it found is that “work is generally good for your health and well-being, provided you have ‘a good job'” (emphasis theirs).
A discussion of the study, published in an Oxford Journal, pointed out this is a “a no-brainer”. If you love your job, are well paid, and have a boss who is sensitive to health requirements then this might well be better for your health then the poverty and social isolation that can come from unemployment. But even this is only a ‘general’ effect. Work can also be bad for your health the study found. Low status and low paid jobs are a particular risk, as is work that is ‘unsatisfactory’. The review even found that for a significant minority of people, between 5 and 10%, unemployment can lead to improved health and well-being.
Even this may not tell the full story. Often it is assumed that because evidence shows that (generally) unemployed people are less healthy then this means that unemployment is bad for your health – rather than poor health being likely to lead to unemployment. The researchers warn of this ‘health selection effect’ although they claim to have accounted for it. There is also an economic dimension – unemployed people are poorer, and it may be poverty that is bad for your health, not unemployment. The researchers appear to agree and caution that in areas of high social disadvantage then a range of factors impact on health and even then “It is all very well to say that work is good for your health, but that depends on being able to get a job.”
Finally it’s worth noting that many of these studies featured in this review were carried out in the US where the loss of a job may mean an end to health insurance. Government policies can certainly attempt to socially engineer poor health due to unemployment – already the UK has a benefit sanctions regime designed to harm the health of those who do not keep up with endless Jobcentre demands to look for work. It may be that impacts on health due to unemployment could be mitigated by paying people more benefits and ensuring access to free healthcare. The idle rich seem healthy enough after all. The Queen Mother was 101 when she died and you can’t get much more workless than someone who didn’t even wipe her own arse.
The truth then, at least as far as this review is concerned, is that a good and well paid job is probably good for your health if you only have a mild to moderate health condition. But it might not be. You might even be one of the 5-10% who are better off being unemployed. Also there is no evidence that the health benefits of work applies to sick and disabled people, although lots of very important people think it should. A bad job however, with low pay, low status and little prospects, could be worse for your health than unemployment. And yet these are exactly the types of jobs that many of the claimants who face being bullied off sickness or disability benefits are likely to end up in.
According to the Mental Health Taskforce “people with mental
health problems are also often overrepresented in high-turnover, low-pay and
often part-time or temporary work”. Current Jobcentre policies aim to get people off benefits and into work – any work – as soon as possible. Private companies running back to work schemes are paid according to how many people they find a job, not on the quality of those jobs. Some of those jobs will make people sick, or will worsen existing health conditions.
Astonishingly, if Iain Duncan Smith gets his way, then GPs themselves will be involved in handing out these work cures, without any regard for the evidence which shows that poor quality work might harm people’s health. The employment advisors, soon to be installed in Islington GP surgeries offering ‘jobs on prescription’, work for Maximus, the sinister US outsourcing company who also run the despised Work Capability Assessments used to stop people’s benefits by finding them ‘fit for work’. They cannot be trusted to be aware of the complex interactions between work and health. They will not be medical professionals but welfare-to-work busy-bodies tasked with bullying and coercing people into low quality jobs as soon as possible.
If there were loads of great jobs out there, jobs which are genuinely rewarding, well paid and enjoyable, then any coercion or conditionality within the benefits system would seem bizarre. People are already queuing round the block in some parts of the country just to work in a coffeeshop. Tens of thousands of people are working without pay. Despite the snide rhetoric from government ministers and the media that unemployment is caused by lazy or deficient unemployed people there is no shortage of hunger for work. There is a shortage of jobs though, especially good ones, likely to not damage your health.
In such a cut-throat employment market, dominated by ever more demands on workers to raise productivity then patients themselves, not welfare-to-work advisors, or even doctors, are the best ones to judge whether a job is likely to be suitable for them, or whether they want to go back to work at all. The medical ‘consensus’ that work is good for your health may apply to doctors, healthcare bureacrats and other pampered professionals but it is just not true for many of us who face long hours, low pay and insecurity. A middle class solution to a working class problem is not acceptable. The duty of the medical profession is to first do no harm, not parrot ideology intended to trick us into low paid work by lying about the health benefits. And that means keeping the Jobcentre out of the NHS.
Join the protest to keep work coaches out of doctor’s surgeries outside City Road Medical Centre, 190-196 City Road , London, EC1V 2QH on Friday 4th March from 3pm. Please spread the word, more details on the facebook page.
You can read the report at: https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being
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