Category Archives: ESA/Atos

How The DWP Is Drafting In Doctors To Promote Iain Duncan Smith’s Warped Ideology

fit-note-guidanceAre you working hard enough?  Are you sure?  What if you get sick, or have an accident?  Are you prepared to go to work anyway, even if you don’t think it would be good for your health?  What if your doctor and boss agree you could do something other than your usual job instead of malingering at home?  Like making cups of tea all day, or cleaning the bogs, or any form of work your empoyer can dream up to force you not to take time off.  Because that is now the chilling reality as the DWP attempts to inject Iain Duncan Smith’s warped ideology into the NHS.

Last week the DWP issued patronising new guidance to GPs on when they should issue a Fit Note.  Doctors are warned of the dangers of ‘worklessness’ and told they must consider “the vital role that work can play in your patient’s health”.  According to the department, “the evidence is clear that patients benefit from being in some kind of regular work”.

This is an outright lie.  What the evidence says is that on balance most people might be better off working but the beneficial health effects depend on the nature and quality of that work.  In the report on which the DWP’s claims are based – a paper incidentally commissioned by the DWP themselves – the authors actually warn that “a minority of people may experience contrary health effects from work”. 

This study – called Is Work Good For Your Health and Well Being (pdf) – has formed the basis of government policy ever since the Labour administration launched the despised Work Capability Assessment for out of work sickness benefits in 2008.  It features a reasonably wide-ranging review of the evidence of the health risks and benefits of work and concludes that work, on balance, is better for most people’s health than unemployment but with important caveats.  These findings have been consistently misrepresented by politicians who have used them to claim that any kind of work is good for health, and that this applies to everybody.

The study found that in some cases – possibly 5-10% – unemployment can lead to improved health and well being.  It warns that negative health impacts of unemployment are “at least partly mediated through socioeconomic
status” – meaning it is not work that is good for you, but poverty that is bad for you.   The review points out that whilst the evidence is conflicting, shift work and long hours could have a weak negative impact on health.  It also finds that school leavers who move into ‘unsatisfactory’ employment can experience a
decline in their health and that economically secure people who retire early may experience beneficial effects on their health.   Even if this report is taken at face value – and it comes loaded with assumptions about the social and moral imperatives of work – all it shows is that work can be good for your health – but only if it’s a good quality well paid job.

If you are in low paid or insecure work then what your GP should tell you – based on the existing evidence – is to take a few days off if you aren’t happy or feel unwell.  Perhaps they should warn that you might be one of the 5 or 10% of people who are healthier if they are unemployed, despite the loss of income.  A more recent study carried out in Australia, and quoted on The Conversation, found that people “who moved into poor-quality jobs showed a significant worsening in their mental health compared to those who remained unemployed.”

What the new guidance to GPs is intended to do is impose workplace dicipline via the healthcare system.  Much like a seven day NHS is a health service for bosses, not patients, and likely to lead to pressure on workers not to book medical appointments in working hours, the Fit Note scheme is designed to bully people into the workplace even if they are sick.  That is why the guidance states that if GPs consider their patient could do any work at all, regardless of their usual job, then they should tick a box suggesting amended duties, or workplace adapatations rather than issue a full Fit Note.  And if doctors are too squeamish to treat patients this way then they are instructed to refer them to Maximus – the shadowy US conglomerate brought in carry out health assessments under the new Fit For Work scheme.

To help doctors decide what is best for their patients, or more correctly their patient’s employers, the new Fit Note guidance features case studies, with recommended courses of action that GPs should take.  They include an example of someone diagnosed with anxiety disorder who says that her work in customer services is giving her panic attacks and that she is too distressed to carry out her duties.  According to the DWP her doctor should first warn her that working is important for her mental health and “remind her that there are still other things that she can do – for example, physical tasks or back-room duties.”  This will help her feel more positive according to the department.  Then she should be referred to Maximus who will develop  a plan with her boss, such as sending her on a course to learn coping techniques, or doing quieter shifts.  And of course bosses, being always right and always reasonable, will not abuse this new power to force sick employees into the workplace.

Yet even the most bullying of bosses are to be accommodated according to the DWP.  Another case study features someone – a woman again – who complains that a poor relationship with her manager is causing her severe stress.  She says the manager has been ‘really horrible’ to her and she feels unable to cope.  Rather than raise any concerns about what seems to indicate workplace bullying however, her doctor is instructed to declare she does not have a health problem and she should speak to her human resources department, or union rep.  She should not be issued with a Fit Note and her GP should explain that they are “acting with her health interests in mind.”  It is better for her health to be bullied and abused in the workplace than be workless, even for a short while, according to the DWP.

The introduction of this guidance makes it clear that the scroungers vs scroungers narrative is now impeding on healthcare even amongst those who are not on benefits.  It is not hyperbole to suggest that the credibility of doctors is now at stake.  For too long the entire healthcare sector has remained silent whilst scientific evidence is distorted to further the ideology of modern capitalism and increase the power of employers over their staff.  Any GP who believes in evidence over rhetoric should tell Iain Duncan Smith to stick these guidelines up his fucking arse.  Anything else is a betrayal of the role of doctors as guardians of our health and well being.

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These Statistics Tell Us Fuck All But One Death Was Too Many

first-they-cameIf there’s one thing we can learn from the release of statistics examining the deaths of sickness benefit claimants it’s that most journalists writing about social security haven’t got a fucking clue what they are talking about.  Both The Guardian and The Daily Mail* reported this week that 2,380 people died within two weeks of being found Fit For Work by the DWP when in truth these people could have died anytime up to two years after their assessments.

The reason for this blunder – and that seems the wrong word given the subject matter, negligence might be better – is simply because they misunderstood the DWP’s garbled explanantion of how they collect data for statistical purposes.

Two statistical reports were reluctantly released by the government yesterday and both are equally confusing – and no doubt deliberately so.   The first is a report on the death rates of people on all out of work benefits and the second a response to the long-standing FOI by fellow blogger Mike Sivier asking about the deaths of claimants on Employment Support Allowance (ESA), the main out of work sickness and disability benefit.  Sadly neither of these documents tells us very much about the impact of the despised Work Capability Assessment, the crude benefit eligibility test which was introduced by the last Labour government, not Iain Duncan Smith.

The ESA statistics show the total number of people who have died whilst claiming the benefit, and of those how many had previously been found Fit For Work.  The key questions which are left unanswered are whether those judged ‘Fit For Work’ were more likely to die than the general population, and exactly what is meant by claimants who the report says were found Fit For Work but were also still on ESA at the time of their death.

According to the department, 2,380 people who had previously been found Fit For Work ended their claim for ESA because they had died.  Now this doesn’t seem to make any sense because they shouldn’t have had an ESA claim to end if they had been found Fit For Work.  However, as the DWP allude to in the report, those who appeal a Fit For Work decision may have their ESA claim re-instated whilst awaiting the outcome of that appeal – or at least they would have until Mandatory Reconsiderations were introduced in late 2013 but let’s ignore that because it only muddies the waters even more.

What this suggests is that those 2,380 deaths do not represent the total number of people who have died after being found Fit For Work , but only those who went on to appeal that decision and died before the appeal was heard.  Some people who didn’t appeal will have died as well, which means that the number of people who died after being found Fit For Work may be significantly higher than reported yesterday.  But without a clarification from the DWP on exactly who they are talking about we cannot be sure.

The statistics also report that there were 1,340 deaths amongst people who had completed an appeal against a Fit For Work decision.  The DWP do not tell us what the outcome of these appeals were, but given they were on ESA at the time of their death it seems reasonably certain they were successful.  This means that 1,340 people were found Fit For Work, subsequently appealed, won the appeal, got their benefits back, and then died.

These numbers sound shocking, but they still don’t tell us much.  As Ben Goldacre pointed out yesterday, without knowing the rate of deaths compared to the rest of the population – as in are people found Fit For Work at a benefit assessment more likely to die than a non-claimant – then we don’t really know much at all.  It is worth remembering that a large number of people claiming  ESA are nearing pensionable age.  There are many deaths amongst non-claimants in this age group as well.

Where Goldacre is wrong, despite his snide remarks about confused bloggers, is in assuming that we could establish the rate of deaths amongst those found Fit For Work by tracking them through other benefits they may be claiming.  DWP research shows that over half of those who lose ESA due to a Fit For Work decision disappear from the benefits system completely (pdf).  The DWP simply does not know what happens to them after that, including whether they are alive or not.

There are two interesting facts that can be gleaned from yesterday’s statistics however, one being that people in the Work Related Activity Group are over twice as likely to die as non-claimants.  These are those assessed as fit for some work, or being able to work at some point in the future, but who keep sickness benefits and cannot be forced to take a job.  The government has just announced that this group will soon be abolished with benefits slashed to the same rate as Jobseeker’s Allowance (the dole).  There is now clear statistical evidence that people in this group are significantly more likely to die than the general population.

The other surprising news is that people on Jobseekers Allowance are less likely to die than those not on benefits.  This is a consistent trend that is recorded as far back as 2003.  Care should be taken on how to interpret this, but it surely demands further research.  Sadly with the government, charities, think-tanks and the health establishment all currently obsessed with the flawed notion that work is good for your health, we are unlikely to see any.

Iain Duncan Smith is a fetid piece of shit but he didn’t invent death.  And we shouldn’t attempt to conjure up thousands of deaths to show why current social security policies are causing horrifying suffering.   The massive growth in the use of foodbanks, soaring malnutrition cases in hospitals, rocketing homelessness – these all tell their own story about what is going on in the lives of the poorest.  As do the ever-growing number of coronors reports and anguished stories from relatives about deaths that we know for sure are linked to failures of the benefits system.  There should be no assumption that just because tens of thousands of people have not been killed by Iain Duncan Smith’s welfare reforms then that makes everything okay.  Hundreds of thousands, if not millions, have had their lives turned into a miserable and daily battle for survival and that is an atrocity.  The Work Capability Assessment needs to be brought to an immediate end, one death was far too many.

UPDATE 29/08/15  Both The Guardian and The Daily Mail have added an amendment to these stories, with the Mail seeming to clarify that the Fit For Work deaths were people going through the appeals process.

For the sad list of those we know have died due to failures of the benefits system visit:

Above pic from here

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Iain Duncan Smith Is Still A Fucking Idiot – And Only We Can Stop Him

Incapacity Benefit for new claimants will go, replaced by Employment and Support Allowance with the emphasis on what a person with a physical or mental health condition can do, rather than what they can’t.

Peter Hain, Labour Secretary of State for Work and Pensions, 2007

We need a system focussed on what a claimant can do and the support they’ll need – and not just on what they can’t do.

Iain Duncan Smith, Conservative Secretary of State for Work and Pensions, 2015

It’s just the same old shit, over and over again, whichever bunch of bastards is in charge.  The above two comments were made almost a decade apart and in that period the number of people claiming out of work sickness benefits has barely changed.  And why would it?  In any society there will be some people who cannot work due to illness or disability and as the pension age gets ever higher then that number as a percentage of the workforce will grow.

There is nothing unusual or unexpected about this.  Whoever you are reading this, one day you will get sick and then you will die.  If you are lucky this will not happen until you have reached retirement.  If not then you will be helped on your way to an early grave by politicians desperate to cover up for their failure to provide enough jobs by blaming unemployed, sick and disabled people for unemployment.

Iain Duncan Smith’s speech yesterday was a masterclass in this deception, but everything he said has been said before.  So out of ideas is the Secretary of State that he is now misrepresenting the entire process for claiming sickness benefits – pretending it is a binary system which “decides that you are either capable of work or you are not”.  This is simply an outright lie and he knows it.  Currently claimants are assessed as being fit for work, unable to work, or placed in the Work Related Activity Group which means capable of some work, or of being able to work in the future.  In the recent budget George Osborne declared that this group is to be scrapped, creating precisely the binary system that Iain Duncan Smith says he opposes.  Perhaps he hopes we won’t notice.  Perhaps even he hasn’t noticed.

The UK does not spend significantly more on out of work sickness and disability benefits than other comparable economies.  According to the OECD we spend a fraction more than Poland as a percentage of GDP on ‘incapacity’ – and less than Australia, New Zealand, Spain, Israel, Belgium. Luxembourg, Iceland, Finland, Sweden, Denmark, Norway, Switzerland and the Netherlands.  It is true as Iain Duncan Smith said yesterday that the UK spends more than France, Germany and Japan.  In humane society this would be a source of pride.  Or at least it would be until you found out that Germany spends over three times as much on unemployment benefits whilst France and Japan – where the retirement age is lower – both spend almost double what the UK spends on pensions.  And the incapacity spending figures by the way come from 2011, before most of Iain Duncan Smith’s benefit cuts had been implemented.

Only an astonishing degree of self-delusion could explain Iain Duncan Smith’s latest belief that more workfare, more assessments, and more benefit cuts will magically cure those unable to work because of illness.  But then he is deluded.  That’s why he could claim yesterday that  “The Work Programme is … the most successful back to work programme we’ve ever seen.”  That’s the Work Programme that has seen less sick and disabled people enter employment than it was estimated would have done if the scheme hadn’t existed.  Hundreds of millions of pounds spent on making things worse.  This is what Iain Duncan Smith calls a success.

Rarely, if ever, has such a fucking idiot been given so much power over so many people’s futures.   If the human cost were not so great then the best response would be to point and laugh.  But we can’t do that, not as millions of lives are destroyed.  If society means anything at all it means looking after each other and that means driving Iain Duncan Smith back into the sewer he crawled from before he can do anymore damage.  No-one should stand idly by now.  We need to be relentless as he is, to wake up every day with one thought on our minds – to destroy Iain Duncan Smith’s welfare reforms before they destroy us.

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Important Information: DWP Finally Admits To ESA Sanction Safeguarding Policy

esa-sanctionsSickness benefit claimants with a mental health condition who have been forced to attend the Work Programme should not have their benefits sanctioned without a face to face meeting first the DWP have finally admitted.

This important clarification, which could mean many people have been wrongly sanctioned, was finally published in an amendment to the Work Programme Provider Guidance.  This is the rule book that companies running the Work Programme must follow and last week a new chapter was added detailing the procedures for safeguarding so-called vulnerable claimants.

According to the guidance, claimants of the main sickness and disability benefit Employment Support Allowance only, who have “mental health conditions or learning disabilities or conditions affecting communication/cognition” must not be referred for a sanction without safeguarding activity being carried out.  This means a home visit if necessary to establish a face to face conversation to ensure that the participant understands the reason they have been sanctioned.  If this face to face contact does not happen, or if the Work Programme provider believes the claimant did not understand the requirement to carry out mandated activity, then a sanction referral must not take place.

These rules, which also apply to Jobcentre busy-bodies hoping to sanction sick and disabled people’s benefits, are not newHowever they were previously only published in internal Jobcentre documents and only came to light due to a Freedom of Information request.  It is likely that this is the first time many Work Programme providers have even heard of them.  Anecdotal evidence has repeatedly warned of people only finding out they have been sanctioned when they check their bank balances and find out they don’t have any money.  The number of sickness and disability claimants who have had their benefits sanctioned is soaring, with almost 125,000 sanctions applied since new rules came into place.  Some of those sanctions should not have been applied.  How many is anybody’s guess.

Whilst these safeguarding rules will mean it is now harder for Work Programme companies to sanction people’s benefits, many claimants will not relish the prospect of some A4e dickhead turning up at their front door to interrogate them about why they didn’t attend workfare.  The best piece of advice?  Never answer the fucking door to any cunt with a clipboard.

You can download the safeguarding rules at:

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Welfare Reform Has Failed – And These Latest Statistics Prove It

ids-slug1Welfare reforms have barely made a dent in the number of long term benefit claimants figures quietly released last week revealed.  There are just 91,000 fewer people who have been on an out of work benefit for at least three of the last four years compared to 2010 despite grandiose claims that a million new jobs have been created during the period.

The figures are one of the Government’s ‘social justice outcome indicators’ and include everybody on sickness benefits, the dole and unemployed lone parents.  2.381 million of these groups had been on one, or a combination of, these benefits for three out of four years in 2014 compared to 2.472 million in the period following the recession in 2010.

Perhaps most significantly the slight fall in the figures coincides with a huge rise in benefit sanctions suggesting that people are just being stripped of  benefits, not finding jobs.  The statistics do also not include people hounded into low (or no) earning self-employment by their Work Programme provider and now claiming Working Tax Credits – a practice which has been well documented.  The most recent year’s figures do not even include people who had benefts stopped temporarily following a sickness benefit assessment but have since appealed and are now claiming again.  The truth is that when these factors are taken into account then welfare reforms may have had no impact at all on the number of long term claimants.

Billions of pounds has been squandered by Iain Duncan Smith to bully these 91,000 people out of the benefits system.  Longer term claimants are exactly the group that all of his reforms were aimed at and the dire results show beyond doubt that he has failed.  Economic growth may have returned, but the very poorest are poorer than ever and there are just as many of them.  The cost of these reforms to the tax payer has been astronomical – far more than if these 91,000 people had just kept claiming.  The impact on the lives of those affected by endless assessments, sanctions and benefit cuts has been devastating.

One million people were forced to depend on a foodbank in the last year.  The number of suicides linked to withdrawal of benefits grows ever higher.  Every measure of homelessness has risen steeply.  And it has all been for fuck all.  Billions of pounds spent on brutalising people for no reason and with no results should be the only remembered legacy of Iain Duncan Smith’s nasty little experiment at the Department of Work and Pensions.

Join Disabled People Against Cuts on April 25th when they will visit Iain Duncan Smith Chingford constituency.

You can view the latest statistics at:

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RIP Julia Kelly: Another Tragic Suicide After DWP Threats

julie-kelly1A woman who founded a charity to help people suffering with chronic pain committed suicide after a battle to claim disability benefits ended with the DWP demanding that she repay £4000 in backdated payments.

Julia Kelly was just 39 when she took ker own life at the end of last year.  In an  inquest into her death the Northampton Chronicle reported that the coronor believed the “upset caused by the potential withdrawal of her benefits had been the trigger for her to end her life.”

According to a statement made by her father at the inquest, Ms Kelly had attended three tribunals in her attempts to gain disability benefits.  Mr Kelly said he “firmly believed” correspondance from the DWP triggered her death adding:

“Not to be believed by the DWP that she was suffering chronic back pain and also to be accused of wrongdoing and be told her payments might be stopped – we believe she snapped and could not take it any more.”

Despite this the DWP made a nasty statement which attempts to suggest she had thousands of pounds and was therefore not eligible for out of work disability benefits.  According to a spokesperson for the department “If a claimant exceeds the threshold with thousands of pounds in savings, they may no longer be entitled to the benefit.”  It would not take three tribunals to establish how much someone had in savings.   There is far more to this than the DWP are suggesting.

The news of the inquest into her death comes on the same day that Iain Duncan Smith said that stopping people’s benefit is ‘compassionate’.

The charity founded by Julia Kelly, which her father has said he will continue, can be found at:  Please support them if you can, they are also on twitter @awaywithpain

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Are The DWP Following Their Own Safeguarding Rules When They Sanction Sick and Disabled Claimant’s Benefits?

sanction-sabs1People with a mental health condition claiming out of work sickness benefits may have had their benefits wrongly sanctioned due to the DWP not carrying out correct ‘safeguarding’ procedures.

Over 100,000 sick and disabled people claiming Employment Support Allowance have had their benefits stopped or reduced for not carrying some form of ‘work related activity’.  A report released recently by the Methodist Church found that around 100 people a day with a mental health problems are currently having their benefits sanctioned in this way.  There is growing concern however that many of these sanctions could have been incorrectly applied due to the DWP failing to carry out home visits to assess the impact on the claimant of stopping their only source of income.

The Jobcentre guidelines are clear“If a claimant has a condition that could affect their ability to understand and comply with conditionality, a Core Visit to their home must be arranged before any sanction decision is considered. “

According to the DWP these visits should be carried out before sanctioning anybody with a “mental health condition or learning difficulties, or conditions affecting cognition such as stroke, autistic spectrum disorder or attention deficit disorder that might affect their understanding of mandatory interview requirements and the consequences of failing to comply.”

The guidelines state that two attempts must be made to visit the claimant at home and if contact is not made then “every attempt must be made to ensure the claimant’s welfare … the HEO must attempt to contact the following sources to establish the claimant’s welfare: Claimant’s Appointee/POA/next of kin, 
Claimant’s Community Psychiatric Nurse, Social Services, Police.”

These rules only apply to people on Employment Support Allowance (ESA) and there is reams of anecdotal evidence that they are being flagrantly ignored.  One reason for this could be because the guidance is only published in internal Jobcentre documents and not routinely made available to the general public or their advocates.  Were it not for a Freedom of Information request then this information would probably have never seen the light of day.

If you are an ESA claimant with a mental health problem and you were sanctioned without these guidelines being followed then this may be a legitimate reason to have the sanction overturned. According to Disability Rights UK, who have called for the little known rules to be extended to people on Jobseeker’s Allowance, “If the DWP stop benefit for a customer without applying Mental Health Safeguards then, according to the guidance, they must reinstate benefit.  If the DWP do not have information about the customer’s mental health at the time that they stop benefit but later receive this information then they must reinstate benefit.”

Let’s make sure everyone knows about this, the safeguarding guidelines start from paragraph 95 in this document (pdf).

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