Thursday, 1 September 2011

The sick way Britain treats her sick and disabled

This is an article I wrote for the conference edition of the Liberator, but, due to my stupidity, I missed the deadline for submission. This article concerns the utterly disgusting way in which sick and disabled people are treated in this country and I sincerely implore everyone who reads this to share this article with their friends and any Lib Dem members or representatives they know. If any bloggers are reading this then please consider crossposting it or linking to it on your own blog. Thank you.

The main form of support which sick and disabled people receive, is called the Employment Support Allowance (ESA) which is the successor to the old Incapacity Benefit (IB). This is to help with their living costs, which tend to be much higher than those of able bodied people - the cost of petrol for regular hospital trips can quickly add up, for example.

The current system of determining eligibility for support originates with Labour who created a system based on the (incorrect) assumption that the many of those receiving IB were perfectly healthy due to Thatcher moving people onto it during the 80s in order to massage the unemployment figures.

But, while it is true that the number of people receiving IB had remained mostly static at around 3 million for twenty years, the people on it have changed. It is years since able bodied people were deliberately moved onto IB and most of them had died by the time the system was overhauled. The reason the number of claimants had remained static was because both medicine and diagnoses had improved so that people who would have died or gone undiagnosed in the past were now on the system when they hadn’t been before.

Yet this one, utterly flawed assumption, was used as the basis of the last government’s treatment of those on IB. Under the auspices of Labour’s James Purnell, a system was created whereby those seeking to claim IB had to go through an assessment process run by the private French IT company Atos.

The assessment process developed works on the basis of an interview. In this interview, claimants are asked a series of questions by interviewers reading off a points-based, tick-box system on their screen. The system offers a selection of possible answers and the interviewer has to choose the one which best fits the claimants answer. The problem is that the people who designed the assessment did not have medical knowledge of all the conditions possible, nor does the test even begin to take into account the time variant nature of many conditions.

People with time variant conditions, such as disability campaigner Sue Marsh, can’t, on her worst days, get out of bed, can't walk at all, can't eat, vomits every twenty minutes and has to shove needles into herself every 2-4 hours to control the pain and nausea. Yet, on a good day, she might actually be well enough to do most of the things an able bodied person can. But the test only concerns itself with the ability of claimants to complete basic physical tasks on the day - if Sue were assessed on one of her rare good days then she’d be deemed as needing no support whatsoever despite the fact that most days she’s in near constant pain and lacks the strength to even go on a short walk by herself. The system utterly fails people like Sue, who has recently received an assessment decision letter telling her she is perfectly healthy. And it’s not just Sue, I know of a man in a wheelchair who was classed as being as capable of moving about as an able bodied person and of a man with terminal cancer who was told he was fit to work then died three months later.

This horrendous flaw is compounded by the fact the assessment does not at any point consider the medical history of claimants. A claimant can have been diagnosed by the best medical minds on the planet and none of that would matter as no medical evidence is taken into account during the assessment process.

The new coalition government has recently replaced IB with ESA and all those on IB are now being migrated to ESA with the assumption that some of them will fail to qualify and that the welfare bill will be reduced. The DWP is already encouraging that expectation by the recent, and utterly false claim, that 75% of all those being assessed for ESA are fit to work - a figure which the Office for National Statistics has described as “misleading”.

The assessment system for ESA is identical, in all major aspects, to the assessment system for IB. Because of the flaws in the old system, appeal tribunals were set up for those dissatisfied with the decisions made by Atos. On average, 40% of decisions appealed are overturned at tribunal and this rises to 70% when those appealing are given aid and advice from the Citizen’s Advice Bureau - an organisation which is stringently critical of the flawed way in which the system operates. The cost of the appeal system has been increasing rapidly as more and more people successfully appeal incorrect decisions.

This increased cost is on top of the £100 million cost of the Atos contract - a contract which does not include any fines for the extra cost to the taxpayer when Atos get a decision wrong. But the estimated cost of fraud with regards to ESA is £25 million. So, in addition to human cost on the sick and disabled of these flaws, the system doesn’t even save money. In fact, the only cases of fraud identified so far have been discovered by special investigation teams. This is because deliberate fraudsters know how to play the system while the genuine sick and disabled do not.

On top of that, those found eligible for ESA only receive it for a maximum of 12 months if they have made a national insurance payment in the past three years - so if someone has held a job before becoming sick or disabled then they can only have support for a year. After that, the assumption is that they will have recovered and should be able to work and support themselves.

The only way they can become eligible for support again is if they end up in a situation with total assets worth less than £7,500. Only once they have entered destitution does the system consider helping them again.

And as for those put in the Work Related Activity Group (WRAG), who are put in a half way house between being fit as a fiddle and eligible for ESA, they receive partial ESA - but only subject to strict conditions that they meet exactly the same kind of requirements as able bodied unemployed people. They are expected to attend several interviews a week and meet other, similar conditions, or face stiff financial sanctions. But these are not healthy unemployed people, these are people with severe medical conditions and disabilities who need support to help them find and apply for the kind of work they are capable of doing. They need a helping hand but are made to jump through hoops or face strict punishments instead.

I wish I were making all of this up, but I’m not. The system which is supposed to support our sick and disabled really is like this. The most vulnerable people in our society really are dependent on a system as flawed and uncaring as this. A Liberal Youth sponsored motion which deals with this very issue will be debated at Lib Dem Autumn Conference on Saturday the 17th of September and I urge any Lib Dems reading this to lobby their reps to attend the debate and to back both the motion and the amendment.


  1. Mostly I'm too distressed and embarrassed to write about my experiences with the new system and the effects these changes are having on me... It may well prove to fatal in the long run.

  2. As your party supports a bill which will remove the duty of the Secretary of State to provide or secure the provision of health it seems you are just going to make things worse.

  3. Thank you for campaigning on behalf of sick people such as myself and trying to influence your party to stop this inhumane treatment. Of course the Tories don't care, by and large, but the LibDems have in the past always been great friends of sick/disabled people. You have, at least, given us a bit of hope, which can go a long way. Thanks again!

  4. George: I've put the post up and received a few comments.

    Socrates. Write to your MP; Ask Atos for a copy of the tape of your interview. They are counting on people giving in. If you are too sick to do these things yourself, get in touch with the CAB. The nurse at your practice should be able to put you in touch with them.

    If your illness has a "group", contact them and ask for help.

    I wish you luck.

  5. Can I say I've appealed and won but would have found it hard without help from my local Community Legal Advice Centre but we won very easily in fact so anyone out there I would advise all of you appeal appeal and appeal because it clogs up the system and costs the government a fortune. I don't get any rent or council tax rebate so I apply every month and appeal every month why because it costs they are unwilling to help me yet I've contributed for years and will have my 10 penoth even if its not paid to me.

  6. The point is that so many wrong decisions shouldn't be happening in the first place! That so many people have to go through the ordeal of an appeal when they are ill is clear evidence that they are getting it badly wrong and must be stopped from doing any more damage to people who are already very vulnerable. The fault is not only with those carrying out the tests but with those who are employing them to do so on their behalf. Radical changes need to be made very quickly or the whole thing stopped until the system is changed.


I'm indebted to Birkdale Focus for the following choice of words:

I am happy to address most contributions, even the drunken ones if they are coherent, but I am not going to engage with negative sniping from those who do not have the guts to add their names or a consistent on-line identity to their comments. Such postings will not be published.

Anonymous comments with a constructive contribution to make to the discussion, even if it is critical will continue to be posted. Libellous comments or remarks I think may be libellous will not be published.

I will also not tolerate personation so please do not add comments in the name of real people unless you are that person. If you do not like these rules then start your own blog.

Oh, and if you persist in repeating yourself despite the fact I have addressed your point I may get bored and reject your comment.

The views expressed in comments are those of the poster, not me.