It’s not “well fair” for the most vulnerable

Anxiety about welfare changes and, in particular the impact of the Work Capability Assessment, remains top of our postbag as a charity and a serious issue for the wellbeing of people affected by mental illness and those who care for them.

It’s not the overall objectives or reform which are the problem.  In the right circumstances employment is good for one’s mental health and I think it’s one of the great urban myths that disabled people aspire to a life of unemployment and living on benefits.

What happened in the 1980s when it was convenient for millions of people to be placed on Incapacity Benefit without any responsibility for helping them find work was a tragedy and it is right for the Government to try to ensure that the benefits system encourages individuals to look for and take paid employment. I support the thinking behind the Universal Credit as a means of improving the incentives to move from benefits to paid employment and agree it is  not fair if people take jobs and find that they and their families are no better off than if they had stayed on benefits.

At the same time the welfare system must take proper care of those who genuinely cannot work.  Take people affected by schizophrenia as an example. Probably only about 5% of people with this diagnosis are currently in full time work.  Many more with the right support from both employment and health services could be helped into work, especially if there are better incentives, as may be the case with the Universal Credit, to take up part time employment. 

However even under the best of regimes there will be a significant number of people with severe mental illness who will be too ill to work or who may need extended periods away from the stress of the workplace. In a civilised society the welfare system needs to provide those individuals with a reasonable level of income and,  just as importantly, it needs to treat them with understanding and dignity, recognising genuine barriers to employment rather than tarring individuals with brush of being workshy.

Key to this is any assessment process used in determining whether claimants are “fit for work”. The Work Capability Assessment, introduced under the last Government, has been an unmitigated disaster in this respect.  It lacks sensitivity to the way in which the symptoms of mental illness present and might impact on someone’s ability to work. It takes scant regard of the fluctuating nature of mental illness. 

Failings in the assessment system itself have been compounded by poor practice demonstrated by ATOS, the contractor appointed by DWP to administer the process in how they have responded to the needs of people affected by mental illness. It is scarcely surprising therefore that 40% of cases where people are claiming for a primary reason of mental illness have been upheld at Appeal.

Failings in the WCA have been recognised by the Government’s own adviser Professor Malcolm Harrington and changes have been promised.  Whether these will go far enough is to be seen. I have a fundamental concern with the Government’s current emphasis both with WCA but also in future plans for eligibility to DLA on the value of independent medical assessment. From our experience the involvement of the clinicians providing care for an individual is crucial in making decisions about whether or not they can work  and in fact should be given greater prominence in any decision making process.

When a bus or a train isn’t working we expect it to be taken off the road until it is mended.  In view of the distress which this test is causing to thousands of people with mental illness across the country I would argue there was a similar case for taking the WCA off the road until it could be demonstrated that concerns had been addressed.

So in the end is it all about money.  We are all aware that times are tough and hard decisions need to be made about priorities. However, personally I’d happily see my bins emptied fortnightly if it made it easier to provide support for the most vulnerable in society.