by Frances Ryan
This sense of ‘punishment’ has been an underlying force in the shift to increased ‘conditionality’ in the ‘welfare’ system in recent years. As then disability minister Esther McVey put it in 2013 when defending sanctions, ‘What does a teacher do in a school? A teacher would tell you off, or give you lines and detentions, or whatever it is, but at the same time they have your best interest at heart.’12 Here, disabled people are not human beings who need support to find a job, or compassion during times they are too unwell to work, but naughty children-cum-scrounger who need discipline as motivation to get off the ‘easy life’ of benefits.
An unemployment system based on the premise of pulling social security from people who don’t show ‘correct behaviour’ is damaging enough for a standard jobseeker. But for disabled claimants, it’s little more than a punishment for being disabled: their disability means they physically or mentally often have no way to comply with the conditions they have to meet to avoid being sanctioned. When the state deems it a success to stop the money a disabled person needs to eat, it hasn’t only abandoned its duty of care but morphed into an agent actively causing harm. This is government of the grotesque.
The roll-out of Universal Credit (UC) – the ‘all-in-one’ social security system that will impact millions of out-of-work and low-earning disabled people13 – is set to embrace a particularly pernicious sanctioning culture. Between 2015 and 2017, more than 100,000 UC claimants have already had their benefits stopped.14 That this is set to continue becomes even more disturbing when you consider that the system has been proven not to even work. Ministers have repeatedly claimed that sanctions are effective in ‘focusing’ people for work – as if going hungry clarifies a lazy mind – despite repeated evidence from the National Audit Office,15 among others, that they do no such thing.
‘Most men who have once gained the habit of work would rather work – in ways to which they are used – than be idle, and all men would rather be well than ill,’ Sir William Beveridge wrote in the Beveridge report in 1942. Over seventy-five years on, Britain has actively regressed from these aspirations. The acceleration of the benefit sanction system is emblematic of a wider shift in this country towards a perception of disabled people as ‘work-shy’ scroungers – boiled down and packaged as major government policy. Research by the London School of Economics in 2016 found that half of Britons believed that out-of-work sickness benefit claims had risen in the past fifteen years.16 In fact they have fallen.
It is not hard to see why people might fall for this misinformation. When ministers announced cutting part of the out-of-work sickness benefit, ESA, by a third to just seventy-three pounds a week in April 2017, it was on the premise that it would give disabled people an ‘incentive’ to get a job.17 Such an assumption supposes that the reason someone with Parkinson’s has been out of work for a year is not that they cannot hold a pen because of their tremors, but because they’re too idle to get off benefits. At the same time, the government substantially stepped up its scrutiny of disabled people receiving out-of-work benefits, resorting to using supermarket CCTV, gym memberships, airport footage and surveillance video from public buildings, as well as posts from personal social media accounts, to suggest people are lying about their disabilities. The number of benefit investigators increased by over 40 per cent (from 2,600 to 3,700) between 2015 and 2016; notably more than five times as many officials than were deployed to investigate fraud by the super-rich, despite the fact that benefit fraud costs the government around £1.3 billion a year compared to around £34 billion for tax evasion.18
It has become normal for politicians to use inflammatory language about people on sickness benefits, or for newspaper editors to dedicate front pages to warning of the burden of the masses of faking disabled people supposedly milking the welfare budget. By 2015, then welfare secretary Iain Duncan Smith was imploring business owners to get disabled employees ‘signed off sick’ back to work – in his words, so they could no longer ‘wallow in a life on benefits’.19 The Daily Express, meanwhile, devoted an editorial to welcome the ‘crackdown on sick-note culture’.20 The phantom work-shy – long a target of those keen to shrink Britain’s safety net – now included people too sick to make it to work in the morning.
There is perhaps no starker signal of this than the post-2010 rise of the Work Capability Assessment – or ‘fit-for-work’ test – used to determine whether disabled people are eligible for out-of-work sickness benefits or must look for a job. The concept of the state providing a safety net for disabled citizens unable to earn a wage has been building in Britain for the last hundred years. While the turn of the twentieth century saw the first sickness benefits introduced as part of the radical National Insurance Act, it wasn’t until the 1970s that social security specifically for unemployed disabled people started, with Edward Heath’s government bringing in the formative Invalidity Benefit for citizens too disabled to work. It was the benchmark of a civilized welfare state in which, along with the pillars of the NHS, citizens collectively paid in to have the security of a safety net in times of ill health.
By the mid-1990s, John Major’s Conservatives were ushering in the new Incapacity Benefit (IB) and with it a fundamental change: for the first time officials could ask for claimants’ disabilities to be ‘confirmed’ using a special testing procedure dubbed the All Work Test. Almost twenty years on, this shift to the state monitoring disabled benefits claimants grew, with New Labour introducing the Work Capability Assessment (WCA) – a new digitalized, ‘tick-box’ assessment – to decide who was eligible for its new incapacity benefit, ESA.
But it was the post-2010 coalition government who orchestrated an unprecedented acceleration of this testing regime. While Tony Blair’s government sought to introduce ESA for new claims only, within its first year in office the coalition – promising to remove £3.5 billion from the benefits bill by 2014–1521 – chose to push the almost two and a half million existing Incapacity Benefit recipients through the new system. The roll-out of the Work Capability Assessment was the embodiment of the post-crash narrative that disabled people were suspects. On the back of a bid to drive down the so-called ‘bloated welfare bill’, every single disabled person on out-of-work sickness benefits in the country was told they were to be tested to see if they were in fact ‘fit for work’.
Ask Christina what the reality of a ‘fit-for-work test’ is and the answer comes without pause: ‘It’s Russian roulette with our lives.’ The fifty-five-year-old was in the middle of training for a new job in a hotel in Northampton when she fell suddenly ill in 2017 with a pulsating pain in her gut. Within a month, she’d been diagnosed with gall bladder disease as well as inflammation of the stomach.
Christina was already living with debilitating health problems before this latest hit. Fibromyalgia leaves her with ‘unbearable pain’ through her spine, neck and joints. Her ankles are visibly swollen. It’s a ‘brain fog’ too, she explains: where she knows the words she wants to say but they get lost somewhere between her brain and mouth. Some days, she says, she’s sitting upright and will simply fall asleep. ‘The body aches tip to toe as if I’ve been beaten up or thrown from a horse. I genuinely feel about ninety years old.’ Nevertheless, when the government decided to test Christina’s capability for work they did not liaise with her consultants at hospital. Instead she was invited to an assessment centre run by a private company.
From its beginning, the roll-out of the WCA has been delivered through a large-scale outsourcing programme, with the government hiring multi-billion-pound firms such as Atos and later Maximus to deliver the computer-program-led assessments. This is tick-box, brown-envelope bureaucracy at its worst. A disabled person’s fate is decided by questions of whether they can, for example, lift an empty box. Rather than being overseen by a doctor or specialist, the whole thing is typically conducted by a nurse, paramedic or ‘medical professional’. In Christina’s case, the tester did not even understand what fibromyalgia was.
Read throu
gh the report made by the assessor and the mistakes are copious. At one point, it states that Christina can walk 200 metres easily without difficulty. ‘I stood up once [in the assessment] … I wasn’t even asked about walking difficulties,’ she tells me. There’s no mention of the fact that standing on her feet even to make dinner results in three to four hours of pain. Such omissions and errors are par for the course, however. In 2016, the National Audit Office (NAO) found that not one of the companies carrying out the tests met the government’s own quality assessment threshold, with communications including errors, spelling mistakes, and unintelligible acronyms.22 Only half of all the medical professionals hired to carry out the assessments had completed their training. The result is disabled people being incorrectly dumped off their benefits en masse: as the assessments rolled out, headlines spoke of terminal cancer patients and people in comas found ‘fit for work’. The latest figures in 2018 show that, staggeringly, 70 per cent of disabled people declared ‘fit to work’ who appeal have the decision overturned at tribunal.
Within weeks of her WCA, Christina became another statistic. A ‘decision maker’ at the Department for Work and Pensions called her at home and told her she’d been judged ‘fit for work’. The assessor had given her ‘zero points’. Christina tells me she called the DWP to ask how this was possible. ‘The woman said, “If Stephen Hawking can work, so can you.” ’ It means that a severely ill woman is now being forced to look for jobs that she can’t possibly do. ‘I’m unfit for work according to my GP, yet the DWP can apparently disregard that,’ she says.
Christina has the support of her son, Martin, as she waits for surgery on her gall bladder while having to navigate the JobCentre, and is as resilient as she can be. Some have been less fortunate. Flick through local papers in recent years and deaths of disabled people ghost through the pages. On 18 January 2017, the Camden News Journal reported that Lawrence Bond – diagnosed with a heart condition, obesity and shortness of breath – died six months after he’d been assessed ‘fit for work’.23 The fifty-six-year-old had a fatal heart attack on the way home from Kentish Town JobCentre and was found dead in the street. In August that year fifty-four-year-old David Metcalf ran into the sea after being found ‘fit for work’.24 The Hartlepool Mail reported that Metcalf had been on out out-of-work sickness benefits for almost a decade due to anxiety, stress and panic attacks before the new test saw the benefits stopped. Sandra Burns, who had chronic back pain with five fused vertebrae, was repeatedly tested and rejected for disability benefits, and won on appeal each time, getting into debt during the process.25 Luton Today noted how the fifty-seven-year-old’s body was found by police at the foot of her stairs after a suspected heart attack, surrounded by debt letters telling her the gas, electricity, water, telephone and television were in danger of being cut off.
For one person to die in this manner is obscene, but this is more than a handful of cases. Death has become part of Britain’s benefits system, in which people who have life-threatening illnesses can be deemed ‘fit for work’, while those who need support for mental health problems are instead thrown to the JobCentre with their benefits cut. Researchers from the University of Liverpool in 2015 found that the new ‘fit-for-work’ tests could be linked to 590 extra suicides and 725,000 additional antidepressant prescriptions in England.26
At the same time, coroners have repeatedly pointed to ‘fit-for-work’ tests as a contributory factor in a number of disabled people’s deaths. For example, Tim Salter, who was blind, depressed and agoraphobic, had his benefits removed in 2013 after being deemed capable of work. Unable to pay the rent, the fifty-three-year-old took his own life before he was due to be evicted. As the South Staffordshire coroner investigating Salter’s death said, ‘A major factor in his death was that his benefits had been greatly reduced leaving him almost destitute.’27
Suicide is complex, and the Samaritans rightly discourage reports that put any such death down to a single cause, but it is not hard to predict what the impact might be on someone of losing their only income. Remove social security from a disabled person too disabled or ill to work and it’s like pushing someone off a cliff and feigning surprise when they hit the beach. The assessments themselves are categorically proven to have made disabled people sicker. Research by charity Leonard Cheshire in 2015 found that almost three-quarters of those who had gone through the process said they found the assessment had a negative impact on their health.28 More than six in ten said they had ended up with more pain afterwards. The idea of a safety net has gone so severely wrong: where people who need benefits because they’re disabled are made more disabled simply trying to get help from the state.
Professor Jonathan Portes, formerly the chief economist at the DWP and later the director of the National Institute of Economic and Social Research, has described the reassessment programme as ‘the biggest single social policy failure of the last fifteen years’.29 In 2014, the chaos was such that Atos bought its way out of its £400 million contract early, with the company becoming so synonymous with disabled people forced into work that disability campaigners were picketing its offices holding placards reading ‘Atos Kills’. A Facebook group named ‘Atos Miracles’ – ironically celebrating the apparent miraculous cure achieved by those assessed and found to be fit – garnered over 30,000 followers.
Fatefully, it was also discovered that the scheme was not even a money-saving initiative. By 2017, with a new private company, Maximus, having taken Atos’s place, the NAO calculated that the government was actually spending more money assessing whether people are ‘fit to work’ than it is saving in reductions to the benefits bill.30 While disabled people like Christina have their income cut, the government blew an estimated £1.6 billion of taxpayers’ money on the faulty assessments between 2016 and 2019.
On top of this, by 2020 the government will have had to pay out £970 million in arrears to 180,000 disabled people it wrongfully withheld support from in the transfer to the new out-of-work sickness benefit – a bill that will go up to £1.7 billion by 2025 once the cost of paying them at the higher correct rate is factored in.31 The scandal was a microcosm of the wider cruel and costly ‘welfare reforms’ forced onto disabled people in recent years. As the Conservatives brought in their new tougher ‘fit-for-work’ test, they did so without checking that claimants were receiving the right level of benefit, despite it being legally required. Although the error was picked up in 2013, a culture of indifference and incompetence meant it took another five years and an investigation by the NAO for ministers to admit the need to provide £5,000 in compensation to each person affected.32 In the meantime, hundreds of thousands of the country’s poorest disabled people needlessly lived in further hardship. Fifteen thousand people died while waiting.33
One of the great ironies of the austerity era was that while it attempted to force disabled people too unwell to work into a job, the disabled people whose conditions mean they were actually able to work were routinely shut out of employment. Unemployment among the disabled community is an epidemic: just under half of disabled people aged sixteen to sixty-four are in work, compared to over 80 per cent of non-disabled people, as of 2017 (that means fewer than five out of ten disabled people have a job compared with eight in ten non-disabled people).34 Break this down by disability and for some it gets worse still: just 16 per cent of people with autism are in full-time paid work,35 while less than 6 per cent of learning-disabled people are in full-time employment.36
This scale of unemployment isn’t simply about not being hired; it’s about shutting out disabled people from whole swathes of society. Engineering a system where disabled people are unlikely to find work means withholding their chance at economic independence or finding a place in the community and the social status given to paid work. Rather than the stability and higher living standards of a wage, they are pushed into surviving on low-rate benefits. It’s disabled people’s exclusion from the labour market that in many ways is fundamental to perpetuating a disa
bled underclass.
Britain has a long-standing history of inequality in employment for disabled people. As Sonali Shah and Mark Priestley write in their book Disability and Social Change,37 the 1944 Disabled Person’s Employment Act made gains by establishing a national register of ‘substantially handicapped’ persons, as well as a statutory 3 per cent quota for their employment. Based on the principle that ‘disability is a handicap, not a barrier, to employment’,38 it designated certain occupations ‘reserved’ for disabled people and formalized sheltered work facilities for those deemed unable to gain work in the open market.
Against a backdrop of mass unemployment and declining industry, however, the 1970s and 1980s saw a substantial drop in the number of employers fulfilling their obligations under the national disability quota scheme. Meanwhile, a surge of disabled men transferred to out-of-work sickness benefits after losing their livelihoods to closing industries. There were gains in the late 1990s and early 2000s under New Labour – the employment rate for disabled people rose from 38 per cent to 47 per cent39 – but it stalled once more under the coalition and Theresa May’s government, despite a succession of Conservative administrations pushing to remove disabled people from out-of-work sickness benefits.
While ministers in recent years have repeatedly promised to halve the disability employment gap, the government quietly dropped this pledge in 2017. Instead, they promised to get an extra one million disabled people in work by 2027.40 It’s no wonder: the All-Party Parliamentary Group for Disability has calculated that if you take the rate the disability employment gap has fallen in recent years and assume the rate stays the same, it will be another forty years before the gap is even halved.41