This is going to be a longer and much sharper post than I had originally intended. What first came to mind was an open letter to the new Work and Pensions Secretary Iain Duncan Smith, pointing out a simple £50 million cost saving to the welfare bill, but then yesterday the new coalition government handed down its emergency budget [PDF] to tackle the massive deficit facing the UK.
Underpinning the Goverment’s approach is a commitment to fairness. The Government will ensure that every part of society makes a contribution to deficit reduction while supporting the most vulnerable, including children and pensioners. The Government will also seek to build over the long term a fair tax and benefit system that rewards work and promotes economic competitiveness.
Unfortunately in their attempt at “fairness” the government has ensured that 1.25 million people with disabilities, generally considered one of the most vulnerable groups in society, is set to be hit twice as hard as anyone else.
As with my previous posts on Welfare in the UK, I’ll begin with a declaration of interest. I am one of those 1.25 million who stand to be particularly disadvantaged by the new Conservative/LibDem coalition economic policies. Please forgive my frankness about my financial situation, but as most of our readership tend to be employed professionals it will help to explain why the current choices will actually raise welfare costs rather than reducing them. As someone on benefits my right to privacy is generally considered moot anyway.
I have peripheral nerve damage with symptoms that prevent me from working. Because I was employed for several years prior to becoming disabled I was eligible for taxable Incapacity Benefit to replace my income up to £91.40 a week. Due to the limits of my disability this was not considered “what the law says you need to live” and disability premiums meant I qualified for additional means-tested Income Support up to a total of £147 per week. This is higher than the basic rate of Jobseekers Allowance (£65.45 per week) due to the added living costs related to travel and personal care, but is slightly lower than the minimum wage. It meant submitting extensive medical evidence from my Neurologist and GP together with satisfying a Personal Capability Assessment in order to qualify. For several years I was then required to submit evidence of my continuing incapacity (using form IB50) on an annual basis. I simultaneously qualified for Disability Living Allowance at the Higher Rate of Mobility and Middle Rate of Care, money meant specifically to meet the additional costs of disability – for example, buying a car or wheelchair (mobility scooter in my case) for those who are virtually unable to walk or pay for assistance with personal care such as meals or help with laundry. After several years of reapplying on an annual basis (requiring the completion of 60 pages of intrusive personal detail each time) AND failing the medical first time around, the Department for Work and Pensions (DWP) eventually accepted that my physical problems can only get worse and made the DLA award permanent.
That was then, this is now.
One of the first acts of the coalition after the general election was the announcement that they intended to continue with the abolition of Incapacity Benefit, begun by the previous Labour administration. Eighteen months ago, new claimants began to apply for the Employment and Support Allowance, targeted to those with disabilities and long-term health problems and paid at two levels. The Support Group are accepted as being unable to work and receive a means-tested income indefinitely. Those placed in the Employment Group are thought capable of rehabilitation to employment within 2-5 years so they receive a lower income and are subject to compulsory workfare and ‘support’ programs. Eligibility is currently determined by a new, far stricter Work Capability Assessment and cursory “medical assessments” conducted by the private company ATOS, which has resulted in huge numbers of appeals of which 40% are successful. The new government has already vowed to accelerate the process of forcibly migrating existing recipients of IB across to ESA (or Jobseekers Allowance) from October this year. There are presently 2.65 million people in receipt of IB and even if the appeals rate only equals that of new applicants, and appeal times remain in the six-month range, the entire system is liable to collapse.
For me, the move from Incapacity Benefit/Income Support to even the highest earning Support Group for ESA means reducing my income by £28 a week, plus I’ll get hit with the consumption tax (VAT) rise to 20% on most of my living costs. The DWP will need to calculate very carefully how much of this potential £3.5 billion saving will actually survive once appeals are added to the budget for administration costs. (And believe me, I DO expect to appeal.)
My cheat to saving £50 million pounds (and possibly the system) comes from DWP research that shows there are 1.25 million people just like me who currently receive Incapacity Benefit AND Disability Living Allowance. This is significant because the Work Capability Assessment used for the various health-based benefits has pretty universal parameters that assess claimants ability to walk, sit, lift and rise etc. to a standard points system.
Even with the significantly tougher WCA standards required by ESA, people who now receive the Higher Rate Mobility and either Higher or Middle Rate Care components of DLA should still qualify. All have had to submit extensive medical proofs of their condition from both personal GPs and specialist consultants, most have to reapply or submit proof of continuing disability on a regular basis, and since the early 90′s many have already been subject to a medical assessment by the same company now responsible for ESA examinations, ie. ATOS. Simply accepting that those in receipt of DLA have sufficiently proven their medical status and transferring them to ESA would save at least £50 million pounds. This is achieved by multiplying the £40 ATOS pays its ‘medical professionals’ for each assessment by the 1.25 million people who are already receiving DLA on top of Incapacity Benefit. Savings would obviously be much greater than this given the difference between what ATOS actually charges the DWP per assessment and what they pay the doctors, nurses, midwives and physiotherapists currently doing the interviews (no vets as yet, but it’s probably only a matter of time). Not to mention the significant reduction in appeals that would result, even if the auto-migration was only to the Employment group of ESA.
That seemed a pretty easy £50 million to me, and a neat solution to the administrative nightmare and potential cost blow-out that haunts the promised migration process.
I decided to reserve my post until the emergency budget was announced in case a similar thought had already occurred to our cash-strapped government. Instead we got THIS:
From 2013, those seeking disability living allowance (DLA) will have to go through a strict new medical assessment to help “reduce dependency and promote work”, with many current claimants set to lose out under the new regime.
The benefit will not be reduced but the government estimates the move will save £1.4bn by 2015, suggesting many of those seeking support will be turned away.
Some 2.9 million people are currently eligible for DLA, three times as many as when it was introduced eighteen years ago, chancellor of the exchequer George Osborne said while delivering today’s budget, at a cost that had quadrupled in real terms to over £11bn. The medical assessment would be a simpler process than the “complex forms” claimants must fill in at present and would allow those with the greatest needs to continue receiving the benefit, while “significantly improving incentives to work for others”.
That’s right. Having put the 2.65 million people who receive Incapacity Benefit through this particular wringer once, the 1.25 million of us also receiving DLA get to do it all over again in 2013 which is when the ESA migration is meant to be completed. Like a guess as to who gets the contract?
No, actually I DON’T think that is fair. “Grandfathering” those of us still on IB and allowing a million of us to age out of the benefit naturally over the next decade would be fair. Reducing my income by £28 a week is NOT particularly fair but I accept it as my contribution towards reducing the economic deficit. Forcing me to jump through the ATOS hoops twice is not only incredibly UNfair but extremely expensive. Surely an honest admission that we can’t afford the bills and a 15% cut in everyone’s benefits would be a far cheaper route to large scale savings?
This retroactive redefinition of disability by the DWP has already proven to be a raving nightmare. The ATOS medical interviews have been the subject of widespread criticism over the questionable accuracy of a 20 minute “assessment” that consists of ticking boxes on a computer program with at most a cursory physical examination, taken without reference to the medical documentation from the patient’s own doctors. The first year’s statistics as of April 2010 show that only 5% of new applicants have been qualifying for the Support group, and only 13% are accepted into the Employment group. As the professor who helped design the system has pointed out, at least 39% of all those claiming have been dumped straight onto Jobseekers Allowance without access to the specialist support programs they’re likely to need in order to facilitate a return to work. 8,000 appeals are already being heard every month, each requiring the assistance of voluntary sector organizations who specialise in Welfare Rights such as Citizens Advice Bureaux. Continuing this process is going to hammer the unemployment figures as well as raising costs, especially as existing IB claimants have effectively been ‘shortlisted’, possess well proven health conditions and are experienced at both applying and appealing. We’ll be a lot harder to discourage than the quarter of newbies who presently abandon their application mid-process.
There are big scary alarms flashing for me just at the budget wording itself:
Disability Living Allowance
1.103 The Government will reform the Disability Living Allowance (DLA) to ensure support is targeted on those with the highest medical need. The Government will introduce the use of objective medical assessments for all DLA claimants from 2013-14 to ensure payments are only made for as long as a claimant needs them.
MEDICAL need. Hmm. Is needing to eat but being unable to cook a meal for oneself a “medical” need? Perhaps not, given that help with housekeeping already isn’t covered by DLA even if the reason you can’t do the housework is a physical disability. If cleaning isn’t considered a “special” cost of disability will eating continue to be? Does my indefinite award of DLA now end in 2013? Having to reapply every year or two isn’t going to alter my permanent nerve damage, and has anyone in government considered what this will do to the viability of the Motability Scheme that provides finance for those on the Higher Mobility rate of DLA to buy wheelchairs or lease cars? With the financial crisis, easy credit isn’t exactly widely available to those living on welfare.
Local councils have already restricted their definition of “personal care” to bathing, laundry, heating up food and a light tidy in order to reduce their social care budgets. Does this announcement simply foreshadow the resurrection of Labour’s discredited plans to abolish DLA and divert the money directly to councils?
The benefits bureaucracy is so complex that it seems deliberately designed to make it impossible for an individual to negotiate independently. (If the DWP is seeking third-party assurance that I’m actually disabled this is not a cost effective way of going about it.) A “medical need” certainly doesn’t sound like one that can or ought to be defined by people with disabilities themselves. In my experience the use of “medical need” is deliberately used to minimise the support afforded to disabled people. When unable to walk the “medical need” is for a manual wheelchair. Even if a powerchair would significantly increase the disabled person’s independence and employability (thus reducing social care costs) they’ll have to pay for it on their own dime. Given this kind of policy direction, deciding that individuals are less capable of designing and paying for their own care package than suitable professionals from the local council doesn’t seem so much of a leap.
And as for those “objective medical assessments”? A BBC Scotland investigation “Who’s Cheating Who?” recently interviewed Vikki Bell, a former DWP benefits advisor whose ATOS workplace medical determined that she was too sick to continue working for the department. Three weeks later her claim for ESA was rejected at another ATOS medical that decided she had no health problems at all!
Bureaucracy costs. Tax Credits could be discarded entirely (at a saving of £23.7 billion) by raising the personal tax threshold immediately to £10,000 a year rather than the derisory £1000 increase to £7475 – £170 a year for basic rate taxpayers – that we’ve been offered in this budget. Migrating disabled people directly onto ESA based on their DLA qualifications saves another £50 million. Both are fair on the poorest in society – unlike what the coalition’s current proposals have in store for people with disabilities.