Compassionate Conservatism

By DeusExMacintosh

Thousands of seriously ill cancer patients will be forced to take medical tests and face “back to work” interviews, despite assurances from ministers that they would not make it harder for the sick to get welfare, charities have warned.

Buried in a report to ministers by Prof Malcolm Harrington, the government adviser on testing welfare recipients, are proposals to force cancer patients who are undergoing intravenous chemotherapy to prove they are too ill to work.

At present, patients who are unable to work because of cancer and the side-effects of treatments are allowed to claim the highest rate of employment support allowance (ESA), worth up to £100 a week. More than 9,000 cancer patients were placed automatically on the welfare payment from October 2008 to June 2010. However, the expert report says this “automatic entitlement” has encouraged dependency on benefits, “encouraging wrong behaviours from employers and stigmatising cancer as something that can lead to unemployment or worklessness”.

Instead, cancer patients on chemotherapy in hospitals will now have to prove that they are too sick to work, and take part in the controversial work capability assessment to determine whether someone is eligible for benefits. If cancer patients are found able to return to employment they may also be required to participate in work-related practice job interviews, as a condition of receiving their benefit.

The Guardian


  1. kvd
    Posted December 7, 2011 at 3:31 pm | Permalink

    stigmatising cancer as something that can lead to unemployment or worklessness

    – and also death, the expert didn’t mention death. Reading this, I’m now surprised I didn’t get a letter from the Queen, or at least my local member, thanking me for my wife’s contribution to the common wealth. Never mind, never mind; it’s all for the common good.

    Have a read of Ch 5 of the wca review pdf – link buried in DEM’s scratch from The Guardian article; item 10 is indicative: “However it does appear that the use of free text within LiMA is key to individualising the assessment.” (I bet that gets underlined, highlighted, and very swiftly actioned on the ‘do we really need that facility’ list)

    These people, these experts, these ‘public servants’ have metastasised into something I do not recognise as even remotely human.

  2. Adrien
    Posted December 7, 2011 at 5:32 pm | Permalink

    Proof that not all Nazis moved to Argentina after the war.

  3. Patrick
    Posted December 7, 2011 at 6:54 pm | Permalink

    My grandfather was very keen to keep working, to at least some degree, for at least the first few years of his cancer. His employer was reasonably skeptical as you can imagine.

    Not suggesting that the proposal is a sensible idea, only that the authors of the report might not have completely fabricated their conclusions (even if they clearly went overboard with them).

  4. Posted December 8, 2011 at 1:52 am | Permalink

    Thing is Patrick, there is absolutely nothing to STOP you working through cancer treatment should you be able to. It’s just that until now, people who found that for whatever reason they couldn’t were automatically eligible for disability benefits based on their doctor’s confirmation of the diagnosis and that was one less thing to worry about. Now they have to prove they can’t work (employer asking them not to will not count), which will limit the support available to them to about 12 weeks statutory sick pay and whatever their individual employer can afford to give them beyond that.

  5. Posted December 8, 2011 at 6:25 am | Permalink

    I could perhaps understand such a measure during times of low unemployment in order to coax more workers into the work force, but how is adding more people to the unemployment queues going to help the UK economy? It’s hard to see this as anything but a money grab from cancer sufferers.

    Unless there’s a whole heap of scheming people out there getting cancer just so they can avoid work…

  6. lomlate
    Posted December 8, 2011 at 8:04 am | Permalink

    Let’s play the devil’s advocate here…. I think when I read this my initial reaction is “they’re dying, why should they have to work” However most cancer patients survive now don’t they?

    And if you’re young and you’re likely to survive the cancer and you have the capability to work, isn’t it better to be at work?

    A lot of Victorian worksafe ideology stems from the idea that the longer you’re away from work the harder it is to get back to work. Assuming that’s true, wouldn’t encouraging cancer patients to get back to work actually improve their long term happiness and life satisfaction, since they’ll be less likely to be unemployed once the cancer abates?

  7. John H.
    Posted December 8, 2011 at 5:51 pm | Permalink

    However most cancer patients survive now don’t they?

    No, and given stress is immunosuppressive the idea of making sick people work is only going to make them recover more slowly. The other problem is that cancer treatments can have long lasting consequences for overall health(esp brain and heart), including increased later case risk(long overdue because the data has been there for years). The treatments saves lives but at a cost. As to curing cancer in general, that heed:

    “In my view,” he said, “cancer is a problem that will be part of human life for a long time, if not forever … and I expect that therapy will be slow to come. Even when new therapeutics schemes come, the plasticity of tumor cells will make it very difficult to effect total cures. For those who hope for rapid progress, this is clearly a pessimistic view.” But, disturbed by his own pessimism, he concluded, “But results will come, and we, as a nation, must maintain our commitment t6o finding everything we can about the disease and to try in every way possible to prevent or cure it. There is, of course, the real possibility that my whole analysis is wrong and that there lie out there magic bullets that will make a huge impact on cancer mortality rates in a relatively short time. To have judged so completely wrong would give me great pleasure.”

    Ahead of the Curve: David Baltimore’s Life in Science, Shane Grotty

  8. kvd
    Posted December 8, 2011 at 6:23 pm | Permalink

    Well I’m somehow pleased I deleted my ninth highly personal attempted follow up on this post, in favour of John H’s contribution. I’d only add that his phrase ” treatments saves lives but at a cost” should be ‘extends lives’. As far as I’m aware no doctor will pronounce you ‘cured’ of cancer. That is just a fact, and in no way a criticism of their efforts.

    Now if I could only get my head around the thought that one can “stigmatise cancer”…

  9. Posted December 8, 2011 at 11:53 pm | Permalink

    Bad things happen to bad people too, we just don’t tend to mind as much. {blush}

    As you say Lomlate (should that have been Lolmate?) having cancer doesn’t prevent everyone from working, however undergoing chemotherapy which involves immune suppression and large amounts of hugely toxic drugs almost invariably does. Even if you’re not being sick as a dog, for your own safety its best to be exposed to as few people as possible.

    IDS is assuming what you call the “victorian worksafe ideology” is true, but this need not be so. For example, many types of high dose pain relief medication is extremely addictive, both chemically and psychologically, and has a high potential for abuse. However patients who use it to deal with high levels of chronic pain experience significantly less addictive effects and misuse rates than the ‘average’. For really bad pain, people are more likely to use the meds only when they have to.

    Sometimes you CAN actually trust people to be the best judge of what they can and can’t do – personally, I’m inclined to believe that people under active chemical or radiological treatment for cancers are among these. I seriously doubt there’s a large problem with remission ‘skivers’ who simply can’t be bothered to go back to work. Yes, there may well be a problem of employers being scared off employees with “the big C” but punishing sick employees in order to make their employer behave is sheer lunacy. Attempting to push the sick leave costs onto the private sector in this way will simply raise the odds that patients with cancer lose their jobs entirely. Messages are for western union, as they say.

    Professor Harrington is very big on ‘personalisation’, unfortunately I don’t really think we can afford it. It’s a matter of balancing the possible losses from being ‘over generous’ with automatic entitlement against the actual cost of assessing every single person who steps through the door. Steven Hawking may well be able to work despite motor neurone disease but the number of other people who can is so tiny there is no way it is financially worthwhile to assess everyone with the condition, so automatic entitlement on the basis of diagnosis is appropriate. Automatic entitlement for cancer patients undergoing active therapies is also fair. The only debatable issue I can see is the time allowance made at either end – in the period waiting for access to NHS treatment and then recovering afterwards.

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