Health Social Affairs

Social security has been redesigned to cheat disabled people

George Freeman, MP for Norfolk and chair of the Prime Minister’s Policy Board, has defended the government’s decision to subvert the judicial system, by disregarding the rulings of two independent tribunals regarding Personal Independence Payment (PIP) for disabled people.

The upper tribunals ruled that the Department for Work and Pensions (DWP) should expand the scope and eligibility criteria of PIP, which helps both in-work and out-of work disabled people fund their additional living costs. 

Following a court ruling in favour of disabled people last month, the government is rushing in an “urgent change” to the law to prevent many people with mental health conditions being awarded the mobility component of PIP. The court held that people with conditions entailing severe psycholgical distress can qualify for the enhanced rate of the mobility component, on the basis of their problems with “planning and following a journey”, or “going out”. 

The government’s new regulations will reverse the rulings and will mean that people with mental health conditions such as severe anxiety who can go outdoors, even if they need to have someone with them, are much less likely to get an award of even the standard rate of the PIP mobility component. The new regulations also make changes to the way that the descriptors relating to taking medication are interpreted, again in response to a ruling by a tribunal in favour of disabled people.

PIP is defined by Capita, the private company employed by the government to carry out “functional assessments of disabled people as “a non means tested benefit for people with a long-term health condition or impairment, whether physical, sensory, mental, cognitive, intellectual, or any combination of these.” It is an essential financial support towards the extra costs that ill and disabled people face, to help them lead as socially and economically inclusive, active and independent lives as possible.

Before 2010, policies that entailed cutting lifeline support for disabled people and those with serious illnesses were unthinkable. Now, the systematic dismantling of social security for those citizens who need support the most has become the political norm.

In an interview on Pienaar’s Politics, on BBC 5 Live, George Freeman MP said:

“These tweaks [new regulations to cut PIP eligibility] are actually about rolling back some bizarre decisions by tribunals that now mean benefits are being given to people who are taking pills at home, who suffer from anxiety”.

He claimed that the “bizarre” upper tribunal rulings meant that “claimants with psychological problems, who are unable to travel without help, should be treated in a similar way to those who are blind.”

He said: “We want to make sure we get the money to the really disabled people who need it.” [Bolding added].

He added that both he and the Prime Minister “totally” understood anxiety, and went on to say: “We’ve set out in the mental health strategy how seriously we take it.”

He said: “Personal Independence Payments reforms were needed to roll back the bizarre decisions of tribunals.”

To clarify, the first tribunal ruled that more points should be available in the “mobility” element of PIP for people who suffer overwhelming psychological distress when travelling alone. The second tribunal recommended more points in the “daily living” element for people who need help to take medication and monitor a health condition. 

The DWP warned that it would cost £3.7bn extra by 2022 to implement the court rulings. The government have responded by formulating “emergency legislation” to stop the legal changes that the upper tribunals had ruled on from happening. From 16 March the law will be changed, without any democratic conversation with disabled people and related organisations, or debate in parliament, so that the phrase “For reasons other than psychological distress” will be added to the start of descriptors c, d and f in relation to “Planning and following journeys” on the PIP form.

The new regulations have some serious implications for the socioeconomic inclusion of disabled people, and they fail to observe the Equality Act 2010 and Human Rights Act 1998.

Freeman’s controversial comments about people with anxiety “at home taking pills” implies that those with mental health problems are faking their disability. He trivialises the often wide-ranging disabling consequences of mental ill health, and clearly implies that he regards mental illnesses as somehow not “real” disabilities.

His comments contradict the government’s pledge to ensure that mental health and physical health are given a parity of esteem, just months after the Prime Minister pledged to take action to tackle the stigma around mental health problems.

Yet people with the following mental health conditions are likely to be affected by the reversal of the Independent Tribunal’s ruling on PIP mobility awards – those in particular who suffer “overwhelming psychological distress” when travelling alone:

Mood disorders – Other / type not known, Psychotic disorders – Other / type not known, Schizophrenia, Schizoaffective disorder, Phobia – Social Panic disorder, Learning disability – Other / type not known, Generalized anxiety disorder, Agoraphobia, Alcohol misuse, Anxiety and depressive disorders – mixed Anxiety disorders – Other / type not known, Autism, Bipolar affective disorder (Hypomania / Mania), Cognitive disorder due to stroke, Cognitive disorders – Other / type not known, Dementia, Depressive disorder, Drug misuse, Stress reaction disorders – Other / type not known, Post-traumatic stress disorder (PTSD), Phobia – Specific Personality disorder, Obsessive compulsive disorder (OCD).

Note that some of the listed conditions have known physiological causes, too, such as “Cognitive disorder due to stroke”, whereas Agoraphobia, “Stress reaction disorders”, PTDS, some anxiety and depressive disorders, substance use and PTDS, for example, most often arise because of context, circumstances, events and experiences, whilst the aetiology of some of the other conditions is not yet clearly understood.

Regardless of the cause of an illness, it is not possible or appropriate to use taxonomies and hierarchical ranks of disability to decide in advance of an assessment how those conditions negatively impact on disabled people’s dignity, social inclusion and independence. Freeman’s generalisation was therefore inappropriate.

Freeman’s comments signposted the Conservative’s “deserving” and “undeserving” narrative, implying that some disabled people are faking their illnesses. However, disabled people do not “cheat” the social security system: the system has been redesigned by the government to cheat disabled people.

Any social security policy that is implemented with the expressed aim of “targeting those most in need” and is implemented to replace a policy that is deemed “unsustainable” is invariably about cost cutting by reducing the eligibility criteria for entitlement. The government were explicit in their statement about the original policy intent behind PIP. However, those being targeted as “most in need” is an ever-shrinking, constantly redefined category – an ever-shifting goalpost.

Prior to the introduction of PIP, Esther McVey stated that of the initial 560,000 claimants to be reassessed by October 2015, 330,000 of these are targeted to either lose their benefit altogether or see their payments reduced. Of course the ever-shrinking category of “those with the greatest need” simply reflects a government that has made a partisan political decision to cut disabled people’s essential income to fund a tax cut for the wealthiest citizens. There is no justification for this decision, nor is it “fair.”

A policy review last year led the government to conclude that PIP “doesn’t currently fulfil the original policy intent”, which was to cut costs and “target” the benefit to “those with the greatest need.” That originally meant a narrowing of eligibility criteria for people formerly claiming Disability Living Allowance, increasing the number of reassessments required, and limiting the number of successful claims.

Criticism

Despite some scathing comments and challenges from the opposition, Freeman maintains: “My point was that these PIP reforms are partly about rolling back some frankly bizarre decisions in tribunals which have seen money that should go to the most disabled spent on people with really much less urgent conditions.”

The chief executive of Scope, Mark Atkinson. said: “It is unhelpful to make crude distinctions between those with physical impairments and mental health issues because the kind of impairment someone has is not a good indicator of the costs they will face.

Many disabled people will be now be anxiously waiting to hear as to whether or not these tighter rules will affect their current PIP award.

The government must offer clarity and reassurance that these new measures will not negatively affect the financial support that disabled people receive now or in the future, and that they stand by their commitment to making no further changes to disability benefits in this Parliament.”

Debbie Abrahams MP, Shadow Work and Pensions Secretary has also responded to the comments by Freeman. She said:

“Mr Freeman must immediately apologise for the comments he made regarding sick and disabled people.

Freeman dismissed the needs of people with mental health conditions saying support should go to “really disabled people” rather than those who are “taking pills at home, who suffer from anxiety.

Not only does this fly in the face of the commitment to ‘parity of esteem’ for people with mental health conditions, but it directly contradicts Theresa May’s comments on mental health and two recent tribunal judgements.”

The Shadow Chancellor, John McDonnell, has called on Philip Hammond not to go ahead with the £3.7bn worth of cuts to PIP which will hit 160,000 disabled people.

The announcement about the two controversial regulations to be imposed without any parliamentary scrutiny and debate, and without any democratic dialogue with disabled people, was sneaked out last week by the government. It will mean 160,000 disabled people are likely to see a loss in their income as a direct effect of the changes made by the government to how PIP is awarded.

McDonnell said:

“Theresa May has used the cover of the by-elections to sneak out this announcement hurting so many vulnerable disabled people.

His is a return to the worst politics of spin that so tarnished our politics for so long. It is an act of immense bad faith. She is degrading politics and demeaning the role of Prime Minister.

Next week the Tories will make out that the economy and the public finances are doing better, however, they are planning to go ahead with a £3.7 billion cut to the disabled.

This time last year when the economy and public finances were not doing as well, and the then Chancellor George Osborne tried to cut PIP, Labour stopped him. And in his u-turn he claimed that he could “absorb” the cost of reversing this cut.

Hammond can’t hide from these PIP cuts in his Budget. He needs to explain why he can’t absorb them like his predecessor while he is still going ahead with tax giveaways to the very wealthiest in our country.”

But cutting PIP may cost more than it will save.

PIP is an in-work benefit as well as being accessible to disabled people out of work. Cutting PIP will invariably mean that some disabled people can no longer remain sufficiently independent to work. Many have lost their higher mobility rate component when they were reassessed for PIP after claiming Disability Living Allowance (DLA), and as a consequence, have lost their motability vehicles – which includes wheelchairs as well as specially adapted cars – which may leave them completely housebound and unable to work.

The Conservative claim that “the government is committed to supporting the most vulnerable” doesn’t stand up to scrutiny, given the Conservative’s policy record, including cruelly scrapping the Independent Living Fund, which has had a hugely negative impact on those trying their best to lead independent and dignified lives, and the Access To Work funding has been severely cut, this is also a fund that helps people and employers to cover the extra living costs arising due to disabilities that might present barriers to work.

The mental-physical illness distinction is a false dichotomy

It’s not appropriate to dichotomise mental and physical illness, as they are not clearly distinct. Most people would probably recognise that trauma, anxiety and stress can exacerbate illnesses that have a clear physiological basis. However, illnesses that have clearly defined “physical” symptoms can often also cause mental illness. Depression resulting from dealing with chronic pain and adapting to progressive illness and increasing disability is one example of the overlap between the physical and mental dimensions of illness.

I have lupus, which is an autoimmune illness that potentially progressively damages the joints, tendons, muscles, nerves, skin, eyes, blood cells, capacity to fight infections, heart, lungs, kidneys, stomach and liver. And the brain.

Most people with lupus complain of severe headaches, cognitive dysfunction, short-term memory loss and often, coordination difficulties. However, some suffer from depression and anxiety as a direct consequence of inflammatory changes in the brain, and some people also experience mood disorders. Other forms of neuropsychiatric lupus include psychosis, seizures, stroke and vascular dementia, chorea and cerebrovascular disease. There is often no clear boundary between the mental and physical symptoms of illness.

Health and wellbeing have socioeconomic determinants

Another important consideration is the context in which people live, as this also has a significant impact on health and wellbeing. There is an extremely unequal distribution of power and wealth in the UK. There are also corresponding unequal distributions of opportunity, health and psychological wellbeing, inclusion, human rights and citizen freedoms more generally, such as freedom of choice and participation in democracy.

Precarity and anxiety directed by the state through targeted and discriminatory policies at the poorest citizens mediates and maintains a repressive state–citizen power relationship.

There is also an emerging and clear “cognitive” hierarchy: those in positions of power are formulating policies that are premised on a fundamental assumption that poverty happens because of something that poor people don’t do, or that they do “wrong”, and this happens because of cognitive errors and “wrong” behaviours and attitudes. The assumption, of course, is that the policy decision-makers are more cognitively and behaviourally competent than those they are “nudging” to change their thinking and behaviour.

However, we know that an economic system founded on mythical “market forces, an even more mythical meritocracy and other just-world fallacies, and competitive individualism, which sets citizen groups fighting for increasingly scarce resources, creates just a few “winners”(around 1%) and many more who are dispossessed (99%).

Policies controversially aimed at “correcting behaviours” are increasingly punitive (benefit sanctions, increased welfare conditionality generally and restrictions on child tax credits are examples of the government’s behaviourist approach) that draw on psychosocial dynamics – imported from techniques of persuasion at the low end of the advertising industry – build and reproduce socioeconomic hierarchies, not only materially, but through dominant discursive practices, and also through inflicting precarity and perpetual anxiety on those people who have the least share of national wealth.

It’s remarkable that a government that claims “work is beneficial to health” also fail to recognise the impact of neoliberal socioeconomic organisation, prejudiced political narratives and draconian policies, the relationship between growing inequality and increasing poverty, and how this toxic context has a detrimental effect on people’s physical health and psychological wellbeing.

The Conservatives are so busy diverting public attention, and pointing out what they think those people who need mitigation from the worst ravages of neoliberalism are “doing wrong”, they fail to recognise and acknowledge what it is that the government is doing wrong.

When people are attacked, oppressed and controlled psychologically by a so-called democratic government that embeds punishment at the heart of public policies to target the poorest citizens, it’s hardly surprising they become increasingly ill.

 

 

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About

Social affairs editor for Scisco Media. Sue is an independent researcher and public interest writer with a particular focus on social affairs; policy, democracy, ideology, techniques of persuasion/propaganda, the political misuse of psychology, human rights and welfare. She also contributes regularly to Welfare Weekly, and other publications as a freelance writer. Her main home is the Politics and Insights blog site. She started writing four years ago because she felt that the mainstream media has become increasingly unreliable over the past five years, reflecting a triumph for the glittering generalities and dogma of a neoliberal elite. We need to challenge this and re-frame the presented mainstream debates, too. The media tend to set the agenda and establish "priorities", which often divert the public from much more pressing and real sociopolitical issues. Independent writers have a role as witnesses; recording events and experiences, gathering evidence, analysis, insights and truths that are accessible to as many people and organisations as possible. We have an undemocratic, neoliberal government that reflect the interests of a minority - the wealthy and powerful 1% - by systematically dispossessing the majority. We must constantly expose and challenge that and actively participate in democracy, presenting clear, wholly inclusive alternative narratives.

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