Wednesday, 1 June 2011

Crippling the Disabled - Where Compassion Comes With an Invoice

The last twenty four hours have seen Britain's social care system plunged into genuine crisis on several fronts.

Most graphic has been the secretly filmed abuse of residents with learning difficulties at a hospital facility in Bristol. An undercover journalist spent five weeks posing as a member of staff to record images of residents being doused with water for not obeying instructions, beaten, stamped on and verbally abused by the people responsible for their care and well being.

Next came the news that Southern Cross, the country's biggest care provider and landlord to over 31,000 elderly people with care needs, is in deep financial trouble. It has staved off bankruptcy by securing temporary rent reductions from its own landlords, but only until October.

And finally, but by no means least, a group of senior clinicians wrote to the Guardian condemning the Con Dem Coalition Government's heartless pursuit of hundreds of thousands of people with mental health problems on Incapacity Benefit and Disability Living Allowance. Since their election a year ago, the Government has massively revamped the already widely criticised tests for disability brought into operation for new claimants only in 2008. In addition, it announced that all claimants are to be reviewed, eventually every six months, in what amounts to a blatant attempt to hound some pretty vulnerable people off benefits into an uncertain future where jobs are relatively thin on the ground and where many employers are clearly deeply prejudiced against disabled people to begin with. The result, the clinicians warn in their letter, has been to increase the stress and mental health problems of the people targetted, with growing evidence of both attempted and actual suicides by deeply distressed people facing the loss of the pretty tenuous safety net that has been in place until now.

But what if they can't work?
ATOS Origin, a large French-based IT and facilities group, has been engaged to carry out the review, which will cover some 1.5 million people. Buttressed by pronouncements by Conservative Ministers that at least 20% of people on disability benefits should be in work (a rather arbitrary figure with no research to support the assertion), ATOS to date fail or cut payments to over 90% of people who go through what should be a comprehensive assessment lasting an hour or longer. Many claimants emerge with tales of 10 minute gallop-throughs, with surreal lines of questioning including imagining how people with walking difficulties might cope better in a wheelchair; or how a blind person with a guide dog has consequently no disability. Terminally ill people have been ordered back to work - though perhaps the most bizarre incident was where a woman dismissed by her employer as permanently unfit for work after an assessment by an ATOS occupational health therapist was sent for a IB review with ATOS, who decided there was nothing wrong with her.

On appeal up to 2/3s of people have their benefits reinstated, but only after some months and after a deeply worrying time for them. And many are then called back almost immediately for a new assessment - harassment in all but name. With the drip-drip of Government propaganda increasingly portraying disabled people as a burden on society, the last year has seen a rise in aggression and violence towards disabled people according to a survey by Scope, and terms of abuse such as "spastic" and "mentalist" are creeping more and more into the acceptable lexicography of the mass media. So-called comedians such as Frankie Boyle are feted and awarded TV shows in spite of "jokes" about disabled babies.

Disability has long been an awkward issue for society. I have worked with organisations providing disability support for the last 21 years and can only put this down to ignorance at one end of the spectrum and real, genuine evil at the other. The media is frothing spectacularly at the abuse filmed in Bristol, but this is the same media that routinely denounced those with mental health and other less physically evident disabilities as scroungers, malingerers and frauds. The Con Dems play up to this with stunts like the list of excuses put forward by people found to be defrauding disability benefits earlier this week - implying that fraud is widespread when in truth every audit carry out confirms the level as around 1% of total spend, costing the exchequer some £2 billion p.a. - not insignificant and not to be ignored, certainly, but where is the same pursuit of tax avoidance which robs the nation of at least £20 billions p.a. in lost revenue?

Misleading headlines stigmatise claimants
Of course, the elephant in the room with all three of the crises brought to the public's fleeting attention is that the profit motive features in all of them: the Bristol hospital is run by a private contractor, Castleback Care. Southern Cross, meantime, is a large business, complete with its Investor Centre (click here). which has happily ratched up five figure profits in the not-distant past (and its former Chief Executive was personally £13 millions richer when he left them after heading up a tendfold their expansion in Southern Cross' operations). Meantime, ATOS Origin stand to make over £300 million from their efforts to stamp down on disabled people, with unconfirmed rumours that additional bonuses (or perhaps bounties would be a more appropriate word) payable for each person knocked off the incapacity benefit or DLA registers.

Prime Minister David Cameron claimed that the disability of his late son, Ivan, had opened his eyes to the prejudices and barriers facing people with disabilities. Poor little Ivan is sadly gone now, but his father's awareness appears to have passed away with him - referring to disability benefits as a "something for nothing" culture and slashing hundreds of millions from local authorities social care budgets, leading to the closure of day centres and the isolation of thousands of disabled people, unable to leave their homes or access any sort of beneficial social interaction. And yet, perhaps unsurprisingly, he seems content with arrangements that pour good money after bad into the pockets of companies that seek to make a profit out of welfare, creaming off cash from compassion.

Society, it has been said, even by Mr Cameron, is judged by how it treats the vulnerable. By that standard, Britain is failing badly and its Prime Minister is encouraging its failure, forging a society where compassion comes with an invoice. Good care and support is not cheap; it comes at a price, one which society should be more willing to meet, rather than take the narrow view that sees vulnerable people as a burden on everyone else. If for no other reason, the blinding truth is that effective welfare and social care is important to us all because, whether we like it or not, in the end, we are all at least potentially vulnerable
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