Osbourne’s Obfuscations

The Observer reports on a secret exchange of letters between Osbourne and Duncan-Smith which targets ESA (Employment Support Allowance –the successor to Incapacity Benefit).

To quote the article which, in turn, quotes the leaked letter

“Reform to the employment support allowance is a particular priority and I am pleased that you, the prime minister and I have agreed to press ahead with reforms to the ESA as part of the spending review that will deliver net savings of at least £2.5bn by 2014-15.

Employment Support Allowance is specifically targeted at people who are unable to work for health reasons. To qualify there are a number of hoops and assessments that need to be jumped through with sufficient points but I’m no expert on benefits rules – especially benefits for adults of working age – as that is an area I have no experience of.

The details can’t be commented on because they don’t exist yet – although we’ll know soon enough – what I find particularly despicable is Osbourne, the multi-millionaire, public school educated, aristocrat who has never held a proper job in his life before politics – criticising the so-called ‘benefits lifestyle’ and cutting further money from the benefits bill on top of that already announced.

I wonder what Osbourne and his advisers know about the ‘benefits lifestyle’. I wonder if he actually, personally, speaks to people who are trapped in an inefficient benefits system and who are struggling to maintain dignity despite the governments’ rumblings. I wonder if he has ever met anyone ‘poor’ and actually spoken to them face to face. The problem is that decision-making is so far removed from the people the decisions most affect.

There has also been some very intentional obfuscation of the details of Disability Living Allowance and the announcement of more testing to ‘proof’ ones’ entitlement smacks of pulling it into the group-think of ‘benefits bad’, ‘disability bad’, that is veering on discriminatory. Of course, legally, all the bases will be covered but socially, this kind of talk DOES stigmatise disabled people. Who would be encouraged to put a claim in that they are wholly entitled to if they feel that the government and the media and by extension the ‘general public’ are castigating them for not being as fit and  healthy as everyone else.

The obvious comment as well is that jobs are more difficult to find now.

I have no doubt, in fact, I’ve met a few people who don’t work and have no intention of every finding work, but that doesn’t mean that people who are entitled to the benefits that exist should feel guilty about having to claim what they are entitled to. A few people (and it IS a few people – make no mistake) do not create a ‘rule’.

There are far more people who would benefit a lot more by being supported and encouraged through the periods of time that they might have to claim state benefits to live than by being continually hounded, harangued and ostracised by the government itself buying into a media frenzy of targeting people on benefits.

It is a horrible middle-class sport to play on the ‘superiority complex’ of those who have to gloat over those who have little. We can snigger from behind our copies of the The Telegraph or The Mail at people who live in poverty  and rail about how much they might cost ‘the system’ but I begrudge them far less than those who live in their Knightbridge mansions and snigger while shifting millions into off-shore accounts and playing the tax systems through their use of skilful accountancy. It is no better morally but we are allowed to target the poor and the disabled as if it were a blood sport?

But no-one is asking me.

I did not vote for a government to make a sport of taunting people who are least able to defend themselves.

I did not vote for a government to cut disability and sickness benefits.

Yes, the system of benefits needs to change but it needs to change by stripping away or means testing some of the ‘middle-class’  benefits. Universal child benefit? Seriously. Universal Winter Fuel Allowance. Scrap it as well. It should go to those who actually need it. I don’t understand tax credits at all so can’t comment on them!

The change needs to come and was supposed to come through the introduction of a ‘fairness’ principle and perhaps if we could see some more evidence of that before we hear about all the cuts being made, it might help but to be honest it isn’t just about the cuts being made. I know they need to be made. It is about the narrative that they are couched in. ‘Benefits lifestyle’ ‘scroungers’ ‘cheats’ – all the language creates an artificial divide and a social agenda that speaks very clearly to one narrow section of society while alienating another. The language is not one of reconciliation and support. It is one of stigmatisation.

This same government that scorns the people who live on ‘benefits lifestyle’ don’t want to pay for their own residential, nursing and domiciliary care costs by selling the properties they own. Is that not the same thing another way around?

I know it’s not quite the same but it isn’t a massive leap to see that there are different ‘rules’ and ‘expectations’ according to where you might figure on the social scale.

I wonder if Marx had a point.

Saving DLA

It looks like Andy Burnham, the Secretary of State for Health, has ruled out any use of DLA (Disability Living Allowance) to fund a ‘national care service’. DLA is one of the few non-means tested benefits that is provided to people aged under 65 who have ongoing mental or physical health difficulties over a long term.

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There have been campaigns to protect DLA and Attendance Allowance (the equivalent benefit for over 65s) but, worryingly, no mention has been made about Attendance Allowance and I can’t help thinking this is either because it is proving too expensive or that those who receive it have quieter voices to engage when shouting.

It was suggested earlier in the year that funding for a more comprehensive and ‘fairer’ system of paying for care would leave DLA at risk however this might have proved to be just too politically sensitive at a time when it has been to be fair game to pick on benefits for those who are sick.

I remain concerned about the lack of commenting on Attendance Allowance though. Already those who are over 65 receive less in payment for exactly the same presentations of disabilities as those under 65 and it remains one of the more obvious ‘age discriminations’ in the ‘system’. We are told that the costs would escalate if the same criteria and funding were applied to those under 65 as those over 65 but it becomes something of a game and a reason for more inequities across the board.

If someone applies for DLA before their 65th birthday they retain the higher rated allowances for the rest of their lives whereas if they wait and claim one day after their 65th birthday, the receive the lower Attendance Allowance for life.

I remember one woman I worked with whose daughter was furious that she was only advised to claim a month or two after her 65th birthday, meaning she had lost out on the higher ‘lifetime benefit’ she would have had under DLA. We are advised to recommend making applications for these benefits as soon as we become involved but often this is after 65.

I hope very much that the differences between treatment of Disability Living Allowance and Attendance Allowance will be addressed. Especially as, in the same speech, Burnham vowed to abolish age discrimination in the Health Service.

Benefits

Yesterday I visited G, a woman with anxiety and depression. . She had been very well for a good few months but of late, I’ve stepped up my visits a little as I can sense a downturn in her mental state. She is beginning to feel very low in mood.

We talked about benefits together. She receives Attendance Allowance. I see lots of people who claim Attendance Allowance and she falls right into the ‘absolutely eligible’ category, but she is concerned that before her health fluctuates, she is not entitled to receive the payments when she is ‘well’.

This has been a cause of great anxiety to her and in the context of politicking through the conference season targeting those who claim benefits for disabilities, she is feeling not only anxious but guilty. She is worried and concerned that she will be checked and discovered ‘on a good day’ and that her entitlement to these benefits will be rescinded.

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There is no way that that would happen in my opinion because I have seen so clearly the effects that her illness has on her over a long term period.

A part of me though can’t fail to feel angry that both the government and the opposition are targetting those with the lowest income levels and with the highest level of needs in their ‘benefit fraud’ campaign. In my experience, those who do not claim that which they are entitled to, WAY outnumber those who fiddle the system but the scare tactics and villifications have led to a real fear among some people who have every right to claim from the ‘system.’

The DWP (Department of Works and Pensions) report that

In 2007-08 benefit thieves stole an estimated £800 million from public funds

While the BBC report that

Up to £10.5bn in income-related benefits went unclaimed in Britain in 2007-8, government figures reveal.

I wonder if the amount of fear and terror that is placed in the hearts of those who are rightfully claiming benefits is considered by the DWP. Believe me, I don’t condone benefit fraud, not in the slightest, but the focus of press attention needs to be brought onto those, like G, who feels terrified that she is claiming a benefit she is more than entitled to. And the many others who don’t want to claim because they fear the stigma attached to hand-outs, even though the option is abject poverty.

It makes me angry that the politicians who without any exception are, by definition of their salaries, living very comfortably with their juicy expense-claims, see fit to target those who can least afford it rather than just raising taxes at the higher echelon wage-earners.

Caring for Carers

This week is Carers Week. There has been quite widespread coverage in the press – certainly from where I’m sitting anyway. Yesterday the government printed its 10 year Strategy for Carers.

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It has been widely reported that the main tenet of the strategy published – as far as I could tell from the reporting of it  as I haven’t actually had time to read it yet, was a Government pledge to increase spending on

Respite care (£150m)

Support for return to work and training and general work/life balancing health checks(£38m)

Training for GPs to raise awareness of Carers’ Health and Input from Voluntary Organisations (£61m)

Focus of young carers (£6m)

Which adds up to the total £255m injection into carers’ services in total.

More money is better than no money. A recent survey, carried out to coincide with Carers’ Week suggests that

‘ a large majority of carers admit to feeling ill, anxious or exhausted, with a staggering 95% of those questioned said they regularly cover up or disguise the fact that their health was suffering in order to continue with their caring responsibilities. Worryingly, one-fifth (19%) of these carers said they ignored feeling ill “all the time”.

Almost 1 in 4 (24%) of carers say they frequently felt unable to cope with their day-to-day duties due to the physical and emotional stresses of their caring role, and a further 64% said they were occasionally unable to cope.’

So pushing finance into a focus on Carers’ own health is a positive step.

Flexible working patterns are, as well, important. I know that some employers are more sympathetic than others to time being taken for caring duties and some kind of statutory guidance that would provide more protection to Carers would be helpful.

Alison Benjamin on The Guardian website sums up some of the responses from the main voluntary organisations which work in the field.

She writes about a scheme of ‘Caring Vouchers’ which has been advocated by leading charities and some larger employers to work in a similar way to childcare vouchers – allowing for services relating to care, podiatry is given as an example, to be purchased with these vouchers.

But these are some of the elements missing from the strategy.

Rethink approaches some of the proposals from a different angle asking

‘What does £15 pounds buy you?’

Noting that dividing the £150m set aside for ‘Respite’ breaks by the amount of carers in the UK doesn’t exactly make for extensive holiday breaks.

But it won’t be £15 each because some people will never claim holidays or respite they are entitled. My difficulty at work has been more trying to desperately convince people to take those breaks that they are entitled to and that they can access money for.

Where I work, there is a fairly substantial pot of money which has been put aside specifically for carers breaks. It is consistently used by the same groups of people which isn’t a problem because there is always some money in the pot as others are so reluctant to consider using it.

Strangely, the existence of money to go away isn’t the issue – it is persuading people to access it.

I work primarily with older people and older carers so I can’t speak more generally, but often, regardless of the amount of stress, time and health concerns, they do not want to leave their partner in a residential home for a week while they go away.

I hope there is more access to creative options for respite such as allowing (paying) for someone to come and allow respite in the home. But the costs of that would, I fear, skyrocket far past £150m.

Bert 2332 Bert 2332 @ flickr

The other major criticism of the strategy drawn out by Alison Benjamin is the lack of any revised approach to Carers Allowance.

‘The most glaring omission from the government’s strategy is any proposal to increase the carers’ allowance or provide additional financial assistance to carers who are struggling to make ends meet. Although their role is estimated to save the state £87bn a year, many are living on just over £50 a week, plus other meagre benefits.’

And it is an embarrassing and humiliating attempt at piecing together a so-called ‘benefit’. Perhaps some more money for carers directly, rather than vouchers or health checks or training of GPs would have a more immediate effect quickly.

Of course, throwing money at problems is hardly the most creative approach but the Carers Allowance, is one of the worst examples of a poorly thought out benefits system that is insulting to those who jump through enough hoops to be able to claim it.

My own fear, and granted this is a result of reading the press rather than the actual strategy itself, is that the focus will be on those, again, who can ask for help and who shout for it when necessary. Those who are the ‘silent carers’, who need more time, money and outreach may be missed in the floods of additional funding trickling through the system. But I’m hoping to be proved wrong!

Spend, spend, regret?

The Independent writes about the link between bipolar disorder and overspending. It doesn’t really come as any surprise and seems logical that a link would be made.

I remember a conversation I had with a patient who spoke in terms of genuine regret that her care coordinator at the time had completely bypassed any financial issues as he had not felt that they were the priority when she was so unwell – but as a result of her illness, her house had been repossessed.

We concentrate a lot (naturally) on social factors around illness and social models of mental disorder in the work we do. Ignoring financial matters can have massive future implications.

So it was timely that I found the Mental Health and Debt site which seems to be aimed at Mental Health professionals and provides practical ideas and ways that debt management and budget management in general can be approached. I personally, have found it very interesting and potentially (because I didn’t know of it’s existence until the weekend) incredibly useful.

If we work towards recovery – assisting with management of finances when someone is unwell forms, in my opinion, part of that responsibility.