‘John’, schizophrenia and his debts: The DWP can’t abdicate responsibility

It’s emerging that the Department for Work and Pensions (DWP) has carried out what the Disability News Service (DNS) says were ’60 secret reviews into benefit-related deaths in less than three years’. The excellent DNS obtained the figures from the DWP in response to a series of Freedom of Information Act (FoI) requests. The DWP has always rejected any connection between the coalition’s welfare reforms and cuts and the deaths of claimants.

Additionally, the DWP has now released guidance to staff saying that peer reviews might also be considered in cases involving ‘customers with additional needs/vulnerable customers’.

The vulnerability of many benefits claimants is illustrated by the case of ‘John’, who came into the London food bank with a voucher on Friday. He’s 33 and explained to me that he’s in debt. He still owes well over £2,000 to ‘payday’ or short term loan companies. These include Cash Generators, TextLoanUK (offering up to £100 for seven days at APR of 894%) and Miniloanshop. The repayments are coming directly out of his bank account and are causing him to incur bank charges.

‘John’ is on employment and support allowance (ESA) – a UK benefit paid to people whose illness or disability affects their ability to work. He has also only just started receiving personal independence payment (PIP) – a non means tested benefit that offers help with some of the extra costs caused by long-term ill-health and disability.

He  has serious long-standing mental health issues – he lives with schizophrenia and depression. The very strong anti-depression and anti-psychotic medication he’s on ‘makes you drowsy and you forget a lot of things’, he says. He adds that he ‘ends up paying money back, but getting new loans’.

I wasn’t able to establish how much he’s currently having to repay per week to meet the horrendously high APRs on his loans. Neither was he able to tell me the rate of PIP that he receives: The level of PIP varies hugely from £21.55 to £138.05 a week, depending on the outcome of the assessment process. I was however able to advise him to immediately contact Christians Against Poverty – a debt counselling charity. He promised that he would indeed get in touch with them urgently.

'John' has been referred to CAP for advice
‘John’ has been referred to CAP for advice

He lives in a hostel, but it does not seem to offer much if anything in the way of personal support or advocacy. His health is deteriorating and he is losing large amounts of weight. ‘I’ve lost two stones in two months and my nutrition is up and down’, he says. When he goes to the GP, he sees a ‘different doctor each time’. He’s started having blackouts, at which point a GP referred him to the hospital. He still doesn’t know what’s wrong with him. He sees a psychiatrist once every three months, and has no community psychiatric nurse.

He’s been told by the DWP that he is due to have a work capability assessment (WCA) for his ESA, and has been waiting for this since January this year. No doubt this process will do nothing but add to the stress he is under.

Given his deteriorating health, fast weight loss, lack of day-to-day support with his mental health issues and debt problems, in my lay view any future decision by the DWP to endorse a withdrawal of his ESA following WCA would pose a real risk to him.

Has the DWP got any risk assessment procedures in place for individuals awaiting WCA? The effect on people who are already vulnerable of long waits for assessments that may result in removal or refusal of benefit is a matter of huge concern.

I’ll be contacting the DWP to let them know of ‘John’s’ situation. Many thanks to him for talking about his circumstances.

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The wait for disability benefit and the impact of being declined: Tales from the London foodbank and beyond

The existence of  a massive  waiting list for decisions on Personal Independence Payments (PIP) and accounts of long waits faced by individuals is becoming better known. The Department for Work and Pensions (DWP) says this social security payment is designed to ‘help with some of the extra costs caused by long-term ill-health or a disability’ for those aged between 16 and 64. According to DWP figures, of the 529,400 cases registered for PIP between April 2013 and the end of July this year,  just over 206,000 have been cleared (awarded, declined or withdrawn).

Yesterday in the House of Commons Mark Harper the current Minster of State for Disabled People said that by the end of the year no-one would be waiting for longer than 16 weeks for a PIP decision.

How deliverable is this, given the scale of the fiasco?

Statistics capture one aspect of  the saga, of course. But they do not show how long people are waiting within this 16 month period. Mark Harper has said: ‘The delays faced by some people are unacceptable and we are committed to putting that right’. According to an article in the Guardian here, the figures show that 51 per cent of new claimants had been awarded PIP, and it had been granted in 72 per cent of reassessment cases to people previously in receipt of Disability Living Allowance (the benefit that has been replaced by PIP for all new claimants).

But what about the day-to-day lives and feelings of the people caught up in this catastrophe, many of whom have been waiting eight months and longer for that life-changing letter to drop through the post? Also, what happens when that long-awaited decision turns out to be a ‘no’?

One of the worst cases – reported on the Same Difference blog and elsewhere –  involved Lyn Ward, who applied for PIP after she was diagnosed with breast cancer. In March this year she was still waiting for help  – 11 months after applying for this help and having undergone an operation to remove the tumour, her lymph nodes, a mastectomy, chemotherapy and radiotherapy. While PIP itself is not a means-tested benefit, finances were so tight that the delay forced Lyn to go back to work just days after completing her radiotherapy.

It’s worth stating the unavoidably obvious fact that people who apply for PIP are some of the poorest people in society – those with long-term ill-health and disabilities that more often than not impact on their ability to work. The ill-health can be physical, mental or a combination of both. Richard Hawkes, the chief executive of disability charity Scope, is quoted in the Guardian article saying that ‘Scope’s helpline has been inundated with disabled people phoning for advice on their PIP claim, and many are facing extreme delays of well over six months’.

Recently at this London food bank, I spoke to Theresa (not her real name),  who has recently been diagnosed with borderline personality disorder (BPD), which can make people at risk of self harm and suicidal behaviour. Theresa, a single person,  told me that her experiences while on Workfare – working for no pay while in receipt of jobseeker’s allowance (JSA) – had driven her to take an overdose. Now on the waiting list for specialist counselling, she has just filled in the forms to apply for PIP. But she has no idea at this stage how long it will be before she hears if her application has been successful. Even if it is successful she has no idea how much she’s likely to receive. Applicants could get between £21.55 and £138.05 a week, depending on how their health needs have been assessed – ie how many points they accrue. If she’s turned down for the payment she faces the decision of whether to go down the route of a mandatory reconsideration and if that’s not successful then an appeal to an independent panel. This would  – and again it merits hammering home  –  be particularly stressful in her circumstances.

I’ll be keeping in touch with Theresa to find the outcome of the decision and to keep track of how long it takes to come through. In the meantime, she is trying to survive and pay all bills including rent on her employment and support allowance (ESA) payment of £140.80 a fortnight – a challenge that has driven her to ask for support from the food bank.

Amy (not her real name) is 29 and lives in Sheffield. She’s had an extended wait for a decision on a PIP application. Her circumstances are slightly different to Theresa’s – but she like Theresa is struggling daily with the impact of  serious mental health issues. She lives with her 35-year-old partner in a rented flat, and her mental health issues include, but are not limited to, anxiety, agoraphobia and hearing voices. She has previously had to spend time in hospital. Amy’s partner had been a full-time student, but ended up working during the day and staying up all night to finish his dissertation. Her partner currently earns £16,000 a  year, and they both depend on his income. He is hoping that his contract-based job is extended from this December. Their rent of £440 a month is paid to a private landlord. She says their situation, though hard, would be worse if they lived somewhere like London where private rents are much higher. The couple, who have no children, receive no benefits. I’ve suggested she and her partner immediately get some advice on whether he can apply for Working Tax Credit – worth up to £1,940 a year –  based on the level of  his income. A useful benefits calculator is here.

She applied for PIP in March, and she was helped to do this by her mental health home treatment team, whom she says give her good support. She also has a social worker. She supplied medical evidence, including a report from her psychiatrist. There was an eight month wait, then the decision came two weeks ago – her application was turned down. Her mental health team had thought that she might only get the lowest rate of just over £20 a week – but even that lowest level of PIP would have covered her food bill of £15 to £20  for the week. Amy eats a vegan diet and is skilled at making a little bit of food go a long way. Her partner has a lot of food allergies, so she uses a lot of tinned vegetables and cooks from fresh when she feels able enough to do that. They couldn’t afford ready meals, even if he was able to eat them.

But the decision to reject her application was devastating. She says that if she’d got the money – and particularly if it had been backdated – she could have used it to pay for the tiny extras for herself or someone else that might make the occasional difference between existing and living. Not that she goes out much, being agoraphobic. But the extra bit of cash might have paid for the odd trip to swim at the local leisure centre – which she used to find relaxing. It might also pay for a birthday present or a card for someone. She likes cooking and said a few extra pounds a week might also give her the chance to risk trying out one or two different things. She can’t risk experimenting when she cooks at the moment, because when you’re on the sort of budget she’s on, you can’t afford even one mistake.

Before she got ill, Amy worked as a cleaner. She had been able to put aside some savings during that time, but by the start of this year that money had run out. ‘I thought – I don’t want to be a burden. I think it precipitated me into being very unwell, which is why mental health services helped me apply for PIP. They recognised that the financial worries were making me more unwell. I think they (the DWP) do want to put people off applying by making people wait too long.’

I asked her if she’s going to request a mandatory reconsideration of the decision, which would potentially lead her to an independent panel appeal. But she says that she won’t do this. ‘Most claims go to appeal and I can’t face the stress of  it being turned down. My partner says he’d rather we scraped through than for me to get ill again. I feel the risk wouldn’t be worth it. I know that I do very badly under stress. The worry about going back to hospital outweighs any benefit that money would bring.’

She added: ‘The system can make you more unwell. What they try to save by not giving me £20 a week makes me ill and anxious. They are not saving any money overall. Social care costs more than benefits would cost.’

 

Lord Freud, Theresa, and the evil of workfare: The ‘fragile artifice’ of morality

In a long essay in yesterday’s Guardian, John Gray notes that our leaders talk frequently about conquering the forces of evil – for example when Barak Obama vows to destroy ISIS’s ‘brand of evil’. But he believes that this rhetoric illuminates a failure to accept that cruelty and conflict are basic human traits.

John Gray’s essay – I urge you to read it here – refers us back to an ‘old-fashioned understanding’ that is ‘a central insight of western religion’, as well as Greek tragic drama and the work of the Roman historians  that ‘evil is a propensity to destructive and self-destructive behaviour that is humanly universal’.  He adds: ‘The restraints of morality exist to curb this innate human frailty; but morality is a fragile artifice that regularly breaks down. Dealing with evil requires an acceptance that it never goes away.’

His essay continues: ‘When large populations collude with repressive regimes it need not be from thoughtlessness or inertia. Liberal meliorists like to think that human life contains many things that are bad, some of which may never be entirely eliminated; but there is nothing that is intrinsically destructive or malevolent in human beings themselves – nothing in other words, that corresponds to a traditional idea of evil. But another view is possible and one that need make no call on theology. What has been described as evil in the past can be understood as a natural tendency to animosity and destruction, co-existing in human beings alongside tendencies to sympathy and cooperation.’

He refers to the study On Compromise and Rotten Compromises by the Israeli philosopher Avishai Margalit, which distinguishes between regimes that rest on cruelty and humiliation, ‘as many have done throughout history, and those that go further by excluding some human beings altogether from moral concern…. Describing the latter as radically evil, he (Margalit) argues that Nazi Germany falls into this category’.  Judged by Margalit’s formula, John Gray says that the Soviet Union was also implicated in ‘radical evil’.  He adds: ‘The Soviet state implemented a policy of exclusion from society of “former persons” – a group that included those who lived off unearned income, clergy of all religions and tsarist functionaries – who were denied civic rights, prohibited from seeking public office and restricted in their access to the rationing system. Many died of starvation or were consigned to camps where they perished from overwork, undernourishment and brutal treatment.’

I read the phrase ‘restricted in their access to the rationing system’ , noted the role of the work camps and thought of  the impact of current ‘welfare’ policies in the UK on the lives of  the people who visit the food banks in this area of London. Many of them have complex long-term health problems – often including mental health issues. Take the case of  Theresa (not her real name), a lovely and intelligent single person who came into the food bank recently. She ended up in England as a teenager. When she ran away from her home she was very young, pregnant and already the mother of  a small child. She took that child with her.  Her tough, traumatic history has left her struggling on many fronts. She’s now a grandmother and is finally on the waiting list for long-term counselling, following a fairly recent diagnosis of borderline personality disorder (BPD). BPD can make an individual at risk of self-harm and suicidal behaviour.

She had been struggling to survive on her current employment and support allowance (ESA) rate of £140.80 a fortnight, and her inability to find enough money to buy food after she’d paid her bedroom tax (included in her rent of £47 a fortnight), council tax and other bills (her gas and electric costs alone are £25 a week) had forced her to ask a Jobcentre Plus adviser for a food bank voucher. That voucher was welcome – and good of course as far as it went. The three days of emergency help is designed to see someone through a short-term crisis. But a crisis had been building over the course of Theresa’s life, and the crisis had already come to a head.  Theresa’s life is still a very hard one, and she will keep on struggling to survive on ESA while she waits for her recent application for the Personal Independence Payment (PIP) to be assessed. In the UK these assessments for people who need help with some of the extra costs caused by long-term ill-health or disability have been mired in long delays. Theresa, like many of those awaiting PIP assessments,  has no idea how long this process will take.

‘Things started to get really bad two years ago with regard to food,’ says Theresa. ‘I’ve had to go completely without food at times. I sit in my flat without the gas on. I have no choice. I can’t afford to put the gas on during the day.’

Theresa managed to access some college courses two years ago – at which point she discovered she was dyslexic. To some extent this belated knowledge helped this bright and talented woman to start to make sense of some of the problems she had experienced in her early life. The peak of the crisis came when a while back someone – or ‘the system’ –  took the decision to place Theresa on the Work Programme. This involved Theresa offering her ‘free’ labour to two different businesses while she claimed Jobseeker’s Allowance (JSA) . Putting her on the programme caused her ‘tremendous problems’ , she says.

About 14 years earlier she had been hospitalised for depression, but she had hidden the scale of her depression from her children. But she says the unpaid work placements – one in a retail outlet and the other in a cafe – exposed her to issues she found traumatic – including bullying. The manager of the shop ‘for some reason picked on me and he wanted me behind the till all day and he wouldn’t let me fill shelves. I was working there six days a week’.  She finished the work placements and took an overdose very quickly after that. ‘I phoned my sister after I had taken lots of tablets. She rang an ambulance and I went to A&E. I was then discharged and referred to a mental health clinic. They referred me for a mental health assessment and it was then that the BPD was diagnosed.’ She’s now on the waiting list for the specialist therapy she needs for her condition. The only recent positive developments in Theresa’s life as she waits for therapy is that an individual Jobcentre Plus adviser has taken an interest and has spoken to the local council to try to sort out a temporary reduction in her rent. That would make her rent arrears more manageable. She is also receiving support from mental health charity Mind.

The Work Programme describes itself as ‘designed to help people who are at risk of becoming long-term unemployed’ and it says it  ‘aims to support people into sustained employment’. The Work Programme is delivered by providers from the private and voluntary sector, and ‘once a claimant has joined the Work Programme they will be supported by their provider for up to two years’. In reality, just 48,000 people found long-term jobs under the programme in the almost three-year period between the start of the scheme in 2011 and early 2014. That only represents 3.2% of the 1.5 million people the Department for Work and Pensions said it had referred to the programme in total. The financial cost of the programme to the public sector for the three years to March 2014 has been £1.37 billion – but it doesn’t seem as if even the most fragile artifice of morality has been factored into a scheme which puts claimants  – many of whom are some of the most vulnerable people in society – to work for no money.

Writing in the Guardian, Aditya Chakrabortty is one of  many commentators to highlight the fact that the most vulnerable people have been hit the hardest by a perfect storm of cuts to a number of core disability benefits at once. This is at a time when ‘going by GDP data, this country has never been so wealthy. It certainly has the money to look after a group that you and I would recognise as being among our most vulnerable’. His view is that the comments by Lord Freud at a Conservative party conference fringe meeting on whether people with disabilities should work for just £2 an hour  are ‘just the smallest injury Freud has dealt disabled people’.  He says ‘contempt for disabled people runs right through coalition policy’.

Writer and campaigner Johnny Void sees workfare as nothing more than a scheme for employers wishing to scrounge free workers. He asked recently: ‘Is it any wonder that unpaid work is fast becoming the new segregation for many disabled workers?’ Mike Sivier at Vox Political has also written extensively about workfare, including the decision by the High Court to declare as illegal Iain Duncan Smith’s retroactive 2013 law to refuse docked payments to jobseekers who had refused to take part in the workfare scheme. Canadian disabilities studies specialist and disability activist Samuel Miller has been reporting voluntarily to the UN’s human rights office in Geneva on what he describes as the welfare crisis for the UK’s sick and disabled. He has also written to UN High Commissioner Navi Pillay asking for an urgent investigation into the UK’s approach to benefit sanctioning.

It’s impossible to avoid the conclusion that the basic human trait of cruelty has already  been embraced and given a secure home within the UK system of government in relation to its treatment of anyone rash enough to be poor and vulnerable in the sixth richest country in the world.