On Labour’s recent disability discussion paper

There is much to be welcomed in Labour’s discussion paper, “Making Rights a Reality for Disabled People” (pdf), including:

• Using the period leading up to the General Election to develop ideas and to generate debate about disabled people’s priorities
• Undertaking this process with disabled people
• Challenging what is thought to be wrong with current policies regarding disabled people. For example, the paper feels to me to be spot on when it says the changes to DLA stem from saving money and not much else, or when it says that unsustainable risk falls on small third sector providers in the Work Programme, or when it says that the changes to Legal Aid will leave the most vulnerable without any legal support when things go wrong
• Highlighting that disabled people are bearing a greater brunt of cuts in government expenditure than, for example, bankers
• Reasserting that (a) rights should be fundamental to a society where disabled people are valued as participating members of the community, and (b) universal provision should be just that, “universal”
• Similarly, talking of Social Security rather than Welfare (a point Jenny Morris has made many times, and with which I was previously unsure but have now seen Jenny’s point on).

There are also, and you can probably see where I’m going with this, a few things that worry me a little about the discussion paper, including:

• The conflation of “universal provision for those who need extra help because they are unable to work” (my italics). First of all, extra help isn’t limited to only those people who can’t work (think Access to Work); and second, as JRF has regularly pointed out, help is also needed for people who are in work
• Noting that RNIB told Labour “currently someone who is totally blind can be found fit for work”. Erm, yeah – blind people can work!
• The precarious line that’s being drawn between welfare rhetoric and disability hate crime (on which, read Neil Crowther’s excellent post)
• The headings of each section are excellent. The body of each section, though, takes one or some of the government’s welfare changes and has a (justified) dig at them. That’s fine, but there’s a big leap to be made between people’s benefits and people’s rights (see point at the end of this post). This is quite aside from how narrow it makes the focus: the right to a home is much more than Housing Benefit
• Putting the issue of the cumulative impact assessment of changes to policies affecting disabled people so much to the forefront (Demos, amongst others, have already done a great job on highlighting the cumulative impact). This begins to mistake process for policy – something also done in the paragraph on improving assessment, and which makes no reference to the two significant recent attempts to do just that (Right to Control and the Individual Budget pilots)
• Claiming mismanagement of Remploy (something Labour itself did)
• Not recognising some of the more positive things that have happened in the last couple of years, including the Access to Elected Office Fund and the Paralympics
• No meaningful mention of education, civic participation, culture or transport. Why not?

It’s a slightly longer list than what’s good in the document, but I think it’s salvageable if the Labour party is willing to do what it says it will do: listen to and act on, meaningfully, what disabled people want.

There are two wider points to make.

The first is a lingering feeling I have from the document that Labour’s focus is more on impairments you can see than those you can’t. I didn’t get much sense that people with learning disabilities or mental health problems, for example, were prominent in their thinking and I hope there is more focus on these groups in ongoing discussions.

The second picks up on Neil’s blogpost about frames. The whole document has a very heavy basis in welfare, particularly benefits. This is paternalistic at best and, to my mind, doesn’t provide the right platform on which the rights of disabled people should be built.

Others regularly put it better and more eloquently than I will here, but the state must be not only a safety net when people need it, but a mechanism by which the barriers disabled people face can be addressed and removed such that disabled people can use their strengths, capabilities and assets to contribute to their communities and society as a whole.

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Demos’s report on pre-payment cards

I’ve just had a quick read of Demos’s report published today on pre-payment cards.

Recall that pre-payment cards (also called prepaid cards) are like debit cards, where funds are loaded into an account linked to the card and then spent by the card holder until the balance reaches zero. They can be used to make purchases, set up direct debits or standing orders, and sometimes withdraw cash at ATMs.

There has been an increased usage of pre-payment cards by local authorities, especially in the area of administering Direct Payments in social care, and the Demos report makes recommendations about them being considered for wider use, for example in benefits administration and other forms of public payments.

The topic of pre-payment cards is an emotive one, since it symbolises the concept of the state potentially or actually prescribing what Direct Payments or benefits can be spent on. This is fascinating in itself because, as the report highlights, pre-payment cards are essentially a question of the “nitty-gritty of implementation”.

Of course, I have views on pre-payment cards and whether they should be used. This comes from being pretty heavily involved in two areas of work – Direct Payments implementation and making the Right to Control a reality – and especially from the perspective of service users. I’m painfully familiar with the both the advantages and disadvantages that can arise in making payments to people or trying to integrate several types of payment. As I told the judge, I now know more about the appearances of money laundering than I probably should do.

For those interested in the issues, the Guardian has an article by Ally Fogg which covers a lot of the debate.

The wider point to make, though, is that Demos should be congratulated for at least bringing the topic out into the open. Pre-payments cards are a growing phenomenon and there is a need for an open debate on their merits and demerits, rather than their use growing in the absence of a debate.

It would be great if a space could be created in which this debate can take place that brings together users, public bodies, government and those providing pre-payment cards.

Linking rules, IB & ESA and the removal of transitional protection

It used to be that there were rules called “linking rules” for people in receipt of Incapacity Benefit (IB), which has been updated to become Employment and Support Allowance (ESA).

Put simply, if someone stopped claiming IB or ESA but found that they needed to start claiming again within a certain period of time, then their “new” benefit would simply be linked back to the “old” benefit they received – they were “linked”.

If someone came off IB or ESA but didn’t take work, the linking rule was in place for 12 weeks. If someone came off IB or ESA and took up work or training that didn’t work out, the linking rule was in place for 104 weeks.

What’s more, during the transition phase from moving everyone from IB to ESA, people falling under the linking rules would have “transitional protection”, so even though IB technically didn’t exist, people falling under the linking rules would move back to an equivalent benefits rate under ESA.

(Full details of the previous linking rules are available here.)

As the government seeks to move people to the tougher ESA benefit, as of 31 January 2011 the “transitional protection” has been removed. As the DWP itself says:

Before [31 January], the existing linking rules will continue to apply, so a former IB recipient who puts in a [benefit] claim before this date (and in respect of a period before this date) which links back to a previous award will go back onto their previous IB, and will fall to be reassessed (with a view to conversion to ESA) in the fullness of time, acquiring transitional protection, where appropriate.

Whereas all claims for an IB made on or after this date will be treated as new claims to ESA (even if they would otherwise have linked back to the previous IB award), and will therefore fall outside of the scope of the reassessment exercise and get no transitional protection. [Emphasis added]

This seemingly innocuous change removes a key protection for people currently on IB who may wish to take up the opportunity of work, with the relative safety net of the linking rules to fall back on.

Probably achieving quite the opposite of what the government wants to do – it moving people off Incapacity Benefit and into work – it could act as a demotivator in looking for work.

(For those interested in legislation behind this, the previous Labour government – in its welfare Green Paper in 2006 – doubled the linking rule from 52 weeks to 104 (see paragraph 100 here). Linking rules were enshrined in the subsequent legislation – Regulation 145 of the Employment and Support Regulations 2008 and Regulation 2 of the Employment and Support Allowance (Transitional Provisions) Regulations 2008. The current government has removed these provisions through Regulation 23 of the Employment and Support Allowance (Transitional Provisions, Housing Benefit and Council Tax Benefit) (Existing Awards) Regulations 2010.)

Incapacity Benefit linking rules being stopped for disabled people

Benefits and Work are reporting that the “linking rules” for disabled people, which provides some security for those who take up employment but are unsure what the impact may be on their health/impairment, are being stopped:

Linking rules which allow incapacity benefit (IB) claimants to return to their previous rate of benefits if they try work and have to stop again on health grounds are to be scrapped from 31 January.

From that date onwards any former IB claimant who stops work will no longer be able to take advantage of the 104 week linking rules and will, instead, have to make a fresh claim for employment and support allowance. They will be eligible only for the assessment rate for the first 13 weeks of their claim, a lower amount than they would have been entitled to if they had been covered by the linking rules, as they were promised they would be at the time they started work.

This information came via this blog post from Social Worker To-Be (itself via a tweet from @monstertalk).

More on this when I have it.

One Month Before Heartbreak: please read one story

Today is the start of One Month Before Heartbreak – a blogswarm to try and raise awareness of the many negative changes that are being made to various disability benefits, particularly Disability Living Allowance.

You can find links to everyone who has posted during One Month Before Heartbreak on the website itself plus some on Benefit Scrounging Scum. You can also follow all posts and debate about it using the Twitter hashtag #ombh.

I know that not everyone reads about disability-related issues.

This could be because you have an own area of interest that is facing cuts of its own.

It could be because disability doesn’t affect you or someone you know.

Or it could be (and it’s understandable) that you don’t feel as comfortable talking about issues relating to disability.

But if I may, I’m asking that today or this weekend you read just one story – any story – of the people who are posting about the impact the cuts to disability-related support they receive will have on their day-to-day lives.

For my own part, I don’t tend to focus on my own mental health condition. Instead, I crunch the policy, the numbers and the implications and see where it gets us to. For Disability Living Allowance, the Independent Living Fund and Access to Work, this is what I’ve done, and the posts are below. I’m afraid it’s a bit of a “greatest hits” / “bargain basement” contribution, but I wanted to support One Month Before Heartbreak.

On Disability Living Allowance:

• Poverty, Worklessness… and DLA?
• The Budget and DLA: initial reactions
• DLA reform consultation: Great Expectations, Worst Apprehensions

On ILF:

• Independent Living Fund essentially closed for business
• Independent Living Fund to close

On Access to Work:

• Are cuts being made to Access to Work?
• More on the possible cuts to Access to Work
• Access to Work and reasonable adjustments

Linking rules, IB & ESA and the removal of transitional protection

It used to be that there were rules called “linking rules” for people in receipt of Incapacity Benefit (IB), which has been updated to become Employment and Support Allowance (ESA).

Put simply, if someone stopped claiming IB or ESA but found that they needed to start claiming again within a certain period of time, then their “new” benefit would simply be linked back to the “old” benefit they received – they were “linked”.

If someone came off IB or ESA but didn’t take work, the linking rule was in place for 12 weeks. If someone came off IB or ESA and took up work or training that didn’t work out, the linking rule was in place for 104 weeks.

What’s more, during the transition phase from moving everyone from IB to ESA, people falling under the linking rules would have “transitional protection”, so even though IB technically didn’t exist, people falling under the linking rules would move back to an equivalent benefits rate under ESA.

(Full details of the previous linking rules are available here.)

As the government seeks to move people to the tougher ESA benefit, as of 31 January 2011 the “transitional protection” has been removed. As the DWP itself says:

Before [31 January], the existing linking rules will continue to apply, so a former IB recipient who puts in a [benefit] claim before this date (and in respect of a period before this date) which links back to a previous award will go back onto their previous IB, and will fall to be reassessed (with a view to conversion to ESA) in the fullness of time, acquiring transitional protection, where appropriate.

Whereas all claims for an IB made on or after this date will be treated as new claims to ESA (even if they would otherwise have linked back to the previous IB award), and will therefore fall outside of the scope of the reassessment exercise and get no transitional protection. [Emphasis added]

This seemingly innocuous change removes a key protection for people currently on IB who may wish to take up the opportunity of work, with the relative safety net of the linking rules to fall back on.

Probably achieving quite the opposite of what the government wants to do – it moving people off Incapacity Benefit and into work – it could act as a demotivator in looking for work.

(For those interested in legislation behind this, the previous Labour government – in its welfare Green Paper in 2006 – doubled the linking rule from 52 weeks to 104 (see paragraph 100 here). Linking rules were enshrined in the subsequent legislation – Regulation 145 of the Employment and Support Regulations 2008 and Regulation 2 of the Employment and Support Allowance (Transitional Provisions) Regulations 2008. The current government has removed these provisions through Regulation 23 of the Employment and Support Allowance (Transitional Provisions, Housing Benefit and Council Tax Benefit) (Existing Awards) Regulations 2010.)

The case for DLA reform is shaky

Beyond misuse of statistics, sloppy presentation of data and lack of evidence, there are further points to be queried.

In a well-argued post on Benefit Scrounging Scum, Rhydian Fôn James has highlighted several major issues with the government’s methodology in making the case for DLA reform.

It’s a great read, and required for anyone who believes in evidence-based policy and disability equality.

(For anyone interested in the issues with the case the government has constructed with their dodgy methods, I modestly offer my post on DLA reforms.)

Andrew Lansley on the value of disability benefits

People use the attendance allowance and disability living allowance to help them, under their own control, to create a quality of life for themselves that helps them to remain independent. That is precisely in line with the policy we are all trying to pursue. It is clear that if one narrowly focuses only on care needs, we will miss out much that goes to constitute well-being, and there is no health without well-being, and there is no independence, without sustaining people’s quality of life.

That was Andrew Lansley, speaking in parliament during an opposition day debate on the topic of disability benefits for older people.

He was right then. I wonder if he disagrees with what his colleagues – now in government – are thinking of doing now?

Previous Tory views on disability benefits

The government yesterday launched its consultation on reforms to Disability Living Allowance. I blogged extensively on it yesterday.

One of the huge – and, as far as I can see, new – announcements was that the government is considering rolling out the cuts to DLA not just to the 1.8m of working age in receipt of DLA, but also those under 16 and those over 65.

Given this, I thought it was timely to recall some recent history.

As part of their Green and White Papers on adult social care, Labour suggested using £100m of the Attendance Allowance budget to help pay for the National Care Service. (To put that figure in context, the Attendance Allowance budget for 2009/10 was £7.505bn.)

In response to the potential idea (contained in the Green Paper), Andrew Lansley and Theresa May said this, launching a “campaign to protect Britain’s pensioners”:

Shadow Work and Pensions Secretary Theresa May and Shadow Health Secretary Andrew Lansley today pledged that the Conservatives would campaign to Protect Britain’s Pensioners against Gordon Brown’s plan to scrap the Disability Living Allowance and the Attendance Allowance…

Andrew Lansley said: “As ever with Gordon Brown you have to look at the small print. In order to set up a new National Care Service he is planning to take away vital benefits from the elderly and disabled… We don’t yet know what the Government’s plan for a National Care Service would really involve, but let me make it clear – it must not be funded by snatching benefits back from 2.4 million vulnerable pensioners.

“My pledge to you today is that we will Protect Britain’s Pensioners and fight against Gordon Brown’s plan to scrap benefits for the disabled.”

Theresa May added: “Labour has chosen to penalise one of the most vulnerable groups in our society for the sake of another eye catching announcement. As with every Labour initiative, someone has to pay and, as with many of them, it is the least able who are to be forced to do so.

“These benefits are a vital support for disabled pensioners and give them the chance to have an independent life with the freedom to tailor their care to their needs.

In his own Invitation to disabled people, David Cameron promised the Tories would be:

Protecting key benefits: the Winter Fuel Allowance, free bus passes, free TV licences and the pension credit. And unlike Labour, we will not scrap Attendance Allowance or Disability Living Allowance for the over 65s.

Speaking in an opposition day debate in parliament on the topic of DLA and AA, the then Shadow Disability Minister Mark Harper MP:

criticised the proposals for taking away the “control and independence” that these benefits gives older disabled people. “This is a step backwards and I hope the 39 Labour MPs who’ve already signed the motion will vote to protect the benefits so valued by older disabled people”, he said.

Finally, Andrew Lansley cited approvingly the following early day motion at the start of an opposition day debate on disability benefits for older people:

That this House recognises the vital support that attendance allowance and disability living allowance provide for people with disabilities; notes that these benefits are intended to meet the additional costs of living with an impairment or long-term health condition; further notes with concern that approximately 2.87 million people in the UK who receive disability living allowance or attendance allowance are not eligible for social care services; acknowledges that some 20,000 individuals have petitioned the Prime Minister and many more have petitioned individual hon. and right hon. Members to ensure that these benefits are secured; welcomes the Government’s announcement that disability living allowance for people under 65 years will not be scrapped; and urges the Government to ensure that attendance allowance and disability living allowance for people aged 65 years and over are secured and not abolished as part of any future reform of the social care system.

I just thought you’d like to know.

DLA reform consultation: Great Expectations, Worst Apprehensions

The coalition government today published its consultation on the reform of Disability Living Allowance (DLA). The headline is that DLA is going to be replaced by a “Personal Independence Payment” (PIP) from 2013/14.

DLA has been in the news a considerable amount since the emergency budget in June this year, primarily because it has been the main disability-focused benefit the government has looked to cut. I’ve blogged quite a lot on the topic: see here, here and all posts here.

As such, today’s consultation on the reform of DLA is of huge significance and interest because it provides far more detail and intent of what is planned for DLA. Below, I summarise what I think are the key issues. (Via delicious you can keep track of other reactions via my tag DLAreform.)

1. The foreword states that:

We are committed to a sustainable and fair system that allows people to work when they can and provides unconditional support to those who are unable to work (emphasis added).

The idea that the reformed DLA system provides “unconditional” support is palpably nonsense. Moving from the system (where people can self-assess) to one where the explicit aim of the reform is to reduce the number of recipients and spend by 20% is quite the opposite.

2. These proposed reforms suggests introducing “conditionality” into the system (paragraph 2.35). The idea is that as part of the PIP, recipients will be required to discuss their circumstances with a professional who offers advice and “helps them access specialist support”. I’ll explore the intention behind this in point 3 below, but introducing conditionality into the DLA process is a huge shift. Whilst there’s been some debate about whether conditionality in employment benefits is right or wrong, introducing it in a disability setting – where people have already passed through so many tests based on their often intimate and personal circumstances – will feel to many like they’re being kicked when they are down.

3. Throughout the reform consultation there are references and suggestions that DLA should no longer cover the sorts of support it used to, to take account of the fact that aids, adaptations and equipment are now more part of the general landscape. So, where the mobility test used to be based on ability to walk, the mobility test will now be based on being able to get around – and if there’s a wheelchair involved, that will suffice.

The question of how that wheelchair has been paid for – private money, health money, social care money – appears not to matter, which is obviously wrong. If an individual has paid for it, then they clearly had a mobility need. If the NHS or a Council has paid for it, then they obviously thought there was a mobility need. Though it seems innocuous, the intention of the conditionality above will actually require a potential recipient of DLA to explore what “specialist support” is avaliable apart from DLA. By introducing this, and the very narrow focus on what support is in place at the time of assessment, the impression is created that, so long as the need isn’t met by the DLA budget, it doesn’t matter where it’s met from. What wider impact this will have on NHS and social care spending is currently unknown, but I’ll bet they won’t be pleased by this subtle but important chance.

4. The idea that DLA itself is a barrier for disabled people into employment (para 1.19) just isn’t credible. Indeed, the DWP’s own evidence (pdf) suggests otherwise. Even if we take this assertion at face value, I’m already hearing of restrictions of what Access to Work will and won’t fund to enabled disabled people into employment. Thus, with the government also seeking to reduce what proportion of DLA is spent on aids, equipment etc., these two changes combined means the government significantly risks undermining its own policy of supporting people back into work.

5. The reform paper paints a very confused picture on costs and numbers. It states that over 3m people receive DLA – of which 1.8m are of working age (16-64) – with total spend this year being “forecast as £12bn”. But the Dilnot Commission, based in the Department of Health, says that DLA for 16-64 year olds costs £5.487bn (in 2009/10). Furthermore, the DWP’s own figures said that DLA cost £6.2bn in 2009/10. In the emergency budget, the government said they would save £1bn (or 20%) of the DLA budget, suggesting they were using the £5.487bn figure. If that’s right, why quote the £12bn figure? (Quite aside from this, the government fails to mention that Attendance Allowance currently costs £7.505bn. More on that another time.)

6. A massive change – different to anything we’ve heard before – is that the DLA reforms are to extend beyond working age to cover children and those over 65 (paras 0.3, 1.14 and throughout). I don’t recall the government saying that the DLA cuts will affect this group of 1.2m people, in either the CSR or the Budget. If this is true, the impacts will be huge (and go some way to explaining why the £12bn figure above is included.)

7. There is a mixed picture on the role of self-assessment. The government appears not to trust people applying for DLA under the current system, but thinks that self-review under the new one is fine (para 2.32). If self-assessment in social care, with its considerably larger budget, is acceptable (under the banner of personalisation), then why isn’t it acceptable for DLA assessments?

8. In paragraph 1.10, the reform consultation states that “measuring each individual’s expenditure would be administratively complex and expensive”. And yet they think that checking everyone’s needs won’t be.

9. Paragraph 2.4 notes that the PIP will require a “new, fairer, objective assessment, which will allow [the government] to identify those who face the greatest need, in a more consistent and transparent manner”. Transparency is, of course, to be welcomed. I will therefore look forward to full details of the contract between ATOS – who carry out the medical assessments for DLA on behalf of DWP – and the DWP, along with all its financial information, performance information and details of targets etc.

10. Paragraphs 2.33 and 2.34 talk about the “penalties” that will be put in place for individuals who don’t report changes in their circumstances. It’s a shame the report didn’t take the opportunity to note that the fraud rate for DLA is 0.5% – a rate significantly lower than Income Support (2.9% fraud rate), Incapacity Benefit (1%) and Jobseekers Allowance (2.8%). Indeed, it’s lower than the office error rate for the DWP, which stands at 0.6% (data: Benefit Scrounding Scum).

It’s only fair to note that there are some good points in the reform paper:

1. Paragraph 2.18 talks about bringing the definition of those who could potentially get DLA into line with the legal definition of disability. This makes sense.

2. Maintaining DLA as a non means-tested, non-taxable, non-NI contributions dependent benefit is right, as is recognising its role as a passport to many other publicly-funded services.

3. Looking to align assessments across benefits, health and social care, and sharing information (with permission) across professionals about those assessments, could be a big win, for both individuals going through the process and to streamline administration (para 0.11). In its Right to Control work (on which I’ve written a series of posts) the government is developing an infrastructure that could enable this to happen.

4. Throughout this document, the government has finally and explicitly acknowledged that DLA is “not an income-replacement benefit for those who are out of work due to disability” (para 1.1). It’s just a shame that the government did so much to encourage the perception of disability as an out-of-work benefit.

Overall, I’m afraid to say there is a lot for disabled people to be worried about in these proposals. There is no getting away from the fact the government has decided it wants to spend less on DLA and is justifying where it is going to draw the line to save the 20% they’re looking for.

The most superficial of all the proposals is renaming what has become the potent “Disability Living Allowance” and replacing it with a “Personal Independence Payment”, which has the unfortunate acronym PIP, which puts me in mind of Great Expectations.

The problem being, of course, that the government’s reforms aren’t something that disabled people can think of in terms of hope and promise. Instead, the reforms confirm the very Worst Apprehensions that we held over these reforms.