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Eleanor Roosevelt, 1958

'Where, after all, do universal human rights begin? In small places, close to home -- so close and so small that they cannot be seen on any map of the world. Yet they are the world of the individual person... Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.' Eleanor Roosevelt, 1958

The Small Places has moved...

The Small Places has moved to a new home here, including all the old posts. Any posts after 6th March 2014 will appear on the new website, but old posts are preserved here so that URLs linking here continue to work. Please check out the new site.

Thursday 17 January 2013

ESA SOS!

The government are pushing through more changes to Employment and Support Allowance (ESA), this time through regulations.  I hope Sue Marsh doesn't mind, but I'm going to copy and paste her excellent explanation of the problems with these changes:
Although these changes have been advertised as small ‘amendments’, they will in fact have a huge impact on the way people’s illnesses and disabilities are assessed. Many vulnerable people’s needs will suddenly be able to be overlooked or ignored, meaning they could end up losing the support they desperately need to manage their conditions.

PROBLEM 1: FALSE ASSUMPTIONS

In the fitness to work test, your needs are assessed by a ‘healthcare professional’ employed by the French private company ATOS. This assessor doesn’t just need to look at your current difficulties. For example, they can also imagine how using an aid (e.g. a wheelchair) might improve your ability to work and make a judgement based on that –without even asking your opinion!

However, soon this “imaginary test” will be able to be used for many more aids (including guide dogs and false limbs!). This means that soon thousands more people could be judged as fit to work, without being consulted, on the basis of an “imaginary” aid they don’t own or may not be able to use!

It gets worse. Even if returning to work may clearly put you at risk, these changes will mean you can still lose your disability benefit – as long as the assessor believes that trying a new therapy or treatment might reduce that risk. There’s no need for evidence that the treatment will help: you will lose support either way, making it much harder to manage if the treatment doesn’t work as hoped – let alone if it ends up making things worse.

Imagine Bert, who suffers from severe schizophrenia, but is found fit to work and made to take behavioural therapy in the hope of improving his condition. He will lose his disability benefit, without the assessor having to look at several vital questions: how hard it would be for Bert to contact a psychiatrist? How long would an NHS appointment take to organize? Are there private options in his area – and could he afford them if so? What if the therapy doesn’t work, or takes a long time to adjust to?
If the government’s rule changes go through, people like Bert who are desperate to work will find it nearly impossible to get an accurate assessment, affecting the quality of their support and actively preventing their efforts to get back into work.

PROBLEM 2: SEPARATING PHYSICAL AND MENTAL HEALTH
The government is also trying to change the way people’s conditions are assessed bydividing health problems into two separate boxes: ‘physical’ and ‘mental’. When looking at what tasks people can do, only the ‘physical half’ of the test will apply to those withphysical disabilities. The same goes for the effects of treatment: for e.g., if you’re takingmental health medication, only mental health side-effects will be looked at.

This completely fails to understand the way that many disabilities and illnesses can lead toboth physical and mental effects. This is also the case for many common treatments: such as those for schizophrenia, Parkinson’s disease and multiple sclerosis.
Think of Emily, who suffers severe, chronic pain because of nerve damage to her leg. Emily is among the 49% of chronic pain sufferers who also suffer depression as a result of continuous pain. An assessor may see Emily as able to do some work as long as she takes strong painkillers for the rest of her life, meaning she could pass the ‘fitness’ test. Yet the painkillers may not deal with the depression caused by her condition. Painkillers have also often been shown to affect people’s wakefulness and decision-making. So taking the medication may affect Emily’s ability to do a job in a completely new way – yet because these new problems are cognitive, they would not need to be looked at by the assessor when making their decision!
Pretending the effects of illnesses and disabilities can be separated in this way goes against all medical practice. Going even further, and using this method to ignore sick and disabled people’s needs, is at best hopeless policy, and at worst deliberate cruelty. We cannot let the government treat some of the most vulnerable people in British society in this way.

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You can read more about these reforms on Ekklesia's website.  As Sue says, please try to spread the word about these changes, blog, tweet, stop people in the street...  And don't forget to email your MP.

1 comment:

  1. Dear Lucy,

    I love the blog (and it's name). I am a PhD candidate as well and I am writing about the placement of children in a closed treatment setting ; when is that lawful? In the Netherlands, it seems to be a bit arbitrarily if you ends up in the civil law system, the mental law system or the juvenile justice system. Do you have the same experience? kind regards, Maria (m.p.de.jong@law.leidenuniv.nl)

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