To think there will be more cases like this one? Errol Graham, starved to death.

[BillHadersNewWife]

www.bbc.com/news/uk-england-nottinghamshire-51283186

Mr. Graham had his benefits stopped and despite having genuine problems was left alone to starve.

www.disabilitynewsservice.com/the-death-of-errol-graham-man-starved-to-death-after-dwp-wrongly-stopped-his-benefits/?fbclid=IwAR2eRG_-He70F0dQ9tlHzysRvoLijGdROWhM94pn58cmDPclIxTJgVwEwwg

It's absolutely sickening and worrying.

@CecilyP

This is where you stray into what a GP should do to monitor the welfare of their patients in the general sense.

There are lots of patients on a GP's books who might have a learning or social disability like autism or global development delay which Margaret likely had but who do not see their doctor for years because they rarely experience acute ill health. There are plenty of patients like that who have typical development and health. So it would be inefficient to chase up everyone who hasn't seen you for, say, 12-18 months. The answer is to have GPs with a reasonable amount of patients on their caseload as well as allied staff like nurses and HCPs who help support the patients in the holistic sense.

In this thread, I'm mainly speaking about what a GP should do to satisfy the DWP and prevent them halting benefits. What the GP should do in terms of a vulnerable patient who has not attended and will not or cannot engage with HCPs is a totally different matter. The DWP shouldn't involve itself in the medical assessment of people especially where it dictates as something as basal as how much income they have to whether they have somewhere to live. Leave that to people who have gone to university to learn physiology and medicine and who have some individual knowledge of the person outside of stressful assessments that determine their quality of life.

I know the nurses, receptionists and HCPs (not all of them) at the practices I've worked have always been excellent and noticing which vulnerable people haven't been seen for a while and they will mention, look up their notes or even give them a ring. Lots now see their pharmacist for more but electronic prescriptions let you see if they are collecting them/having them delivered with appropriate frequency.

If a condition is indefinite, then the money needs to be as well. Just because someone who once couldn't work with their bipolar now has a job, it doesn't mean they no longer need that extra income to sustain their employment. Maybe they need to avoid the tube/buses and Uber every day to keep their stress level down. So what? Maybe they need weekly massages. They're working in a job that is productive both in terms of role and tax to society so who cares if they still get full DLA even though they can work now? I certainly don't. Do you?

It wasn’t a case that he simply didn’t need to see his GP so why would they check on his welfare.

This man was meant to be on medication, both for MH issues and for hyperthyroidism apparently. No prescriptions were issued for 5 years prior to his death. Nor apparently did the surgery follow up when blood test results showed he needed treatment.

This man did not necessarily have a lifelong medical condition in terms of MH. It’s incredibly sad that posters on here are quite happy to write people off forever with a condition that can, and often does, improve with the right support and a change in whatever circumstances/background are leading to those issues.

If the same happened to me I’d totally expect to have to provide evidence and information to support my request for financial resources and would happily do so.

For the most part, when someone is prescribed "mental health drugs" on a repeat prescription, one would reasonably expect they will be on them for the rest of their life. It's not "recommended" in that one shouldn't consider revoking the prescription at one point, but it is expected that this mental health issue will be a risk factor if not an issue for the rest of their life.

Also, whether or not someone with a specific diagnosis can improve their health sufficiently to access employment should have no bearing on whether they get ongoing financial support for their diagnosis. Someone with bipolar always has bipolar regardless of how severe or obstructive their cycles are. I'm using bipolar specifically because it is a condition where a person can spend part of their life sectioned and go on to have stable mental health with normal access to employment and social support and companionship. There are others of course but that one is particularly favourable to medication and therapy.

Same with hypothyroidism.

Some medication or conditions come with a recommended screening routine for the complications or side effects of that condition or treatment. So someone on lithium for example will have routine bloods to check organ function. People aren't required to comply by any means so his choice to not engage with the recommended treatment is in no way an indication that his mental health or indeed his physical health is okay.

Again, the GP's responsibility to check on his welfare is totally separate to the DWP's responsibility to ask and accept the evidence of a qualified and appropriately situated health professional.

We're mainly discussing how on earth someone starved to death in Britain in 2018, and what on earth we can do to stop it happening again.

Whether or not people with MH issues can cope, work, provide whatever evidence is necessary is not the point. The point is how the hell do politicians sleep at night knowing they devised a system that allowed this to happen.

This is something that I learned in medical school, I'll paraphrase:

"Blame or accountability isn't like a pie where if I take a quarter, you have 75% of the pie left. We all have our own pie. You can be 100% accountable for your actions and I can be 100% accountable for mine. Sometimes, our actions might exacerbate the harm the other causes, or one person's actions might counteract the other person's. Either way, they are 2 separate pies." This was in the context of one HCP acting on the instructions of another where those instructions cause harm. It might be a junior doctor following the orders of a consultant or a nurse following the orders of a doctor. Unfortunately the onus does mostly fall on the person with the least training to know enough to see where the more experienced/qualified professional is flawed. But I digress. Focus on the pies.

your post still relates to the situation found by the baliffs after Graham had died

Not so.
Bailiffs would be sent if rent was not paid and action was initiated against the tenant by the landlord. It just so happened in this case the tenant was already dead.

My point is that every service seems to have a lack of urgency to investigate deeper why a man with no income and grave and complex MH problems is surviving!

But when rent isn’t paid an immediate response in made driven by getting some money out of him (blood from a stone).

Joined up thinking and working is needed with compassion driving the way services work, not just money.

Our public services are being ground down and there are human consequences to that.
As a country we should be appalled.

Maybe reassign bailiffs to deliver food parcels to the needy - they will get them to the right people!

“as well as allied staff like nurses and HCPs who help support the patients in the holistic sense.”

I was just about to (as an ex nurse) say that part of the problem is the decimation of community nursing services.

Back in the day the district nurses attached to a surgery would have a pretty good idea of the vulnerable adults on their surgeries books. Now with 1 district nurse working for 2+ surgeries and covering a ridiculous number of patients the result is patients falling through the cracks.

“The DWP shouldn't involve itself in the medical assessment of people” Absolutely! They don’t have the training, experience or correct attitude to do so.

I’m deeply suspicious of hcps who go to work for dwp or associated agencies to do this work, I always think they’ve ended up there either because they were shit at their job or even we’re on the brink of being barred from practicing. I cannot believe decent, compassionate, professional hcps want to do this work.

“so who cares if they still get full DLA even though they can work now? I certainly don't. Do you?” With the kindest of intentions this is not how it works, but I appreciate this isn’t your field. DLA is not a means tested benefit it can be received by people working too. Plus it’s being replaced by pip. ESA is the legacy benefit for those of us too sick to work which is being replaced by UC. It is very complicated.

“If the same happened to me I’d totally expect to have to provide evidence and information to support my request for financial resources and would happily do so.” How many times do we have to say this?! It’s not simply a case of being “happy to do so” it’s having the ABILITY to do so - that can even include literally the ability to physically write which mental illness CAN affect. It also included the mental ability and emotional strength to deal with gathering and collating evidence and sending it to dwp (who very often “lose” it - I learnt after the first few times of crucial paperwork being “lost” or “not received” that it’s best to take things in by hand and get a signed and printed receipt and check the name on the signature matches the ID of the person signing for it (yes I’ve had them try and sign a false name! As have others I know in similar circumstances - the level of deceit employed by the dwp in trying to block claimants is truly shocking). As I’m currently housebound that isn’t possible for me at the moment so I have been using an advocate who has ensured they get proof of receipt for evidence submitted - she too has experienced deceptive practices by dwp and wasn't at all surprised when I told of the ones I had.

Universal credit was presented as a dressed up simpler system, joined up so no one falls through the cracks etc, a lot of spin geared to get the public onside. It is the total opposite of course.

If even half of that effort was put into maintaining tax rates amongst big business in the UK there would have been no need to decimate existing services and remake "joined up" as "kill em off" in a joined up mask.

All of the while the support system has been dismantled systematically, the tax system has been reducing tax for those best placed to pay into the system. If only the money spent on "kill em off" checks and balances was given to those who need it, if only the government acted for the population and made businesses accountable for the services and people they need here. If only there weren't so much stupidity and greed and short sightedness.

How quickly would things improve if all of the anger and spite generated towards society's most vulnerable was redirected towards those who leech the UK dry by refusing to pay tax, refusing to pay proper wages, refusing to employ proper work conditions etc? You know the people who have actually cheated Britain?

@Graphista

It isn't how it is designed to work but in practice, accessing work is used by the DWP to claim that your health needs are less obstructive than they were or that they were overestimated to begin with.

So for example, I'll have patient who can't work due to depression/anxiety etc. They'll receive the correct diagnosis and treatment and their mental health will improve so they will access education or employment. Then at their next call for assessment, they will be denied the disability benefit or it will be reduced. That goes for all of the benefits associated with disability or infirmary.

Pushing yourself to work when you know that it will call the severity of your health needs into question and you'll lose your financial security doesn't make sense.

t’s incredibly sad that posters on here are quite happy to write people off forever with a condition that can, and often does

Ah yes when gaslighting and goalpost moving doesnt work the next tack is usually emotional blackmail.

Not writing someone off is stopping their money is it? Does that also work for people higher up the economic scale? Hey Mr Stockbroker we are cutting your wage So as not to write you off. I bet you are one of those people who thinks every disabled person can be a Paralympian.

If someone who is mentally ill has a psychotic break in the workplace after being forced back to work and the odd Tory voter ends up on the business end of it a different tune would be played im sure.

Writing them off means assuming that just because someone can’t work now means they’ll never be able to work again.

Studies show that it’s actually better for people’s mental health and well-being long term to be in work or return to work as soon as possible. It’s why we now have a system where GP’s consider what people could do if reasonable adjustments are made rather than just sign them off completely.

And if you think people in employment continue to get paid regardless of whether they engage with their employer, perform well or actually turn up then you must be very naive.

Sustaining their income doesn't mean you're stopping them from working. Your idea seems to be to force them into work by making them poor(er).

Do you think we should burn down the homes of travelling communities to force them to adapt to a settled life which is more convenient for our systems? I mean honestly a good amount of the reason that those communities have poorer health outcomes is because their nomadic lifestyle makes continuity difficult if not impossible. If we burned down their homes and they had nowhere to live, they'd be forced to either gain rented accommodation, enter the social housing system or at least be homeless in one area where we could tailor their health and social care needs.

And if you think people in employment continue to get paid regardless of whether they engage with their employer, perform well or actually turn up then you must be very naive

I referred to Parson's Sick Role Theory earlier, I don't know if you read it. It basically says that in order to escape the normal expectations of a person's role in society in terms of productivity, the infirmed must meet various criteria through their actions and situation. For one, it must be a recognised ailment. Secondly, the person must behave in a way that clearly shows they are ill. It can't be hidden or vague. Next, they must seek medical help and comply with advice. If they do not do these things, then their lack of productivity in accordance with societal values is inexcusable.

This means that people with conditions which are new or not understood well like fibromyalgia are thought of as fabricated or a symptom of decline declining moral standards.

Disability benefits are not designed to be wages for the infirmed. Or at least they should not be. In employment, yes, your performance and productivity is rewarded with payment but disability benefits are not rewards for performing the Sick Role well.

A diagnosis of a chronic lifelong condition should entitle you to extra financial support of which employment has no bearing. Yes that means some extremely rich but disabled people will still get income from the national piggy bank but hopefully they pay correct taxes so it's all swings and roundabouts.

“Universal credit was presented as a dressed up simpler system, joined up so no one falls through the cracks etc, a lot of spin geared to get the public onside. It is the total opposite of course.”

In theory uc SHOULD have made things easier.

To give an example of how it worked on legacy benefits for me as a disabled single mum receiving money in bits and pieces:

Weekly but different days - child benefit and child tax credit
Fortnightly - esa
4 weekly housing benefit
4 weekly DLA - but a different week to housing benefit and not on a week I’d get esa.

So I had to design a 4 weekly rolling budget because as most of us my rent and bills had to be paid calendar monthly and as someone on benefits I didn’t have a stash of savings to give me a “head start” any I had from working had been used to feed & house us while waiting for claims to be processed.

Theoretically being paid calendar monthly, like a wage SHOULD make things easier.

And it would have IF:

They hadn’t also included the stupid punitive waiting period - again, if you’re on benefits you don’t have savings to fall back on - contrary to what a few Tory mps notably spouted when asked about this! Plus it created an instant “backlog”

They had made sure the infrastructure including staff training was properly in place BEFORE introducing it. This resulted in much longer waiting periods (for some over a year!) and many mistakes inc overpayments being made which recipients naturally believed was the correct money they were receiving and budgeted and spent accordingly so it wasn’t there to easily return when the mistake discovered.

They were using software that was properly designed to cope with fluctuating month lengths! Jesus we all KNOW not every month is 30 days or whatever why on Earth wasn’t this accounted for? Or rather why haven’t they used software that already exists for accounting tasks?

They were using software that could cope with fluctuating incomes. Again it does exist why wasn’t it used? One of the things UC was supposed to improve was the difficulty under the legacy system of going from being on benefits to going back to earning full time and hopefully not needing benefits at all. A tapered move. Well that’s been ballsed up! Plus they’ve largely removed the previous buffers that were available to benefits claimants returning to full time work, things like certain benefits being allowed to “run on” for a short period of time to allow for that time between starting work and 1st payday, help with the costs of returning to work etc

It’s been a monumental farce!!

“If even half of that effort was put into maintaining tax rates amongst big business in the UK there would have been no need to decimate existing services and remake "joined up" as "kill em off" in a joined up mask.” The idea that “there’s not enough money” is bullshit clearly! They always find money for tax breaks, wars, vote buying, mps costs, vanity projects... I think the last leg calculated Chris graylings cock ups alone cost us over £3BILLION!

“It isn't how it is designed to work but in practice, accessing work is used by the DWP to claim that your health needs are less obstructive than they were or that they were overestimated to begin with.” You’re not wrong and I know that’s happened to many, but a few have successfully appealed such decisions.

“Pushing yourself to work when you know that it will call the severity of your health needs into question and you'll lose your financial security doesn't make sense.” It often has the effect of making us anxious which of course then tends to exacerbate most mh conditions resulting in us then becoming too ill to work again - vicious circle. We become afraid to get well.

We certainly become afraid of anyone THINKING we are “doing too well” to not be up to working or only able to work part time. It’s why we do things like restrict our social media, are very careful who we discuss these matters with, are reluctant to do things like smile when outside our homes.

“If someone who is mentally ill has a psychotic break in the workplace after being forced back to work and the odd Tory voter ends up on the business end of it a different tune would be played im sure.” I dread to think what their response would be!

“Studies show that it’s actually better for people’s mental health and well-being long term to be in work or return to work as soon as possible” the vast majority of these oft referenced studies are

A based on patients with mild to moderate mental illness they don’t tend to include those with severe mental illness

B were funded/sponsored by people with a vested interest in the supposed results obtained (often the case with research of this type)

C were undertaken many years ago when circumstances were very different

The universal credit system is designed to fail.

It was never going to work as advertised, and in fact kills people instead of helping them live. This has been proven repeatedly throughout forced implementation and yet the saga continues (til no-one is left on it presumably).

Now if everyone with a disability who is (magic cured) back to work was given a job in the benefits office or down the testing centre then we may start seeing progress...

IMHO it's designed to cut government spending on benefits. Fairness and ethics were not considerations in the pursuit of that goal.

Not just in your opinion, safariboot. For example, Maria Miller stated in Parliament in 2010 that the purpose of the change from DLA to PIP was to reduced the bill by 20%.

One factor being considered in developing options for the new assessment is the need for reform of disability living allowance to deliver savings of 20% of working age expenditure.
publications.parliament.uk/pa/cm201011/cmhansrd/cm101018/text/101018w0002.htm

So that's 20% less being received by people with disabilities to pay for their basic care and mobility needs. Obviously some individuals only lost a little; others lost 100%.