Tories' plans to take half a million people off incapacity benefits

[policywonk]

There's not much detail available (that I've been able to find) but the story in a nutshell is here

IIRC, you have to fill in a vast form and be signed off by a GP to receive incapacity benefit. What 'medical assessment' are the Tories going to devise that's going to be more accurate than that? Or are they just looking for a way to take vulnerable people off higher rates of benefits?

Or am I missing something?

I agree with foxinsocks that the government seems intent on killing any entrepreneurship. Possibly a major issue for any business who takes on disabled employees is that there may be additional costs when they take someone on. For e.g., if you have a wheelchair user, make sure the building is wheelchair accessible, you have adequate facilities etc. For my company, if you want to be able to work from home for any extended period of time, they have to come and do a workplace assessment, in your home, to make sure you don't injure yourself and sue the company.

Actually the Black report and fitness for work rather than sickness for work only completed in 2008. It is gradually seeping into the system - as can be seen with the changes to benefits that have already been given dates but not happening yet.

There is also an organisation called America Works, which the govt is trying to emulate here. This is a private organisation that is paid on a per person placed back in employment basis - as opposed to private companies just getting a fee for "training" unemployed people with "work skills". Basically a recruitment consultant - working for hard cash - to get long term unemployed back into work. Tony Blair made a half-arsed attempt to introduce this with the new deal..........but the flexible new deal does go some way to introduse these types of systems.

America Works has a phenomenal success rate - up in the 80's% of people still in work after 2 years, generally in the same job. Partnership of private and public using capitalist motives seems to work.

Although I despised how he phrased it, DC had a point saying that getting them back to work would give "them a life". There is phenomenal rates of depression and low self esteem amongst the long term sick and unemployed.

ST - how does the America Works scheme deal with those (as Peachy says) who might be fine to work today, but not so fine tomorrow? Do you know? Surely it's a feature of a lot of mental illnesses that it's not possible to say whether someone will be fit for work in, say, a month's time.

One thing that would be very beneficial, IMO, would be to give people a long-term IB 'pass', so that if they take up paid employment but lose it, or find that it's unsuitable for them, they can pick up their IB payments again without any delay, and certainly without having to go through the whole humiliating claim process again.

Once you are in employment there are laws to protect you if you become ill. This is assuming you have a mental illness that is not permanently debilitating and more episodal.....sick pay, etc would cover you. It is sort of self perpetuating this scheme as far as I can tell..............people are being "sold" by the organisation basically for a commission (motivation for the org there), the employing organisation is seen to do a good deed by working "for the community" (crass but good for their PR) and the employee is back in work. Which is the best thing that can happen for many mentally ill people because it builds confidence, self esteem, independence.

And so less likely to be continually off sick

Actually the cik today / not tomorrow man I referred to does not have MH issues but a physical problem that is episodic in nature (or he might have- waiting to see iof emergency surgery today has cured or rendered permanenlt disabled)

There are a lot of physical issues like that as well as MH ones.

There are laws to rptect you if you are sick, but DH was employed during his illness and the compant tried everything (understandably?) to get rid. As it happened he recovered (still on meds but doing well in the long term, ben a good while now) but tbh it was stopping nights that did it, which the company refused help with

[Further to something I said down the thread - Osborne announced today that Tories would retain the 50 per cent rate for as long as the proposed public sector pay freeze was in operation.)

DH is a GP. This is why he likes the external assessor system and why he thinks it should be more widely used (regardless of whether it's the Tories or Labour who expand it).

1. Locum GPs - widely used - very very much more likely to simply sign off an IB form with little or no investigation. Fraudulent claimants have been proven to target locums rather than using regular GP to make claim, and (in DH's practice) simply do not attend or refuse appointments with any other doctor, which is their right.
2. GPs frequently threatened, harrassed, warned that patient will claim sexual assault etc. if form not signed. Nasty stuff that can, and has, wreck a doctor's career.
3. Further to the above, patient's family - generally resident in area - have been known to threaten GPs to obtain a signature, wait outside surgery and by car at closing time etc. Using the external assessor means that such personal harrassment far, far less easy.
4. External assessor applies one blanket definition of 'capable of work' and is completely up to date on legal and health and safety law etc. around it - GPs vary widely in their thresholds for 'capable of work' and in their awareness of the law around this issue.
5. GP can fear 'breach of confidentiality' if they think they discover something that affects eligibility to claim during a consultation. This is privilleged information so cannot be shared with the claims office unless, but still puts GP in a nasty quandry re: responsibility to patient vs responsibility to be honest with claims administrators etc.

I could go on, but I think that these points from a practicing GP can help answer this question at the beginning of the thread:

IIRC, you have to fill in a vast form and be signed off by a GP to receive incapacity benefit. What 'medical assessment' ... [is] going to be more accurate than that?

In my fifth point, I meant to say 'unless it it sufficiently serious to pose a danger to life and limb e.g. the intention to rob a bank'.

(Not that I'm sure why you'd tell your GP you were going to rob a bank, but you get my drift.)

Sounds bad Freudian.

And absolutely I do think there is a need for specialised assessors- but not like the DLA, where they are admin staff with no knowledge of SN. Have seen too many traumatised people facing tribunals with clearly disabled children to have any faith left in that.

Nurse practitioners perhaps? A middle road.

But even with the perfect tests in place it will still result in people largely gewtting different payments- so many are emans tested and based on total income, how much admin will be spent playing shuffle-the-benefit I wonder?

When dh was recovering from depression, he applied for jobs, only to find an offer suddenly withdrawn once they found out he had been depressed. They were fine with him having been off sick and now recovered, but not with mental illness.

Thankfully he found agency work, but it was a very worrying, horrible time.

(he wasn't even on incapacity benefit, btw.)

That's interesting, swc and Freudian. I see your point about the conflict of interest between having the patient's interests at heart, and being the gatekeeper to the benefits system. However, many people who have need of the benefits system need an advocate in order to make claims to benefits to which they are perfectly entitled. GPs can perform this much-needed function. Breaking this link between the claimant and the GP will contribute to the most vulnerable people not getting benefits to which they are entitled.

(Of course, it goes without saying that people who threaten or harrass doctors in this way should be prosecuted - why that's not happening is a whole different issue I suppose.)

I also see the point about independent assessors having more time to be up to date with the legal aspects. But will they be properly medically trained? Will they be fully up to date with the clinical aspects?

The CAB are good help for form filling stuff, they helped me enormously.

They can be very good Kay (my mother was a CAB worker for a long time and she was an absolute DEMON at this sort of thing), but others are not so good.

There are some volunteer agencies that have just started setting up camp in eg deprived estates and working through benefits claims with people. They've increased the uptake of benefits enormously.

Cerebra (just in case anyone reading this needs info) have an excellent guide to DLA ont heir website also- not sure if it's just child or if thee is an adult guide as well. But useful info to pass on.

There are advocate agencies about and most syndromes / etc have a charity that can advise or signpost; however by its nature a DLA claim comes at the time of either a DX or awareness of alife changing condition, when people have the least fight in them ever. Three's a lot that'sposiotive about the system- for example it is one of few things absed on actual need rather than dx (DS1's dx precludes him any actual support locally but DLA form is based on his actual life). But accessibility is an issue and advocay support should be mroe easily available. Good qaulity advocadcy- know of some charlatans charging a fortune sadly

You know, if it is adminsuistered by properly trained people I don't have an issue but (and this is my big fear) it is somewhat inevitable IME that the contract will come attached to a target of refusals. Which then turns the system into a lottery.

Yes, the targets issue is a big one (don't know whether the Tories have specified whether there will be targets). Plus the qualifications of the people doing the assessing. I have visions of it being like the people who were trained to do the home energy assessments - a six-month night course, bish bash bosh. That would be a disaster.

lol Peachy, have visions of you cowering in a corner now ;-)

I interviewed someone recently who had a 2 year gap on her CV. I asked lots of questions about it but her story was inconsistent (and quite clearly made up). I didn't take her on (there were other reasons too) but when I had a candid chat with the employment consultant, he said that she had had depression (and been hospitalised) but had stopped putting it on her CV as no-one would give her a chance once they knew that . I am sure this happens all the time.

The government needs to incentivise employers to take on those who want to work but have been on long term sick if they really want it to work. Although, as others have said, there are plenty of unemployed people as it is at the moment. I just wish there were more incentives around for developing business in the country. At the moment, everything seems to be counter that development!

whitecat's idea is a good one - doctors from outwith the area doing the assessment.