We are hearing more and more from people who are not getting decisions on #WCA or #PIP outcomes in writing, but by phone. It is your statutory right to have decisions in writing.
This applies to a decision declaring you are fit for work, in the support group or in the Work related activity group.
It is important to have these decisions in writing to challenge decisions, complete a mandatory reconsideration ( where you disagree with a decision and want it looked at again) or to head off the ever growing bullying of the #DWP and Job Centre Plus who are calling those in the support group for work focused interviews and claiming these are mandatory- they are not.
We also want to stress again that any calls should be recorded or time noted and person’s name taken and that all documents or written communication should be sent by recorded post or email, where you will have a copy
Please pass on any incidents or problems you may have had in any of these areas to mail@dpac.uk.net
As service users and survivors of the psychiatric system, we are accustomed to people in suits ignoring our real concerns, talking down to us and believing that they are acting in our best interest even when we are telling them differently. Sadly, your comment does little to persuade us that you are going to offer us a different trajectory.
It seems you are determined to ignore the problematic issues that your pilot scheme has created, and that you are somehow incapable of comprehending how horrendous it would be for someone to find a DWP funded Employment Coach from the Maximus ‘family’ in the surgery where they seek treatment for a condition that has been exacerbated by a perverse decision in the ESA or PIP sham assessment processes, or a benefits sanction which has removed their very means of survival and independence. Unfortunately such events are now everyday occurrences in your borough, and the areas to which your pilot is intended to spread. It seems we all have to somehow get used to these injustices because all the safeguards appear to have failed. Rather than providing effective opposition to these outrages, you and your pilot seem set on adding to the misery.
We told you that we would meet with you when you are ready to have an adult discussion with us. You are clearly nowhere near ready to do that. I suspect that rather than genuinely reaching out to us, your comment is merely public posturing in the hope that some people will be persuaded by your whitewash.
As we noted in the Open Letter, your Assistant Chief Executive confirmed that this scheme is specifically aimed at claimants with Mental Health issues. You attempt to play this down by telling us that claimants do not even need to be on benefits to participate in the scheme. This is clearly you dodging the issue, as your signature appears on a document which states (at page 17):
“The Council has agreed an ambitious target to reduce the number of people claiming ESA by 2,660 by March 2019”.
“This will mean triaging and focusing the majority of our time, support and resources on those claiming Employment Support Allowance (ESA), Income Support and people who have been claiming Job Seekers’ Allowance or not claiming any benefits and who have not worked for a long time.”
We simply do not believe that there are many people who are long term unemployed and not claiming benefits, although we are painfully aware that Tory welfare reforms have led to the disappearance of a large number of claimants.
We are not convinced or reassured by your claim that “none of the personal patient information from the scheme is, or ever will be shared with JCP or the DWP” bearing in mind that your own council has made it clear that Remploy/Maximus Job Coaches will “add updates directly onto the patient’s medical record”. How do we know they will not pass on information? Unsurprisingly, we have no interest in being part of any scheme that gives corporations direct access to our personal medical records, and we find it shocking that your council and the CCG have adopted so cavalier an approach to patient privacy.
You single out Disability Action in Islington, and quote them as calling for making “current employment, apprenticeships and volunteering support services accessible and inclusive to disabled people”. Nothing in that quote suggests that this means they support the idea of GPs being prompted by a computer screen to nudge their patients towards employment coaching by Remploy/Maximus staff in the surgery. In any case the word ‘current’ can hardly be used to describe a pilot which would not have been current at the time. Perhaps you should approach all the DPOs in the borough and ask them specifically if they are happy with a scheme that runs the risk of replacing health care and treatment with ‘prescribed’ job seeking aimed specifically at getting 2,660 people of ESA? In fact, we may well do that ourselves……..
When the pilot was announced, you said that the aim of the scheme was to “promote the idea of employment for people with health conditions”. Later, your Assistant Chief Executive stated: “Considerable attention has been paid to using this service as an opportunity to embed employment into the ‘wiring’ of the healthcare system” Promoting the idea of work appears to be a far stronger motive than making services more ‘accessible and inclusive’. It shows that the pilot is part of a policy agenda which sees the only relevant indicator of someone’s health and worth being whether they’re working or not.
We have come across another document which seems to be undated – and appears to be an attempt to defend the pilot from our criticisms. That document, like your reply claims:
“The pilot is entirely voluntary. People can opt out at any point. Once begun there is absolutely no obligation to continue.”
You fail to tell us what steps have been taken to ensure that patients understand that the scheme is ‘entirely voluntary’ and that they do not have to take part in it. Many patients would feel compelled to do what their doctor suggested, for fear of being seen as a ‘difficult patient’ if they declined. Most patients would be unaware that the doctor was being prompted by their computer via an Islington scheme to promote the pilot, and if made aware of that fact and the fact that they could say no without fear of being flagged as difficult patients , we suspect you would find take up to be very low , especially if they were also made aware that joining the scheme would give staff of the Remploy/Maximus group direct access to their patient records.
Here is a bit of history for you:
In July 2014, the Tories were already publicly discussing stripping claimants “of their state allowances if they refuse to undergo treatment for anxiety and depression”. They announced plans for a trial which involved hiring “specialist private organisations outside the NHS and welfare system to take control of providing a combination of psychological and employment support to claimants”
In May 2015 your party failed to win the general election and the Tories gained overall control of parliament.
Four months later your Borough, in partnership with the DWP, started a pilot which placed Remploy/Maximus staff in GP surgeries. Your trial did not even include provision to ensure that psychological support would be provided to those claimants who became part of the scheme.
So, even if it is true that participation in your scheme is voluntary at this time, and even if that is being made clear to patients, you are in no position to reassure us that when the pilot is rolled out further, without any formal evaluation having taken place, that conditionality will not be introduced at that stage.
You chose to ignore our points about in work poverty, and the fact that current working conditions in many jobs would be detrimental to many claimants with Mental Health issues. They still stand, and until they are addressed, your reassurances that Islington “has a long and proud history of being on the side of our disabled and vulnerable residents” in no way proves that this scheme is good for us, or that it will not undermine the GP/patient relationship, or that it will not lead to sanctions/workfare and conditionality for disabled people.
Your Labour council should be resisting the Tory attacks on claimants with Mental Health issues, and not mirroring their policies or assisting their implementation.
We will definitely be demonstrating against the pilot on March 4th and we will continue to fight it thereafter.
I have just been sent the link to this blog post and wanted to take this opportunity to clarify our position and again extend an invitation to meet with you to discuss your concerns over our ‘working better’ programme.
I want to start by again reiterating that ‘working better’ is an entirely voluntary scheme. This is a service that is available for patients to join voluntarily if they feel it would be beneficial, it is absolutely not forced on them. Once a patient starts seeing an employment coach there is no obligation that they have to continue and finish. They also do not have to be claiming any benefits to be part of the scheme and once again, it is in no way linked to benefits or sanctions.
I would also like to be very clear that none of the personal patient information from the scheme is, or ever will be shared with JCP or the DWP.
We initially piloted ‘working better’ as a result of the recommendations from the Council’s Employment Commission after listening extensively to disability groups locally.
During its research the Commission heard that disabled people or those who have a long-term health condition or are recovering from illness may need more support and some practical adjustments to enter the workplace.
It also heard how there are some groups, including disabled people that continue to face discrimination in their job search – many of whom just want to be given a chance to show what they can do.
The commission heard from Disability Action in Islington, who called for: making “current employment, apprenticeships and volunteering support services accessible and inclusive to disabled people”
The commission’s final report, called for establishing employment support services where people with extra needs already went – such as GP surgeries.
The scheme is not about work being a ‘cure’ or ‘fix’ for people’s impairments and health conditions. It’s about doing more to break down barriers and help make employment support services more accessible and inclusive to the disabled people who want to benefit from them.
While I do understand your concern over workfare and the sanctions regime – both of which I share, I do believe your opposition to ‘working better’ is misguided.
Islington council has a long and proud history of being on the side of our disabled and vulnerable residents. In 2013 we were the first council in the country to declare a vote of no confidence in ATOS because of their work capability assessments locally. We were the council who led the charge to save the Local Welfare Provision fund, which provides a vital safety net for some our most vulnerable residents. We have also just ring-fenced vital financial support for vulnerable disabled residents who were previously supported by the Independent Living Fund.
I would very much welcome the opportunity to meet with you and discuss this further.
The Welfare Bill will go back to the House of Lords on the 29th of February. That is what is called ‘Ping Pong’ and this will happen until the 2 houses reach an agreement
DPAC will keep on fighting to stop this nasty cut of £30/per week to people in the ESA Wrag Group, and if it goes through we will take and support legal challenges against it.
You can read the debate here and can see how MPs voted in the Commons on Tuesday 23rd Feb to reject the original Lords Amendments that would have prevented the cut going ahead. You can look up your MP on there – if they are not listed – it means they abstained or they were not in the Commons at all (which may have been for perfectly legitimate reasons. – There is a case of an MP who was vilified for not attending a commons vote – it turned out that at the time of the vote – she was in labour giving birth to her first child! ) .
[Reblogged from Johnny Void with thanks] A recent investigation of 50 estate agents carried out by Hackney based tenant’s group DIGS found that just one studio flat was available for people on benefits in the entire borough.
The phrase No DSS will be all too familiar to anyone on benefits who has tried to secure a home. It is a meaningless phrase, referring to a government department that no longer exists. What it actually means is no Housing Benefit. and it is used to discriminate against the poorest tenants whether they be low paid, out of work due to unemployment, sickness or disability, are parents or pensioners.
In some cities wages for many full-time jobs do not come close to meeting ever increasing rents. The so-called ‘Living Wage’ is not even enough to pay an ‘Affordable Rent’ in many parts of London. Tenants who have to rely on Housing Benefit to pay some of their rent are increasingly being excluded from the private sector completely.
This is something many people do not understand. It is hard to find a home if you are poor. Even if you can raise the eye-watering deposits demanded by landlords, or pass their credit and reference checks, then if you need benefits to top up your rent you will be rejected. These policies are a key driver of homelessness. In the case of disabled people they are almost certainly illegal under the Equalities Act. But still it continues as the private rental sector operates as an outlaw class, ignoring laws they don’t like, openly boasting of their discrimination on landlord’s websites and treating their tenants – the ones buying them a house in many cases – with complete contempt.
With social housing fast disappearing then it is time to consign this nasty bigotry to history. A campaign launched by DIGS in response to their investigation is a good start. As they say:
“At Digs, we believe that everyone should have a decent, secure and genuinely affordable home regardless of how much they earn. We also believe that people shouldn’t be forced out of areas like Hackney simply so that landlords and estate agents can make greater profits.
“We’re launching our #YesDSS campaign this month to put pressure on letting agents, landlords, mortgage lenders, councils and the government to make sure that no-one should be prevented from renting a property simply because they receive benefits.
“This is why we’re launching our #YesDSS campaign this Saturday (27th Feb), 11am outside Hackney Town Hall and ask you to invite all your friends and come down: https://www.facebook.com/events/183799625313280/”
[Reblogged from Boycott Workfare with thanks] Employment coaches have been placed in six GPs’ surgeries in Islington. ‘Jobs on prescription’ is part of toxic and dangerous government plans to merge health and employment services – putting the Jobcentre in the NHS. Boycott Workfare, Mental Health Resistance Network, and Disabled People Against Cuts will be protesting the scheme from 3pm on 4th March, outside City Road Medical Centre. For more details on the protest and our reasons for opposing the scheme, see the Facebook event, this co-written article on the DPAC website and this letter from a GP about work cures and the duty to #DoNoHarm.
This guest post is an open letter from Mental Health Resistance Network to the leader of Islington council, Richard Watts.
Dear Councillor Watts
As you are aware by now, the Mental Health Resistance Network are involved in the organisation of a demonstration due to take place outside the City Road Surgery in Islington on March 4th. The protest is intended to voice our disquiet at the introduction of Job Coaches into 6 Islington surgeries, in a pilot project which has been enthustiastically promoted by yourself and Dr. Josephine Sauvage, a GP at City Road surgery, and Joint Vice Chair (clinical) of Islington CCG.
We first learnt about this pilot in an article in Pulse Magazine, and immediately suspected that that the DWP were likely to be central to this scheme. Our suspicions were confirmed when we found a document, authored by Kay Peat, the CCG Employment Lead for Islington CCG. The document makes it clear that Ms. Peat’s job is directly funded by the DWP, and that the Working Better’ pilot which you and Dr. Sauvage were promoting is also directly funded by the DWP. Furthermore, Ms. Peat’s document confirms that Remploy, a company mainly owned and controlled by Maximus, have been engaged to provide the Job Coaches that Dr. Sauvage says she will be ‘prescribing’ to her patients.
Maximus, as I am sure you are aware, have taken over from ATOS, in conducting Work Capability Assessments for those claiming Employment Support Allowance. What you may not know is that we at the MHRN instigated a judicial review of the WCA which found that the procedure “disadvantages people with mental health problems, learning disabilities and autism”.
People with Mental Health issues already have a lower life expectancy of 15 to 20 years, and we are against any merging of health of job seeking services which would make it more difficult for them to access health care. We constantly talk to people who say that they need their Mental Health symptoms to be dealt with before they feel ready or able to start looking for work. Frankly, when you are suicidal or being abducted by aliens work is the last thing on your mind.
We were thus interested to read your recent statement that our “fears about the scheme were “misplaced” because it was “entirely voluntary and not linked, in any way, to any welfare-to-work conditionality or sanctions regime”. This was coupled with a claim by one of your council spokespersons that ” he had been told by Remploy that it was “a completely separate company and brand” to Maximus, and that “Maximus have absolutely no involvement in the Working Better project and none of the coaches are from Maximus”.
It didn’t take long for us to establish that on their own website Remploy state that “MAXIMUS brings commercial knowledge and expertise to the joint venture and will work with Remploy to build on its existing success”. Elsewhere on their site Remploy lists amongst its board members its chair, Akbar Piloti, who is the President and General Manager of MAXIMUS Human Services, overseeing worldwide Child Support Services, Child Care, Child Welfare, Workforce Services, and Tax Credit and Employer Services. Along with Mike Batty:
“With more than 20 years’ experience in financial operations, Mike became the Director of Finance for MAXIMUS UK in January 2015. Mike is responsible for leading the financial organisation across all four business streams in the UK”
And Leslie Wolfe:
“Leslie is General Manager MAXIMUS UK and is responsible for all aspects of its business lines in the United Kingdom. Prior to moving to the UK, Leslie held key roles for MAXIMUS in Canada and the USA.”
So, as the Remploy website proudly notes on its front page, it works in partnership with Maximus. The statement by your spokesperson does not bear up to scrutiny, and neither, it would appear does your own claim that the DWP funded-, and Remploy/Maximus-run scheme is “not linked, in any way, to any welfare-to-work conditionality or sanctions regime”. As we have already noted, Mental Health claimants are placed at a substantial disadvantage in the WCA process, administered by Maximus and the DWP, and those who score 15 points and are then placed in the WRAG group are at serious risk of being sanctioned by the very same DWP which is funding the pilot in your Labour Borough.
You have asked us to suspend our action and to meet with you to discuss the scheme in more detail. We are unlikely to do so. As Ms. Peat notes, “The pilot started in September 2015 and is due to finish in September 2016. No formal evaluation of the pilot is planned however it is being used as a pre-trial for the Supported Employment Trial”. This means that it is then likely to be rolled out in other areas, and we are intent on doing our utmost to persuade GPs not to get involved in the scheme.
Our concerns are numerous. We do not trust Maximus, nor do we trust the DWP, and we are concerned that people who are in need of treatment will be deterred from seeking help if they have cause to believe that doing so may result in them being ‘prescribed’ employment coaching instead of the treatment that they desperately need. Your Assistant Chief Executive also confirms our fears that Remploy/Maximus would gain direct access to our medical notes (at paragraph 4.3):
“enabling the employment coach to add updates directly onto the patient’s medical record (with work planned to assess whether this is happening in practice); and encouraging the coach to present the service to a practice meeting as the first step towards the integration of clinical treatment and employment support”
We are aware that to date the DWP welfare reforms (many of which were initiated when your party was in power) have led to many MH claimants having their benefits slashed, being sanctioned and a significant number of deaths. Very few long term MH claimants have actually moved into jobs, and we long ago gave up on being swayed by the rhetoric of welfare reform and austerity, we focus instead on what we see actually happening to ourselves and others.
We know that GPs such as Dr. Sauvage bear witness to the difficulties people facing MH difficulties face in securing actual appropriate treatment for the issues they struggle with, as patients are being discharged from secondary care back to primary care at an alarming rate, MH budgets are being slashed and at best most patients can expect superfical interventions such as time limited referals for CBT or to the ‘Hubs’ being trialled in other Labour Boroughs such as Lambeth (where the Hub is based in the Streatham Job Centre) and Southwark (where the Hub is based in the so-called Employment Academy). We marched against the introduction of CBT inside Streatham Job Centre, and now we learn that as part of your Islington scheme, there are also plans for CBT to be provided in the DWP Job/Sanctions Centre. No doubt as a councillor you have come across people who experience thses difficulties in your own surgery.
Another of your claims is that “We know that employment is one of the best ways to tackle poverty”. Again this does not bear up well to scrutiny, with a marked increase in in-work poverty and the growing likelihood of Universal Credit claimants facing sanctions if they cannot secure longer hours or higher wages. We have also seen a rapid increase in the use of zero hour contracts.
Until you are ready to start having real discussions about the real issues we are stuck with having to organise demonstrations in order to bring attention to the complicity of elected Labour officials such as yourself with the “welfare-to-work conditionality or sanctions regime” that you so clearly are engaging in and promoting.
Let us know when you are ready to do more than verbally distance yourself from the very same ‘welfare-to-work conditionality or sanctions regime’ you have elected to partner with and promote.
In the meantime, we will see you across the barricades.
The Mental Health Resistance Network
Campaigners from Disabled People Against Cuts, Mental Health Resistance Network and Boycott Workfare will meet outside City Road Medical Centre (190-196 City Road , London, EC1V 2QH) on Friday 4th March from 3pm.
See the Facebook Event Page for further details. If you can’ t get there on the day there will be an online protest – further details will be posted on this page nearer the time. Please also support the thunderclap for the protest.
DPAC is writing to you to urge you to vote against a cut in ESA for claimants in the Work Related Activity Group (WRAG). We will not go over again the reasons for the Lords to vote against it, but we wish to present further evidence which undermines the government rationale for doing this, and especially the 1% statistics presented.
‘We must not forget that ESA WRAG was not a golden solution; it had been criticised by all parties for a long time. Only 1% of claimants a month were coming off that benefit into work’.
This statement echoes Lord Freud’s statement during the 2nd sitting on the 9th of December 2015 although moving into work was not mentioned: ‘However, only around 1% of people in the work related activity group leave the benefit each month, so clearly the existing policy is not working as intended and is failing claimants’http://www.publications.parliament.uk/pa/ld201516/ldhansrd/text/151209-0002.htm
Lord Freud in an addendum gives the explanation for the 1%: ‘Explanation of the 1% figure used in the policy note The 1% off flow figure is derived from caseloads and off flow statistics published through the DWP Tabulation Tool. The latest figures show that 17,000 of the 477,000 WRAG claimants (March 2015 to May 2015) left the benefit. This equates to 3.6% for the quarter and as such an average of 1.2% each month’.http://data.parliament.uk/DepositedPapers/Files/DEP2015-1009/151203_Peers_Briefing_Addendum_-_Clauses_13_and_14.pdf
Although the statement is true, it does not reflect the reality and a department employing a huge number of statisticians such as DWP would know that. What needs to be looked at is not the number of claimants leaving the WRAG per month, but the cumulative number of ESA claimants leaving the WRAG against the total number of claimants placed in the WRAG.
Between October 2008 and March 2015, 573.200 New Claimants have been put in the WRAG and since 2011, 488.400 reassessed IB claimants have also been placed in the WRAG, which means a total of 1,061,600 claimants have been placed in the WRAG.
Obviously, the situation is more complex, as there is an interaction between the assessment phase and the WRAG, and some claimants in the WRAG would have been subsequently placed into the Support Group, while others would have appealed, but these figures are either not known, or they have not been submitted, and MPs and Lords have been asked to make an informed decision on the basis of incomplete, and in the case of the 1%, misleading figures.
The Lords have found no evidence to support the assertion that benefit level was negatively associated with employment.
We hope that you will take this into consideration.We also wanted to make it clear how the 1% figure has been misrepresented ahead of the vote on Tuesday deciding if disabled people in the WRAG should lose one third of their income
PS: you will find as an attached printscreen of all the tables referred to in the main submission (this is shown below)
How the 1% was calculated according to Lord Freud:
First by looking at the off flow of people in the WRAG over a quarter (March to May 2015) = 16,940
Then at the total number of people in the WRAG in May 2015:
The number of people in the WRAG is 476,500. So the percentage of claimants in the WRAG leaving the benefit was calculated out of the total number of claimants. This percentage is 3.5% for a quarter, which equals to around 1% per month.
Let’s look now at the cumulative number of ESA claimants placed in the WRAG:
New Claimants
IB reassessments:
That means that (573.200 + 488.400 ) 1,061,600 claimants have been placed in the WRAG since October 2008.
Caseload in the WRAG in May 2015:
Caseload: 476,500 claimants out of (573.200 + 488.400 =) 1,061,600 claimants placed in the WRAG between October 2008 and March 2015. The number who left the WRAG over this period is 585,100
The Government’s latest proposal to turn GP surgeries into Jobcentre Plus must be treated with extreme caution. The Islington GP surgeries that have agreed to pilot this scheme have, perhaps unwittingly, crossed another boundary which plays into the wider agenda of blurring functions and roles of public servants. Hidden behind the deception of “joined up” services lies a de-professionalisation and lowering of standards the public can expect. Merging of functions and budgets will also provide richer pickings for corporate takeover which is the intended endpoint. Meanwhile respected public employees like GPs will be used to set the precedent.
My experience of patients who have had benefits stopped has not been encouraging. Most have gone on to appeal the decision and won. Many were clearly not fit for work and their accounts of the assessment often beggared belief. One patient sticks in the mind. A 62 years old man with severe Parkinson’s disease who despite medication was struggling to function requiring help to dress and wash himself, walking with the classic shuffling gait and experincing disabling tremors in his arms. He was summoned for a work capability assessment. To my shock he was deemed fit to work. Others have been driven to relapse of chronic mental health disorders and the desperation of relying on food banks. The DWP and its outsourcing partners are interested in one thing alone and that is to reduce the spend on benefits. The impact on those refused benefits that then go on to suffer extreme financial hardship, psychical and mental harm as a result of ludicrous decisions are the collateral damage the government is quite happy to inflict.
As a general practioner I am well aware of the financial and bureaucratic burdens deliberately places on practices struggling to provide safe high quality care with diminishing budgets and staffing vacancies. It can seem tempting when government offers alternative financial opportunities for cash strapped practices to grab them only later to realise how temporary and damaging the deals have been and for what purpose they were offered up. Much of what I am tasked to do with my patients neither serves their best interest nor clinical priority. Limited time and resource is constantly being diverted to activity which has no significant health benefit for patients but has income attached.
The Jobs on Prescription schemes will damage the doctor patient relationship particularly for people with mental distress and physical disabilities. The GP will be seen as an agent for the DWP with a potential conflict of interest in advising patients into job focused interviews. No doubt in time the role will be given to less qualified staff with perhaps less ethical objection. Bonus payments for getting people off benefits could speed up the achievement of the government goal to reduce the benefits bill. The constant focus on benefits and work add further psychological burden to people eroding self-worth and esteem. The threat of “conditionality” implying you either engage or face sanction hanging heavily over claimants. The subliminal message is that the patient is to blame by choosing not to comply so whatever happens they bought it on themselves.
Doctors need to remember their duty to do no harm. Patients pressured into employment schemes or put off seeking medical care from doctors they no longer trust may come to harm. This is against our ethical duty and should be rejected for what it is a draconian attempt to deny basic financial safety net for sick and disabled people.
The introduction of job coaches into seven Islington GP practices has caused a storm of protest. Here a coalition of mental health and disability rights activists, claimants and concerned local residents explain why they are opposed to ‘jobs on prescription’
Government aims to turn GP surgeries into JobCentrePlus
The arrival of job coaches in Islington GP surgeries exposes the toxic reality of government plans to merge health and employment services. In a move that is both unethical and unsafe, health professionals are being tasked to deliver benefit cuts for the Department for Work & Pensions (DWP). This involves a raft of measures to support the imposition of ‘work cures’, including setting ’employment’ as a clinical outcome and allowing employment coaches to directly update a patient’s medical record.
Islington GP Pilot
NHS Islington Clinical Commissioning Group (CCG), who oversee local health care, has accepted DWP funding to ‘drive employment outcomes through strategic health commissioning’, in a move intended to enforce the mantra that ‘work is good for you’, whether it is or not.
‘Jobs on prescription‘ targets people with long term mental health conditions and is being piloted in seven Islington GP practices, as part of a £90K collaboration between the council, the Jobcentre, DWP, and Islington CCG. In other words, a partnership between healthcare and the government departments responsible for administering benefits, including the punitive and unaccountablesanctions regime – a system which is known to disproportionately affect people with mental health conditions, as well as disabled people and those with long term health conditions’ please.
Destroying patient trust
The first casualty of government efforts to interfere with clinical judgment is trust. The scheme will undermine trust between doctors and patients and could discourage disabled people and people claiming benefits from using healthcare at all, if doing so is seen to be linked to pressure to find paid work or loss of benefits. An activist from Disabled People Against Cuts warns that
“many disabled people already feel they have to watch every word they say when seeing their GP, in case it is used against them at some point to stop their benefits. Placing Jobcentre-funded staff in doctors’ surgeries could destroy the doctor/patient relationship and may lead to some people not accessing vital healthcare when they need it most. Many will feel that the GP surgery is not a safe space to discuss their health concerns if a GP can prescribe job coaching. This pilot will pile pressure on patients in mental distress who are already suffering.”
Discredited private contractor Maximus
Employment coaches for the pilot are provided by Remploy, (the recently privatised employment service for disabled people). Remploy is owned by Maximus, the private company contracted to carry out Work Capability Assessments, a process independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing, and found by a judicial review to ‘disadvantage people with mental health problems, learning disabilities and autism’. Evidence that Maximus falsified the results of ‘fit for work’ testshas been raised in parliament and their conduct in both the US and UK has been very widely criticised by claimant and disability rights groups. Maximus was also recently accused of trying to bribe doctors away from the NHS with salaries well above average rates to carry out ‘fit for work’ assessments. It is difficult to imagine any organisation less suited to working in partnership with primary care or with a worse record in relation to mental health and disabled people.
JobcentrePlus Invasion
The Health and Work Programme for Islington explicitly aims to integrate employment support in the ‘map of medicine’ and fully intends to get people into work, whatever their circumstances, and – through the new, improved ‘fit note‘ – to keep them working, whether they are sick or not. In a move that will worry many GPs, Islington Health and Wellbeing board intend to make “employment status” part of the Patient Held Record. Every health care professional will soon be obliged to prescribe the work cure, whether or not they (or the patient) believe this is in the patient’s best interests. This is the real meaning of the board’s intention to “embed employment into the ‘wiring’ of the healthcare system”.
The Islington pilot is part of DWP efforts to place Jobcentre advisors in libraries, in schools, and even in foodbanks – whose use has skyrocketed in the last six years. The presence of the Jobcentre turns these into places where people are coerced into work, no matter how ill-paid, precarious, or unsuited to their skills and other responsibilities. DPAC and the Mental Health Resistance Network said:
“At a time when some claimants have been driven to suicide by the constant bullying, assessments, threats and sanctions that now form part of the UK’s benefits system, there must be no place in the NHS for Jobcentre busy-bodies. Disabled people, benefit claimants and supporters can and will defeat this appalling attack on the fundamental principle that healthcare professionals should ‘first do no harm’.”
These takeover plans do not end with health. The DWP aspires to ‘join up’ all public services to ‘get local people back to work’, including transport and housing. These developments also support the extension of benefit conditionality – the hoops you have to jump through to be eligible for benefits – to a much wider range of people and a much wider range of circumstances.
Mandatory referral
To date there has been no consultation with patient or claimant groups. It is unclear whether there are safeguards in place e.g. to ensure patients are told that choosing not to see the job coach will have no impact on either their health care or their benefits. A promise from Richard Watts, leader of Islington council, that the scheme is entirely voluntary is not reassuring, given that the whole idea behind the scheme is to ‘promote the idea of employment for people with health conditions’. Both service users and health professionals have every reason to suspect that patients will feel under pressure to agree to see a job coach and that over time the scheme will become mandatory.
A spokesperson from MHRN said:
“our concern is that this scheme will not be voluntary. Over time it will become mandatory and lead to sanctions and loss of benefits, as the doctor becomes part of the DWP scheme to force claimants into low paid or unsuitable jobs that will undermine the patient’s condition.”
The case for mandatory treatment for people with long term conditions (first flagged up in the Conservative Party Manifesto) is currently being reviewed, including whether benefit entitlements should be linked to ‘accepting appropriate treatments or support’. Such a move would have extremely serious implications: consent is invalidated if it is given under duress, for example if it is linked to loss of benefits or the fear of loss of benefits. Nevertheless, this is precisely the direction that government policy is moving in and represents a serious threat to the independence of health professionals and to the human rights of patients.
Unemployment labeled a psychological disorder
The Islington pilot comes at a time when unemployment is being branded as a psychological disorder, for which work is the cure. Welfare-to-work companies bid for lucrative contracts to deliver Entrenched Worklessness Provision to ‘change the hearts and minds’ of unemployed people. There are further plans to locate iCOPE (Camden and Islington Psychological Therapies Service) staff in Islington jobcentres, compromising their clinical judgment by embedding them in a coercive ‘back to work’ environment. Commenting on these developments, Paul Atkinson, a psycho-therapist for thirty years, said:
“While health care professionals see the experience of being in sustainable employment as potentially therapeutic for some patients, it’s naive to believe that welfare-to-work policies are led by the interests of the individual unemployed benefit claimant. I am afraid the DWP is a toxic brand for most claimants, and I think for a growing section of the public”.
Such plans also mean placing therapeutic services in a setting responsible for administering the benefits system, including sanctions. A member of Boycott Workfare said:
Support for unemployed people has little to do with helping people apply for jobs or get useful training. Increasingly, it is about making people express a positive attitude to unpaid work and short-term, low wage jobs – under threat of sanctions or other punishments.
Enforcing the work cure
Justification of the Islington pilot relies on a ‘work is good for you’ mythology that denies the reality of the labour market: the stark inequalities in pay, conditions, and security that make it entirely misleading to talk about ‘work’ as if everyone benefits from it.
For many disabled people who do have the capacity to work, gaining a decent quality, fairly paid, stable job does improve their independence and quality of life. And many disabled people do work, and others who can work yearn to have this kind of job.
But this end of the jobs market is often closed to disabled people, with employment discrimination rife and little or no enforcement of the Equality Act. Cuts to government support, (including the access to work budget), which previously enabled disabled people who can work to gain employment, mean that disabled people have to ‘make do’ with low-paid, short term, low-end jobs for exploitative employers. While the government sinks funds into coercive programmes, funding for Motability and Access to Work has been cut– these are schemes that have provided real practical support to disabled people who wanted to obtain or stay in work. A member of Boycott Workfare said:
“we’re always receiving complaints from people who are trying to continue with courses that would give them real skills and qualifications, who face pressure from the DWP to abandon them for workfare or farcical ‘training’ from DWP contractors.”
For growing numbers of people, work does not provide a wage you can live on; for others, it is something feasible on some days, but then not for weeks at a time – a fact that the DWP is determined to ignore. Work is not necessarily ‘good for your mental health‘ either: for many people, especially those in unpaid or low paid, insecure jobs, the workplace is a site of long hours, exploitation, petty tyrannies, bullying and stress.
Mental health services ‘ruining lives’
Islington’s decision to invest in job coaches in GP surgeries comes at a time when mental health services have been neglected, marginalised and under-funded for years, when services are so bad that lives have been “put on hold or ruined” and “thousands of tragic and unnecessary deaths” have been caused. It comes at a time when many people are blocked from accessing the services and support they need, including physical health care. People with mental health problems already have a lower life expectancy of nearly 20 years, mainly due to preventable physical illness. Mental Health Resistance Network said:
“Where is the parity of esteem that the government keeps shouting about? How are barriers to accessing healthcare addressing our lower life expectancy?”
The pilot has been designed without any consultation whatsoever with mental health, disability rights or claimant groups, who are wholly opposed to the scheme and the values underpinning it. DPAC said:
“patients will simply not engage with the health care system with schemes such as this. They will be too afraid if the result is further pressure, further mental distress and further harm. We can see this scheme, if it is rolled out, having a tragic human cost and driving a patient to suicide if pushed. That is not what a doctor should be involved in. They should support the patient and remember the ethics of why they became a doctor in the first place: to care for the patient and above all else Do No Harm.”
Fighting back
Last year, plans to put Improving Access to Psychological Therapies (IAPT) services in 350 JobCentres led to major protests. 400 mental health professionals signed a letter opposing the imposition of ‘back to work’ therapy and describing linking social security benefits to “state therapy” as ‘totally unacceptable’. The protest against job coaches in GP surgeries is attracting even greater support, as growing numbers of health professionals, patients, activists and concerned members of the public come together to protect the fundamental principle of medical care: first do no harm. We will fight any efforts to merge our health services with services responsible for benefit cuts and benefit sanctions. We call on Islington CCG and its partners to immediately terminate this scheme.
[Article by Dr Lynne Friedli and Robert Stearn]
Campaigners from Disabled People Against Cuts, Mental Health Resistance Network and Boycott Workfare will meet outside City Road Medical Centre, 190-196 City Road , London, EC1V 2QH on Friday 4th March from 3pm
See the Facebook Event Page for further details. If you can’ t get there on the day there will be an online protest – further details will be posted on this page nearer the time. Please support our thunderclap for the protest
Remember to be careful when putting things on your Facebook profile. We know that many of you put a brave face on and most photos don’t tell the full story. However DWP will use screen grabs of you smiling as evidence that you are not in pain. I’m in court today for a fraud case where main evidence is from Facebook and stationary photos from a wedding, odd holiday and pictures of her standing.
It’s that simple dwp have access to your Facebook if they already suspect fraud is being committed. Therefore everyone getting dla/esa / pip should ensure there are no public photos that may be misconstrued showing on their FB or twitter.
Not wanting to scaremonger but we are getting calls/messages from on average 5 people a day accused of fraudulently claiming. We have a private platform away from FB and a secret group if you are worried about posting. Posting is fine however it’s the facebook photos that are used as evidence in all the cases we have represented in. I even had a lady who was generally in a wheelchair dragged into a compliance visit after a wedding photo of her stood, (what they didn’t see was her friends were holding her up) was used as evidence. She won her case after dragging 3 of the friends into court to give evidence, however it took a year, she lost her DLA and car and part time job in the process as had been accused of fraud.
A simple check through your tagged and album photos is often all it takes.
On Friday 26th February, support Switched On London’s campaign for energy democracy by tweeting at Sadiq Khan, calling on him to back our proposal
A million Londoners are in fuel poverty, with out of control fuel bills leaving us choosing between heating and eating in the winter. Meanwhile, the big energy companies rake in bumper profits.
While Labour London Mayoral candidate Sadiq Khan says he’s serious about bringing down the cost of living in our city, he’s silent on the question of fuel poverty, cold homes and spiralling bills.
But Switched On London – a coalition of community organisations, environmentalists and trade unions – have a plan for how things could change. We’re calling for a public owned energy utility company in London as a people’s alternative to big energy companies. Driving new investment in renewables and energy efficiency, offering affordable fair prices, controlled democratically and run for the public good, not for profit.
In the run up to the London Mayoral elections, we’re calling on Mayoral candidates to take a stand for something that would cut bills and cut pollution. But we need your help, starting with Sadiq!
On Friday 26th February, join our Twitter-storm, piling on the pressure on Sadiq to back our proposal. Let’s keep the tweets rolling in all day, so that Sadiq and his team can’t ignore us.
Here’s a few ideas for tweets, but please do get creative…
.@SadiqKhan London is getting ripped off by big energy companies. Will you back @SwitchedOnLDN’s public alternative? http://www.switchedonlondon.org.uk
.@SadiqKhan Don’t let Zac outdo you on green issues! Back @SwitchedOnLDN’s call for a people’s clean energy company http://www.switchedonlondon.org.uk
Your response has been magnificent – here are the testimonies that you sent us……
Your Name
Why do you support the Junior Doctor’s Strike?
Lyn Matthews
We should value those who care for our sick and dying. Junior doctors saved my dads life. They work hard & Hunt is wrong in the way he is treating such valued professionals. I support them 100%, as do many others. Hunt is a liar & wants to see junior doctors forced into private health care & use it to sell off the NHS. Everyone should support the Junior Doctors because they are valued and needed by us, the patients.
Lyn Bruce
With complex health issues, and under more than 1 consultant and 2 hospitals. I couldn’t afford health insurance. If these Doctors leave I don’t think I’d survive.
Silver Lining
We lose too many medical staff to Australia and New Zealand as it is, why drive more of them there, or to Scotland, Wales or other places? On top of that, there have been many times in my life I have been to A & E or been an in patient in hospital late at night and have been professionally and compassionately looked after by a junior doctor. These ladies and gents have ALREADY been providing the NHS with a 7 day service for many, many years. I feel the compromise offered by the BMA was fair and for the government to impose terms that the BMA and their members are not happy with upon people who save countless lives- especially in the wee small hours every single day in every hospital in the country- is dictatorial, disrespectful and grossly unfair. I also feel that at a time when we are struggling to recruit people to train as doctors and nurses, why do something that will that will make training even less appealing?
Penny
I have had two successful Bowel cancer operations, these couldn’t have happened without junior doctors and all NHS staff, who don’t need Jeremy Hunt’s imposed weekend working contracts
Iain Macleod
I believe Junior Doctors are grossly underpaid considering the responsibility they have to bear and the amount of hours they have to work in the most vitally important lifesaving work they do, I very much doubt if any politicians would stand up to the plate in similar circumstances, please listen to them before the country loses there vital skills, behind them. 100 percent
Jane Gorman
Government proposals would be bad for patient care as well as junior doctors in the long-term.
Joe Whittaker
The decision taken by Mr Hunt to impose a “contract”, is in my view, not an unintended consequence of failed negotiations. The Government is determined to undermine key aspects of the NHS, to create fractures across NHS staff. Today junior doctors, tomorrow consultants etc ; the disharmony being orchestrated, within our major public service makes it more susceptible to the privatisation that is happening in a systematic and deliberate way by thisTory Government. We have to support the BMA, to support The Junior Doctors.
Anon
53000 intelligent thoughtful well educated reasonable people are not all wrong – perhaps Jeremy hunt is? I had a stroke 3 years ago and was in hospital for 3 months – I have direct first hand knowledge of how hard these people work at the weekends – ancillary staff – radiography / physiotherapist / speech therapy and the consultants are the ones not there at weekends …. Jeremy hunt is trying to stretch the NHS – without more staff or more pay – stretch it any further and he will break it! Jane Speedy
Thomas Sutcliffe
Jeremy Hunt is co-author of a book arguing for the ‘denationalisation’ of the NHS, and every decision he has made as health secretary has been to the detriment of the NHS. People who are tired work less effectively than those who are not, and Jeremy Hunt’s new contracts will mean a lot more tired doctors. A contract only becomes valid once it has been signed, so I suggest that the junior doctors next move should be a universal refusal to sign.
Andrea Mitchell
Because I support a welfare state & am opposed to cuts. I ❤️NHS
Bec Fawcett-Howitt
I support the junior Dr’s 100% because I have a long term degenerating spinal condition. I need the NHS & all the staff because I wouldn’t be able to afford private treatment. It was a junior Dr & a nurse who saved my daughters life when she was struggling to breath. I need the NHS for her so she can grow up with a superb health service. A junior Dr treated my Son in A&E after he’d had a fall. The Dr was calming, understanding & was at work on a Saturday morning, treating my child & hundreds of other children. I need the NHS for him so he can grow up with a superb health service.
We all need the NHS, the dedication of our doctors, nurses, secretaries, porters, consultants, paramedics, everyone who puts effort in to make our NHS great.
Junior Dr’s, I support & stand with you. We will not let Jeremy Hunt & the Tories destroy our health service.
Neil Devlin
The proposed contract would stretch staff & resources too thinly.
Peter
It’s a hellish job very few people can do, certainly not Jeremy Hunt.
Philip Bayes
I fully support the Junior Doctors striking as the Government are putting them in a difficult situation without them having a say by expecting them to work 7 days a week it is putting the NHS & Patients both @ risk, Jeremy Hunt should now do the decent thing & resign as the Health Secretary, who on earth voted this lot back in last May lets push to get Hunt out, Junior Doctors work hard enough already in bad conditions.
Alex Reed
I worked in the NHS for more than 30 years and a member of my family is unwell and in hospital at the moment. Care from junior doctors has been excellent, 7 days a week. NHS staff deserve respect, not Hunt’s contempt.
Mel Errington
Gradually the real reason for the government-driven change of doctors contracts is being exposed – current contracts do not suit the private sector. They must be changed, so that the NHS can be fully privatised.
Peter
I am a retired welfare Sec of Unison for seven years supporting staff cope with bullying by egotistical power hungry management by MP’s, who make arbitary threats (which is a breach of contempt of Parliament) which causes ararm and distress, course of conduct in breach of the Harassment Act 1997, even though the doctors felt alarmed and distressed themselves not being the direct target of the course of conduct, the doctor felt alarmed and distressed over the safety of the patiants in hospital or attending any GP, or any NHS services.
Elen Counsell
I have MS and am totally reliant on my health care team. As well as monthly infusion in hospital and out patients appointment , I regularly attend A&E for emergency treatment for relapses. It is essential that I feel confident that those attending me are rested and equipped to make qui quick and accurate judgements. Any sense that my health care team is working under duress and therefore hampering there. Judgement and demeanour affects my stress levels and therefore exasperates my disease.
Steve D
Junior Drs are the backbone of the NHS and we need to give them an honest remuneration and composite working conditions. We as a country have invested 100s of thousands of pounds to provide the UK with the best Doctors in the world. These junior Doctors have always been there day and night for me with emergency admission to hospital. I support and stand by our Doctors.
Bridget
because I would rather not be treated than be treated by someone so tired they made mistakes
Julie
Because I share their concerns about patient safety and appreciate their skill and dedication for the benefit of all my family. And because I love our NHS
Steven McGuire
they are our future get a grip tories
Bruce Armstrong
As a person with multiple sclerosis, I know how hard Junior Doctors work and how highly their skills and knowledge should be valued.
Pam Sanby
I know Hunt and his side-kicks and cronies are out to destroy OUR #NHS .. It doesn’t belong to the government, it belongs to the people of this country. £30billion of our national insurance contributions are being sat on, they can only be spent on OUR #NHS or welfare. Once the #ToryRentBoys do away with both that money will be lost to us, the people. This blatant attack on the junior doctors is a smokescreen for the inevitable privatisation of OUR #NHS .. Don’t be fooled! The vultures are waiting by the sidelines and please believe me the attack on the junior doctors is another step into handing OUR #NHS over to private companies at knock down prices.. They’ll make it look like they’re swooping in to save the day when OUR #NHS fails … They’re not! This has been going on for years and all the backhanders (oh sorry, donations) to support the Tory party does seem to come in handy!
John
They are working very hard and they are putting vulnerable people at risk with the long hours they are working on now.
Hazel
I love the NHS. I’m proud of it and the fantastic work it does. I believe this junior doctor contract devalues and further demoralises these wonderful and highly motivated staff and is about paving the way for more privatisations – the worst possible outcome.
Sandra Bowes Rennox
We need real talent in doctors but we don’t doctors who are so worn out that it risks our lives. .Hunt doesn’t get it and he needs to stop acting like a school yard bully…We don’t like it. .we’re human beings not cattle.
Zoe Robinson
Doctors work hard, under extreme pressure, to provide an excellent service. We should be supporting them by making their jobs easier and encouraging more people to go into healthcare, not penalising them for political point-scoring.
Hilary Griffin
Junior doctors are highly qualified health professionals who should be paid well for their efforts, experience and expertise. They often remain in post as junior doctors until they are 40 years of age. Doctors frequently marry other hospital doctors. I understand that under the new regime married couples who are both hospital medics will not see much of each other. These incredibly hardworking medics are entitled to a proper family life. If their basic needs are not met they will simply emigrate to countries like Australia where they will enjoy better working conditions. I understand it costs in the region of £250, 000 to train a doctor. We will end up funding the training of medics only to see them emigrate en masse. These medics have my full backing.
Chrissie
I fully support the junior doctors in their justified actions for patient safety, & for an NHS run by concerned health care staff, not by ideologically driven government or profit driven companies.
Daisy May
I was born in May 1945, just as the second world war had ended. It was a home birth as there was no NHS and a midwife was only fetched in dire emergencies because very few could afford to pay for her services. What no one knew then was that I had been born with a congenital dislocated hip, something which is very common and is routinely checked for nowadays, and a “splint” the simple treatment to correct it is usually began fairly soon after it is spotted. However, my dislocated hip was not checked for and went undiagnosed throughout my early development. My parents told me years later that I screamed constantly, and this must have been because my hip was growing in an unnatural position. I do not know all the facts regarding why I did not receive corrective treatment before 1948 at the age of 3, other than even basic medical care had to be paid for at that time. It was never really discussed as my parents marriage had collapsed under the strain of having a disabled child, who had to be carried everywhere. I only found out years later about my surgery in 1948 because I had reason to request my medical records and it was then I saw it. Because there was no NHS when I was born, this simple check and easily corrected condition, went unnoticed. It not only resulted in three years of pain and suffering for a child, and countless operations, lasting until the age of seven, but has been the cause of a lifetime of disability. We must never go back to those dark days before the NHS, there must never again be a two tier service, for the “have’s” and the “have not’s”. The NHS gave all people in this country a level playing field, regardless of status, generations, since 1948 have paid contributions into the NHS, it belongs to the people of this country, it is not for sale and neither are it’s fabulous overstretched staff !
Roger
The action by Jeremy Hunt parallels that of Thatcher in trying to break the miners union. It will be a very sad day for the Health Care Service when a known liar sets the terms of employment.
Jo Green
Where do I start? I’ve seen the mess of the NHS first-hand, through an acute physical and mental health breakdown. I’ve seen the under-staffing, and witnessed a matron on a ward saying there were no more staff available. The ward I was on contained patients that should have been in psychiatric care, and others that were detoxing from alcohol. This was a GI ward. The Drs are thinly-spread, in all honesty, due in a huge part to Govt’s continued determination to stop NHS Bursaries, and to stop poorer people entering the NHS. Basically, if you aren’t minted, you can sod off, yet the minted don’t want the caring jobs; they want the careers. The NHS is being attacked, splintered, primed for sale. I support the Junior Doctors for standing their ground, for going way beyond the call of duty, and for being the life-savers that they are. They are a lot more than life-savers though.
Mike Llywelyn Cox
Junior doctors have save my life twice: once post surgery for bowel cancer and once at 1.30 am in A&E when I had perotinitis.
Micheline Mason
Doctors have saved my life and the lives of many of my loved ones. I believe this fight is about patient safety and is coming from people whose integrity is intact, unlike the people they are fighting. They are also exposing the hidden agenda of privatisation of the NHS, already underway. I hope they do not sign the new contracts en masse.
Sam Brackenbury
Years ago a wonderful doctor, Dr Julien Kahn, (Not her surname now) saved my life and was always there when I needed help, Her wonderful care helped me stay alive and get sober… She told me that as a junior doctor she regularly had to comfort relatives whos relations had been in severe accidents (Many Fatal) and afterwards she would be expected to work a double shift, without any consideration for the mental stress this put her under..
She was one of the most giving people I have ever met in my life, I owe her and my P.A. everything!
How dare Mr “I wrote a book on Privatising the N.H.S”… Hunt enforce this awful contract!!!! All N.H.S. staff have MY FULL SUPPORT!
You are the backbone of the nation…. “Unt prepare for a scrap you Tory Ponce!
Anon
as a person with a heart complaint and a major back problem doctors of all position have been there for me so ill try to help them now
Lou
10 days ago my mother was admitted at 1 pm to the Royal Shrewsbury Hospital, by 4pm she had been operated on and sent to a ward, the care from ALL the staff was amazing, the doctors quite simply saved her life and made sure she continued to get better, they did this all with a smile were cheery caring and gave her and us the time we needed to understand what they had done, why, and what would happen in the future, no disrespect to any other profession they look after ‘people’ you don’t mess or use money as a tool to alienate anyone who looks after and save lives of people, humans. Nor do you ask them to work even longer hours, perhaps if the hours were less and there were more doctors the medical negligence compensation bill would be less. Give them the respect pay and safe hours they rightly deserve
Jucam
The junior doctors are fighting for decent working conditions. Without those they can’t treat patients safely. They are also fighting for our NHS
Marisha
Excellent that DPAC is doing this as I fully support the Junior Doctors !!!!!!!!
Bill
I have copd and heart and neurological problem . Twice my life has been saved. We need alert well paid doctors
Maciej Poplawski
Every person earning their living honestly should have a chance to defend and improve their conditions and rights, especially when it needs to stand against its own democratically elected government to do it.
David Herbert
Without the NHS and dedicated staff including Junior doctors I would not be able to live a normal life. I would probably be bed bound.
Elaine Evans
100% Support. Without the Junior Doctors many of us would not be Alive, with Jeremy Hunt many of us will not be.
Anon
the doctors are being attacked for doing their jobs by a reactionary and nasty mr hunt making their conditions and pay worse by making them work unsocial hours and days without recompense and impairing their judgements not giving them progression to a consultant and scope to advance their careers , We need to recruit more doctors in the UK to save
Susan Martin
I see how hard they work on a daily basis, and the hours they work for no pay, if they were paid for the hours they worked and claimed expenses like the politicians the NHS would be bankrupt in a week and to impose this contract on them is an insult to their intelligence. The Government have used arguments that do not measure up and are not proven to get the public to turn against the junior doctors they will do anything to get the public on their side. Why don’t they make banks open 7 days a week so people can actually access them when they need to or why don’t politicians work weekends so people can see them when they need to? Doctors don’t only work extra hours but continually spend their time off revising for exams they need to further their careers few people are aware of this but I see it on a daily basis. Their leisure time is also given up for the benefit of patients. I agree that more doctors are needed for 24 hour cover at weekends but these need to be recruited not making the doctors we have work more and more hours for no remuneration.
Lorraine Ann Williams
This insidious government has brought misery to millions! Persecuting the sick and disabled and old and poor. Stripping the UK of everything for the elite 1%! I’ve had enough!!!
Lisa
They work very hard, and helped my father when he was ill in hospital.
Ivor Adinuff
I’ve never supported the privatisation of the Health Service, and totally abhor people being misled. Junior Doctors already work 7 days a week; the mortality death at weekends is higher, but there is no evidence showing that it is linked to the hours that the junior doctors work. Junior doctors are amongst the top 1% educated in this country and fully understand your proposals; they are not in the best interest of neither the patients safety, nor the juniour doctors. You may want a mass exodus, to enable you to have a run down service and, thus, justify privatising the health service – if this is the case, then come clean and say it, rather than privatising the Health Service through the back door.
Another win for DPAC, Inclusion London and individual DPAC activists and their tenacity in the face of Tory attacks
Rather belatedly earlier this week Justin Torysnake, minister for disabled people met with ILF campaigners and confirmed that the government is to provide Local Authorities with four further years of transition funding for former ILF (Independent Living Fund) recipients, taking it up to the end of the parliament in 2020. This follows much campaigning by disabled activists.
At the moment no local councils seem to have been informed of this additional funding so we are suggesting anyone who should benefit from this funding contact their local authority to tell them about it and ask whether they will be ring-fencing it for its intended purpose.
On 10/02/2016 the Department for Communities and Local Government published a six-week consultation on the plans, which describes the funding it proposes passing on to local authorities over the four years from April 2016. Annex B gives Local Authority Allocations. This is the link: https://www.gov.uk/government/consultations/former-independent-living-fund-recipient-grant
We also suggest that people might want to contribute to this important consultation.
Help us and the Junior Doctors by filling in this simple form with a name and your reason why you support the Junior Doctors
We will use the material you supply to make up campaign material to show DPACs and disabled people’s support for the Junior Docs, and the NHS against this vile Tory government and Jeremy Hunt in particular
See below Duncan Smith’s furious response to Frank Field’s letter (chair of the Work and Pensions Committee) about mounting evidence of deaths of social security claimants while Duncan Smith has been in charge.
A spokesperson for DPAC said “The response about why DWP does not collect data about claimant deaths is bullshit. If there is any doubt that welfare reform is causing death it should be checked. Look at the Francis inquiry into NHS deaths as an example, the DWP could do this – they don’t want to “
Another spokesperson for DPAC said ” if the polite inquiry from Frank Field sets IDS off like this, just wait till he sees what DPAC has in store for him later on this year “……. watch this space for more information on that in the coming weeks.
So finally we see some angry scrawl at the bottom of the page – we can’t read it, so if anyone wants to have a go at deciphering it, please send it in via the comments below this post. And if there are any graphology experts out there who want to have a go at analysing IDS’s state of mind when he wrote that scrawl – we would love to hear from you via email mail@dpac.uk.net
So the doctor says to their patient “I’ve got some good news, and some bad new. The bad news is you’ve only got six months to live … but the good news is that I’ve found you a temporary job working in Poundland.”
You might have noticed that this joke is not very fucking funny. But this is the dream of council bureacrats in one London borough who are developing a horrifying strategy for local healthcare which will see “employment viewed as a clinical outcome.”
Whilst the final plans for Iain Duncan Smith’s localised Health and Work Programme have not yet been released, the Labour dominated Borough of Islington are jumping aboard the gravy train early and have set up their own scheme to tackle what they call ‘health-related worklessness’. In a report published in 2014 the so-called Islington Employment Commission – a bunch of local employers, councillors, Jobcentre busy-bodies and a token TUC representative – called for radical change in the borough’s employment support strategy. Their proposals mirror almost exactly the current direction of Tory social security policy, even down to using the same words.
All young people should be ‘learning or earning’ according to the commission, a phrase first used by David Cameron when he announced the yet to materialise mass workfare programme for all those under 21. They also claim that many long term sick or disabled people are not receiving enough employment support because “their benefit does not require them to look for work”. And for those who do have to look for work as part of their benefit conditions, they say the support is not good enough, and they think they could do better. In fact salaries depend on it. As such they recommended establishing a local Health and Work Programme to make ‘maximising employment a priority’ for healthcare services.
Six months later Islington Council teamed up with Islington Clinical Commissioning Group who oversee local healthcare and ominously formed a partnership with Jobcentre Plus. The DWP were only too happy to help and agreed to fund the salary of an Employment Lead worker to work at the heart of Islington’s NHS services to “to drive employment outcomes through strategic health commissioning”. What this means is money meant for healthcare will instead be shovelled into the hands of grasping welfare-to-work parasites with the aim of reducing “entrenched worklessness among residents with a health condition or disability in the borough.”
One of the first moves, which is already sparking local outrage, is to introduce Employment Coaches into six GP’s surgeries in Islington. These tax payer funded busy-bodies will come from Remploy who were recently sold off to giant US outsourcing company Maximus who already run many Jobcentre services. Doctors will be encouraged to refer patients for employment support with the same company who carry out the despised Work Capability Assessment used to stop disabled people’s benefits by finding them fit for work. A company that has been the target of ongoing protests by disabled people and benefit claimants. It is hard to imagine a bigger insult to disabled or long term sick people in Islington. But then perhaps that is the point.
This is leafy, lefty Islington, and so there is lots of gushing talk about quality of life and creating living wage jobs in the proposals for the new scheme. They don’t really mean it though. In Islington Employment Commission’s report they discuss how some residents object to taking the first job they are offered because it might be unsuitable or low paid. According to the commission local employers have told them this is not the case and that people should be prepared to take a job that isn’t perfect no matter how shit, just to get their foot on the ladder. But then they would say that wouldn’t they. Islington’s Health and Work service is being designed with the needs of employers in mind, not local people.
As such, whilst evidence shows that low paid, insecure, or unsuitable work is bad for your health, doctors will still be encouraged to coerce their paients into taking these jobs. And whilst Islington Councillors and healthcare bueracrats salve their consciences by telling themselves about all the wonderful opportunities they are creating for disabled people, their partners, Jobcentre Plus will provide the teeth – in the form of vicious and life destroying benefit sanctions – to ensure compliance. Iain Duncan Smith must be pissing himself as the liberal elite dance to his tune in Jeremy Corbyn’s backyard. If he can get away with this shit here, he will consider he can do it everywhere. And that is why it must be stopped.
A protest has been called outside City Road Medical Centre, 190-196 City Road , London, EC1V 2QH on Friday 4th March from 3pm. Please spread the word, more details on the facebook page.
Thanks again to Joe Halewood which published today an article with a new defining judgement of the Upper Tribunal on the bedroom tax. In its judgement, the tribunal has decided what is a bedroom.
What it means practically: Joe estimates that this new decision will concern around 150,000 claimants, about 1/3 of all people affected by the bedroom tax. But what it also means is that each and every single tenant can and should appeal a bedroom tax decision and get their local council to inspect the property to check whether their spare bedroom(s) conform to the definition given by the Upper Tribunal of a ‘bedroom’. The idea is not only to get the local council to revise some bedroom decisions, but alsoto clog up the system, to make it unmanageable and too expensive.
Joe’s article is here: https://speye.wordpress.com/2016/03/31/bedroom-tax-the-defining-moment-as-ut-decision-makes-it-history/
It contains an explanation of the Upper Tribunal decision plus a template letter for you to use, and send to your local council. That is the kind of direct action which can bring down the bedroom tax .
This was the original article by Joe Halewoodpublished on the 3rd February 2016.
Many thanks to Joe Halewood (@SpeyeJoe https://speye.wordpress.com/ for another excellent article which is attached below and which he allowed us to republish.What
In a nutshell, the Upper Tribunal has stated that the Housing Benefit Department of your council should have considered all relevant circumstances of any individual case before making a decision. So within one month of receiving your Housing Benefit decision in March 2016, you should send a letter to ask your council to reconsider the decision as you don’t believe all relevant circumstances have been considered in your case. Joe gives you examples in his article of what might not have been considered. See below.
And if you don’t like the outcome, you can write another letter to your council to say you disagree with their decision and require the matter go to the tribunal. It is free and it is legal. Follow all the instructions given by Joe Halewood .
Every one has a right of appeal against the decision and they SHOULD use that right.
It does not mean that the decision will be overturned in your case but it is a direct action to get the government to back down from what is an awful and damaging piece of legislation. If everybody or most people affected appeal, the savings brought by the bedroom tax which are already minimal will disappear, and the bedroom tax will become such an expensive policy that it cannot be defended and sustained.
The bedroom tax will eventually go, but we can make happen earlier rather than later.
Bedroom Tax – Let’s all cost IDS £1.26 billion per year and get rid
Jeremy Corbyn tweets a story in today’s Mirror which says that the Tories are to spend more in legal fees appealing last weeks Court of Appeal defeat than the ruling would cost them to implement.
IDS is prepared to waste taxpayer’s money in spitting out his dummy is the implication and it’s a correct implication.
So is what is good for the goose good for the gander?
When 449,151 bedroom tax households get their new bedroom tax decision notices in March this year, which on average cuts their housing benefit by £795.72 per year then ALL 449,151 could appeal this decision which is their right and if they did then each First-tier Tribunal costs central government £2,800.
The bedroom tax cuts saves government £357.4 million [449,151 x £795.72] yet if everyone appealed the decision then 449,151 bedroom tax appeals will cost government £1.26 billion – or 3.5 times what they wish to save from it.
For every £1 allegedly saved, the government would be spending out £3.50 to defend that decision in simple terms.
Every one has a right of appeal against the decision to impose it and they SHOULD use that right.
It costs nothing to appeal and it would severely damage the policy by a form of lawful direct action.
All it takes is a letter with a signature within one month of receiving the HB decision notice and handed in to your local council’s one stop shop or office.
Sample letter to explain the simplicity of this below.
Include the date and your HB reference number and/or NI number and say as an opening paragraph the following.
Dear sirs,
I request that you reconsider your housing benefit decision dated dd/mm/2016 as I maintain you have not considered all relevant circumstances of my individual case which the Upper Tribunal state you must do as the decision maker in paragraph 54 of the three judge panel in [2014] UKUT 0525 (AAC).
Then you need to say (a) why you maintain a room is NOT a bedroom and then (b) sign it and hand it in.
There are many reasons you could give as to why you maintain the room or rooms upon which you have been deducted bedroom tax are not a bedroom and I cover some of these at the end (also in blue.)
The key issue is that you appeal as part of a direct action protest which is lawful and a legitimate form of protest – else you would not have the right to appeal in the first place – and these appeals all going to the tribunal service would cost central government £2,800 each.
All it takes is one letter with a signature. Your council’s HB department then have to conduct a reconsideration of the decision and say, in writing to you, why they maintain the original decision was correct to impose the bedroom tax.
Then you could email your council’s HB department (this second step does not necessarily need a signature though the first step does, hence a letter) to say you disagree with their decision and require the matter go to the tribunal.
One letter and one email is all it takes.
Is 1 letter and 1 email worth the trouble to potentially save £795.72 per year? Of course it must be and note many of the 449,151 bedroom tax cases could have very legitimate reasons of appeal.
If EVERYONE appealed which I restate is your absolute right, then this would cause an almighty political stink as well as cost the government much more than they could possibly save. So what!
The fact such a direct action protest would bring the matter to a head and do to IDS what he is now doing by using taxpayers money to appeal the Court of Appeal decisions which will cost more to appeal than the government gets if it wins – is example the same principle.
Do unto IDS as he is doing unto you!!
____________________
Some valid and arguable reasons why a room is not a bedroom are below and kept deliberately short.
I maintain that 1 room is not a bedroom as it does not conform to the minimum size requirements in order to be a functional bedroom in accordance with Tudor Walters issues as stated in paragraph [55] of the above 3JP case
I maintain that 1 room is not a bedroom as of its unusual design and layout
I maintain that 1 room is not a bedroom as to put a bed in that room would deny access to a built-in cupboard
I maintain 1 room is not a bedroom as it has no window
I maintain that 1 room is not a bedroom as it is not ventilated in the same way as other bedrooms
I maintain that 1 room is not a bedroom as it is not heated as other bedrooms
I maintain that 1 room is not a bedroom as it is needed for therapeutic other uses.
I maintain that 1 room is not a bedroom as it is not of normal height
I maintain that 1 room has a sloping roof and it not a bedroom
All of the above are very legitimate legal reasons why a room is not a bedroom even if the landlord says it is a bedroom and you only need to add one reason in the original letter and in addition to the opening paragraph as drafted.
There will be and are dozens more reasons that have all been upheld at tribunals or in which the decision has been changed before the matter going to a tribunal.
One such reason which was an example of common sense and good practice was a case where an 8 year old girl and her 5 year old brother were sharing a bedroom which is what the regulations say. Two children of opposite sexes can share a room if both under 10.
Yet the 8 year old girl started her periods and after discussion and consideration the council bedroom tax decision maker agreed that the girl needed a bedroom of here own which she clearly did. Note too that the NHS have this on their website:
Most girls start their periods when they’re about 12, but they can start as early as 8, so it’s important to talk to girls from an early age to make sure they’re prepared before the big day.
So we see the NHS admitting that some girls start their period as young as 8 years of age.
Regrettably many councils believe they do not have the discretion to do this and must stick rigidly with 2 children under 10 must share a room for bedroom tax purposes. However every council decision maker DOES have discretion and they are free to determine in the individual circumstances that the housing need in terms of bedrooms was not 1 for the 8 year old girl and her 5 year old brother, but, as a matter of correctness 2 bedrooms or a bedroom each.
The example above is used because it illustrates what I drafted in the opening paragraph of the letter above in the council decision maker considering all relevant circumstances on a case by case basis which is what paragraph 54 of the legal precedent says. In discussing what is and is not a bedroom and how decision makers approach that question paragraph [54] says:
We also agree with the Secretary of State that the choice by Parliament of a test using an undefined familiar or ordinary English word supports the view that Parliament intended to allow decision makers to take account of all relevant circumstances on a case by case basis
All relevant circumstances on a case by case basis is discretion for the decision maker and so decision makers – and they are your local councils HB department and no one else – have to consider my points 1 – 9 above and also have to consider the much rarer examples of an 8 year girl starting her periods as I illustrate.
In summary, the most important issue and for me the quickest way to get rid of the bedroom tax is if all 449,151 households who are currently affected write 1 letter and then insist in 1 email their council refers their individual case to tribunal to cost the government £2,800 or so.
I have been in receipt of Disability Living Allowance since 2000, and have had to reclaim every five years. As such I was sent a DLA reclaim pack prior to my claim coming to an end on the 23rd of June 2014. Initially I thought I had been sent the wrong form and checked that I was to complete the DLA reclaim form and not the new Personal Independence Payment.
For various reasons known to many of us the form took so much time to complete. Filling bits out here and there made even more difficult for me due to dyslexia. I spent hours trying to track down an electronic copy to fill in and eventually ended up scanning pages into my computer manually.
I finally finished the form and sent it off with every bit of medical evidence I had including a letter of support from my GP and waited.
At the beginning of August I opened my post box to see the dreaded brown envelope and my immediate thought was that it was a reassessment for ESA. It wasn’t it was a letter from DWP DLA Blackpool informing me that I was not entitled to claim DLA however my claim could be ‘treated as a new claim for PIP’.
Obviously confused by this I rang the DWP and asked for an explanation to be told that as the reclaim form had arrived at their office 6 days after the end of my claim I had fallen outside of the reclaim period and my DLA had ended on the 23rd of June. However, the information provided was enough for the claim to be treated as a claim for PIP and that I should wait for the PIP Unit to get in touch with me.
I asked for a Decision Maker to look at the decision again and was again told over the phone that my DLA had ended but the claim would be ‘treated as a claim for PIP’ and again to wait. The DM also suggested I might want to contact my MP about this issue, something I have never had a DM say to me or others I know.
I duly contacted my MP, to be honest in a bit of panic as I had been using my DLA to cover the £20.00 shortfall in my Housing Benefit as a result of the Bedroom Tax. My only relief was that I could never afford to use the mobility allowance for a Motability car and so at least I didn’t have my car removed. Although finding the money to keep it on the road I knew was going to be very difficult.
I explained what had happened and asked for someone to get back to me as soon as possible. Two weeks passed so I emailed again, this time even more stressed and panicked. Another week went by so I emailed again this time not so polite and deferential.
Finally, I got a response but to my previous email not the stroppy one and so felt even more stressed that I had not exactly made myself likable to a woman I was asking to help me. So immediately emailed again to apologise.
What followed was a series of emails between me and the person in her office who was tasked with ‘Welfare Problems’ arguing over where PIP was being rolled out and to whom, the understanding of various Regulations and Statutory Instruments (pretty much a pissing contest) which yet again impacted on my growing stress levels.
I really didn’t expect when I got in touch with my MP I would know more than the person I was dealing with and so ended my communication with her office with a ‘I thought you might be able to help; I now realise I was barking up the wrong tree’.
Apparently when you do this some people’s ego goes into overdrive, I was mistakenly copied into emails between my MP and the person ‘dealing’ with my case. In which he stressed again and again ‘I am right!!!’. I got one last email from my MP a short one liner “I am sure he is right, sorry”’ At that point I didn’t know who to be angrier with the DWP or my MP’s office who thought it was more important to be right than actually help a constituent.
By this point over a month had passed since my DLA reclaim had been rejected, financially things were getting very tight. I had to borrow some money to pay for the car tax was worried about winter because my home has rotting window frames and an inefficient heating system. I was starting to think that I would just have to give in and make a fresh claim for PIP and forget about the weeks I had already been waiting, which was little comfort as daily there were reports about how badly PIP was rolling out and the massive backlog of claims to be processed.
Despite trying and trying to get through to speak to someone at PIP the phone was either engaged or I was placed in a queue which I couldn’t afford to be stuck in on a mobile phone.
I checked my emails to see yet another email from my MP’s office where he detailed what he thought the issues were with the reclaim. After reading it I realised that right from the beginning he hadn’t actually grasped what my problem was and was just giving me general information. I explained again and also apologised for being abrupt but that this situation was having a very real impact on my health
I was graciously forgiven and then told how amazing my MP is and what a good job she does working with disabled people and that he himself had been congratulated for his breadth of knowledge on the subject at a parliamentary meeting. I bit my tongue because I realised even if my MP was of no use it was better for the DWP to think that an MP was involved in my case the hope being that they wouldn’t mess me about any more than they already had.
I managed to get through to someone in the PIP Unit who told me that the information about being ‘treated as a PIP’ claim was correct and that she would get someone to contact me urgently to explain the process and let me know what the progress of my claim was.
Three weeks went by and the promised urgent phone call hadn’t materialised. I contacted the Unit again only this time to be told the exact opposite of what I had been told previously. My stress and frustration at this point was going through the roof so asked to speak to a manager. I was put through to a Manager who officiously told me that both the letter and information received about the claim being treated as a PIP claim was incorrect and that the letter I had received hadn’t been ‘worded properly’ and he advised me to contact the New Claims department of PIP to request a claim form.
I was stunned, and again not my finest hour but I do remember saying rather forcefully that if he thought I was going forget about weeks of waiting he had another thing coming and did he enjoy earning a wage deliberately misinforming people and making their lives even more complicated and stressful than it already was. Again emailed the MP’s office to update them on this new contact. Then went for a drive to try and just get away from thinking about it and calm down. It was really hard not to feel that this wasn’t a deliberate tactic of the government to make it as difficult and as stressful as possible to dissuade people from claiming Social Security. The news was getting worse regarding the PIP roll out and peoples experience of it.
I then managed to track down what ‘treated as a claim for PIP’ meant.
SI 2013/380 – Interchange with claims for other benefits
S25 (4) Where it appears that a person who has made a claim for disability living allowance or attendance allowance is not entitled to it but may be entitled to personal independence payment, the Secretary of State may treat any such claim alternatively, or in addition, as a claim for personal independence payment.
(5) In determining whether the Secretary of State should treat a claim as made alternatively, or in addition to another claim (“the original claim”) under this regulation the Secretary of State must treat the alternative or additional claim, whenever made, as having been made at the same time as the original claim.
Universal Credit, Personal Independence Payment, Job Seekers Allowance and Employment Support Allowance (Claims and Payments) Regulations 2013.
I sent this to my MP’s office and said that given this information could they please contact the DWP urgently and ask them what the status of my claim was. Which they finally did and on the 19th of September 2014 I finally found out that yes my DLA claim had lapsed due to it reaching the DWP 6 days late but my claim was being treated as a claim for PIP and would be backdated to the date of claim (for DLA).
They went on to apologise to my MP for the lateness of their response and gave an excuse as to why there had been a delay in dealing with my claim but nowhere did they express any acknowledgment to me and nor did my MP think it was worth pointing it out.
That was the last contact I had with my MP’s office, she had been little to no help, had increased my stress and anxiety and forgot to delete my address on an email thread where she had asked if her staff member could ‘bear getting in touch with me’. I had to spoon feed this person what the issue was and track down the Statutory Instrument that related to treating one claim as a claim for different benefit. The only thing I couldn’t do is make the DWP treat me with the same respect that they treated my MP.
I then waited till February 2015 for a Disability Assessor to come out to my home and assess me, then waited again for the outcome. It was an extremely hard winter my car broke down, I couldn’t’ afford to heat my home and my diet was the worst it has ever been.
In April I got fed up of waiting so rang for an update to be told that a decision had been made and money was in my bank. I had not been awarded the mobility component, the thing that I needed. So asked them to resend the original decision letter as well as an explanation has to how the Decision Maker had reached that decision.
I got that letter at the end of May the next day I got another brown envelope through the post informing me that after a Mandatory Reconsideration the decision remained the same! A Reconsideration I hadn’t asked for, but had impressed on the person I had last spoken to that I needed to have sight of the original decision and reasons because time was running out for me to decide whether or not to ask for a Mandatory Reconsideration and gather any further evidence I could in support of my claim.
I can only assume that someone at the DWP realised that my claim had been a cock up from start to finish and were covering their backs. I was at an extremely low point emotionally and mentally and so took the decision to not pursue it to appeal or even to argue about the fact that I hadn’t asked for an MR. I felt too deep into a Kafka nightmare to be able to do anything other than accept what I had been awarded.
My PIP claim from start to finish took 42 weeks, 42 weeks of hell that I never ever want to revisit. Even writing this has brought back some of the anger and frustration I felt at the time.
Do I regret not questioning the mandatory reconsideration or pursuing it to Appeal? Yes, I absolutely do, my car has finally reached the point of no return and my health has progressively worsened. I’m waiting for a neurosurgical consult and another MRI, being without a car has had a huge impact on my ability to take care of myself in terms of shopping, engage with anyone outside my home and getting to GP and Hospital appointments is now a major mission of planning and physical effort which I cannot sustain. So yes I do regret it but then again at the time I don’t know if I would have had the strength to have pursued it to the end and I suppose at least I am in receipt of the Living Allowance which provides enough of a cushion to start this whole sorry process all over again.
By Toni
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