The ‘health and disability’ Green Paper, Shaping Future Support, is nominally addressed to benefits for people with disabilities and ‘health conditions’. It promises a review of three broad areas – ‘enabling independent living’, support into employment and experience of the services, but in the wash this mainly comes out as a review of two issues, assessment and employment.
On the topic of assessment, the paper has little to offer. People find the assessments are repetitive and inaccurate; the main responses are ‘triage’ and developing more telephone and video assessments. On the first point, I defy anyone to develop a triage process that doesn’t lead to people being asked some of the same questions twice – unless, of course, the purpose of the triage is to block some people from going futher. As for inaccuracy, the central problem is that the DWP is still holding to the idea that their assessors can garner more information in an hour than professionals in continuing care can collect over several months. There will be a problem for as long as the DWP continues to disregard medical evidence.
The other issue, and the issue which gets the most coverage in the Green Paper, is about employment. I apologise for repeating myself, but it stands repetition. Two million people who receive Employment and Support Allowance have been receiving it because they are too sick to work, and it is not reasonable to ask them to. I can say that with reasonable confidence, because they have been subjected to a government-set assessment that was designed to establish precisely that point. I am sure that there will be those in government who will say, ‘ah yes, but they are still capable of work-related activity’. They may be, or may not, but there has been no assessment of that; there should have been, there was going to be some relevant test, but the DWP decided not to introduce one. At present the only criterion for being deemed capable of work-related activity is an assumption, that by default people who need less support must be capable of such activity. So they are set to do things like writing a CV and invited to have their confidence built. Just what people with bowel cancer need.
One other point about the Green Paper is worth noting. Late on, in paras 300-303, it floats, for no obvious reason, the possibility of combining ESA/UC with Personal Independence Payment – despite acknowledging that the criteria for eligibility, and the assessments, are quite different. I suspect, but do not know, that this may herald an attempt to restrict disability benefits to people on low incomes.