Assessing cancer patients for ESA

Most people in receipt of Employment and Support Allowance are treated as needing preparation to return to work. It has taken a little time for government to realise the implications of that process, but an informal consulation on the circumstances of cancer patients suggests that the penny has started to drop. When I was interviewed on Radio Wales on 28th April last year, I took the treatment of cancer patients as an illustration of the problems. What I said was this:

“Of the people who are down here as having neoplasms, which are various tumours, we have 33% who don’t get signed off. Some are being found fit for work and some don’t complete the assessment. Now of course, it’s not that people basically say, ‘I’ve got cancer, I’m stopping work.’ What happens is that people are uncertain. They don’t know. They want medical assessment. They want clarification. They are unsure about the situation. Theyhope that things will be different. It takes time to sort this out. And what we’ve increasingly got is a system that is treating people mechanistically, ticking boxes, and saying ‘sorry – wrong boxes – go away.’ “

How copyright threatens academic communication

Wikipedia has announced that it will shut for a day, in protest about threatened restrictions in the USA which will enable rights-holders to shut down sites that breach copyright. My website, like the rest of my writing, is scrupulously referenced, but I have considerable sympathy for Wikipedia’s position. The laws on copyright present a serious obstacle to learning, communication and intellectual development.

As a writer, my work is often used by other people without any form of recognition. Students, journalists and some academics routinely borrow from, copy or plagiarise what I have written. This may rankle, because it’s rude and incompetent, but for the most part I have to put up with it. To publish a work is to place it in the public domain. I expect – or hope – that my work will be read, discussed, and disseminated. The most disappointing experience is not when my work is cited without payment or acknowledgement, but when it sinks under the waterline. I’d much rather that people read and used my ideas than that they didn’t, and I’ve never encountered an academic who thinks differently.

The laws do not work in the interests of people like me; they work against us. The main effect of current rules about copyright, for any teacher, researcher or writer of non-fiction, is to restrict the ability to cite, illustrate points and argue with positions. I can’t use extended quotes from historic figures like Keynes or Beveridge. I’m barred from duplicating some texts first published in the sixteenth century. I can’t afford to use any photos in my books – the standard fees for two or three photos will consume all the royalties for eighteen months’ work. Many respectable peer-reviewed journals insist on full assignment of copyright, without payment. The primary function of the copyright laws is to defend, not the creators of intellectual property, but the interests of the businesses who have secured the rights.

Laws have to be developed to permit the free flow of information. The main rights that need to be protected are the rights of commerce – that people cannot present themselves as someone else, and people should know what they are buying. The laws go much further than they need to do to make that possible. The current rules on copyright, related to the time of death and some bizarre rules about assertion of rights, make it fiendishly difficult to decipher what is available for duplication, what isn’t, and who owns the rights. There’s only one kind of restriction that stands a chance of being understood and respected – that is, as we have with patents, a right to exclusive production for a limited, fixed period of time following publication. And that’s not what the law says or does.

Systems thinking

I attended a dreadful lecture last week about “Systems Thinking”, which had little by way of thought, or indeed of system. Systems thinking was, and could be, a distinctive set of methods for analysing complex relationships within an entity; but the term seems for the moment to be a catch-all term used to describe flexible, responsive organisations that are open to using information. Ideas like Kaizen, Lean and continuous improvement have been drawn in from private sector management in order to criticise the operation of public sector activities – the Department for Work and Pensions has embraced “Lean” in principle, if not in practice. But the ideas are confused. They rely heavily on insights from staff and service users, without considering that policy makers, officials and users might legitimately have different perspectives and priorities. They are overlain with other management fads, like leadership, networks and collaboration. John Seddon’s book Systems thinking in the public sector (Triarchy, 2008) is a prime example of this kind of muddle. Seddon identifies systems he disagrees with as “command and control” – but hierarchical and bureaucratic management are quite different from each other, and different again from management by objectives. He claims that systems thinking is responsive to service users, but then he distinguishes “value demand”, which the service wants to meet, from “failure demand” which is “wasteful” – a distinction rooted in the perspective of the agency, not of the service user. And he supposes that rights of citizenship (like the demands of citizens for security through visible policing) are wasteful, because they do not serve the agencies’ purpose – except that serving citizens may well be the purpose. There are often good reasons why public services behave the way that they do. The first step for would-be critics should be to ask why – and analysing processes in terms of systems ought to have been one way to find out.

Leadership

This is the abstract of a newly published article, in which I discuss the idea of leadership: it has appeared under the title of “Leadership”: a perniciously vague concept, International Journal of Public Sector Management 25(1) 34-47.

Purpose – Despite the vast amount of literature covering the concept of leadership, it remains contentious, under-conceptualised and often uncritical. The purpose of this paper is to question the validity of the concept and dispute its application.
Design/methodology/approach – The paper reviews what the idea of leadership means, how it relates to competing accounts of management in the public services, and what value it adds.
Findings
– There is no evident reason why the supposed roles, tasks, or qualities of “leadership” either need to be or should be concentrated in the person of a leader; the tasks involved in “leading” an organisation are not in fact the tasks of motivation, influence or direction of others which are at the core of the literature; and there is no reason to suppose that leadership is a primary influence on the behaviour of most organisations.
Practical implications – In the context of the public services, there is no set of skills, behaviours or roles that could be applied across the public services; the emphasis in leadership theory on personal relationships may be inconsistent with the objectives and character of the service; and the arrogation to a public service manager of a leadership role may be illegitimate.
Originality/value – The argument here represents a fundamental challenge to the concept of leadership, its relevance and its application to public services.

More on Personal Independence Payment

Following the Lords debate, and disquiet in the press, I should perhaps add a further comment on PIP. The government’s assumption that the reformed new benefit will have fewer claimants than DLA seems mainly to have been predicated on a longer qualification time, removal of those with lower dependencies and some special rules, like the removal of some entitlements to people in residential care. At the same time, the government is proposing a redefinition of rules which will make the benefit more accessible to people with psychiatric illnesses; and it has made no proposal about the very large numbers of older people who have continued on DLA in preference to claiming Attendance Allowance. If that was the whole story, it could mean that PIP will have as many claimants as DLA; it might even have more. But it is not the whole story. The prospect of reducing the number of claims radically seems to depend primarily on the process of re-assessment and disqualification of existing claimants, and the government does not need its reforms to pass to achieve that.

The consultation on Personal Independence Payment

In a previous posting I expressed concern about the announcement of policy decisions before consultations had been closed (see “A failure to consult”, 21st February 2011). A new report, Responsible reform, criticises the consultation on Personal Independence Payment because the government has misrepresented the responses. The authors have mainly counted the responses, which is not necessarily a valid criticism – consultations are not numerically representative, and large umbrella organisations cannot sensibly be counted in the same way as individuals submitting standard responses. However, the overwhelming opposition to the reforms is well conveyed by the quotations.

This contrasts with the government’s response to the consultation, which suggests broad support for the principles even if there are differences on specifics. Responsible Reform thinks the government’s response is misleading, and it is hard not to agree. The report cites a standard legal principle: “once a public body decides to consult it has to do so properly.”

Limits to growth, again

More than 200 years ago, Malthus argued that the world was going to run out of resources, because population inevitably increased faster than our ability to provide for it.  The argument has been disproved time and again, but its adherents  remain convinced that it must be true sooner or later.  It doesn’t seem to matter how often the arguments are shot down in flames – there is always someone ready to pick up the standard.  This week’s New Scientist has four pages praising The Limits to Growth, the book that argued that come what may, we were going to run out of the things we need.  Part of the problem is the flakiness of the predictions – the birth rate has not followed the projected path, and nor will most of the consequent projections.

The NS article comments that economists claimed that “Limits underestimated the power of the technological fixes humans would surely invent.”   If you can’t counter an argument, misrepresent it.  The basic objection from economists is not that new technologies will inevitably appear – even if they might.  The point is that many alternative technologies  already exist, and costs are relative. If a resource becomes scarce, it will cost more, and other technologies which are initially too expensive become  preferable.

The fundamental economic mechanism is one which pushes people to use substitutes. As coal has become more expensive, options for producing energy which once seemed unrealistic – nuclear power, bio-fuels – start to be feasible.  As wood has become more expensive, plastics have expanded.  If food production through conventional methods becomes unsustainable, there is a range of viable technologies, such as hydroponics, which stand in readiness.  There is, certainly, an incentive to develop new technologies, such as electric cars, water purifiers or solar power, and many will be developed, but that is not the central mechanism. We will never use the last piece of coal, the last drop of oil, or the last lump of copper; long before then, it will cost too much.  The argument that we are about to run out of resources is just plain wrong.

Rising unemployment

The Chartered Institute of Personnel and Development estimates that unemployment figures are likely to reach 2.85 million in the coming year, equivalent to 8.8% unemployment.  In principle, this figure should be independent of the claimant count – people who are unemployed do not necessarily qualify for benefits.  In practice, it may not be.  Part of the government’s current policy is to disqualify people from long-term incapacity benefits, in the form of Employment and Support Allowance.  The medical reassessments have led to many people leaving the benefit rolls – 36% of reassessments are brought to an end because the claimant is no longer entitled, but that reflects a certain turnover in the figures anyway (for example, among women who have had to claim sickness benefits while pregnant).   More important for the unemployment figures are the further 39% who are found to be fit for work.  It is not immediately clear how many of these people will go on to claim Jobseeker’s Allowance instead of ESA, but those who do will be redefined as actively seeking work.  If only a third of them make that shift, it will increase the unemployment figures by more than 300,000 – taking the figures well over three milllion.

Scotland refuses consent

The Scottish Parliament has refused legislative consent to the Welfare Reform Bill. There is considerable concern about the direction of welfare reform, especially relating to the treatment of disability, but it would be misleading to say that the concerns have gelled into a solid body of opposition. If people’s concerns have been diffuse and difficult to focus, it is because the Bill itself is so vague. It outlines principles for action, but it is still desperately thin on detail. The Coalition Government has taken the view that the Bill is only about broad outlines; the details will go into secondary legislation. More than a year after the White Paper, it is still far from clear how Universal Credit will work, what will be included, and what its implications will be.

The Legislative Consent Motion effectively asked the Scottish Parliament, then, to agree to the Bill without knowing what they were signing up to. The Health and Sport Committee (the Scottish Parliamentary committee that reviewed the motion) expressed concern that the effect of passing the motion would be to commit Scottish Ministers to come forward later with secondary legislation that would not be subject to scrutiny. Equally, the vagueness of the proposals makes it difficult for the Parliament to be sure what will happen after refusing legislative consent. The Parliament’s consent is needed mainly to ensure that UK legislation is compatible with Scots law, and refusing consent will not prevent the UK legislation from being passed. The most positive interpretation is that the UK government will have to bring forward primary legislation for the system to work in Scotland; but witnesses to the Committee raised concerns that the effect may be the suspension of benefits to Scottish recipients.

The Parliament’s action is more than a gesture. Benefits are a reserved matter – that is, they are governed exclusively from Westminster – but training for employment is a shared responsibility. When the Department for Work and Pensions has taken action in Scotland in the past, it has been done with the active cooperation of the Scottish government. The view of the government was that “they rely on our support”. Scotland will have to take responsibility, under the reformed system, for Council Tax Benefit, and it is likely that other responsibilities, including Housing Benefit and work formerly done by the Social Fund, will gravitate to the Scottish Government. It is difficult to see how Westminster’s programme can be implemented in Scotland without the Scottish Government’s co-operation.

Plan C

The government has represented its spending plans as the only option available. The Labour opposition has called for an alternative approach, “Plan B”, involving Keynesian stimulation of the economy through tax reductions and quantitative easing. It looks as though the government is sticking to “Plan A”: but is it? The recent spending review points to the gradual emergence of an alternative strategy. In November, the government announced funding for 250,000 work experience placements and 160,000 job subsidies, all aimed at young people aged 18-24. Less prominent, but possibly more significant in the long term, were the low-key declaration of a National Graphene Institute, and recent announcements about support for life sciences. These initiatives suggest that the government may be starting to move in the direction of a policy to foster development in selected industrial sectors. That, ironically, was the policy of the Labour government in the 1970s, which sought to pick winners through the National Enterprise Board – for example, its investment in Inmos and microchips.