Does the UK expect too little of disabled people?

64% of working age disabled people are unemployed, and those paralysed by Spinal Cord Injury (SCI) are no exception when it comes to the many difficulties faced when finding work. As a charity offering practical support to spinal injured people, disability, benefits and employment are always high on the agenda as elements affecting opportunity, choice and independence.

We’re a bit late with this, but a week or so on and we’re still disappointed with Dr Stephen Duckworth’s comments about disabled people and employment. You see, we think that disabled people should expect more from Britain, not the other way round as Dr Duckworth suggested.
Duckworth, the chief executive for Capita’s Personal Independence Payment (PIP) assessment services, angered many disabled people recently when he stated that “north of a million” people currently claiming disability benefits should not be. In a rather confusing interview with the Sunday Times, Dr Duckworth suggested, without providing any evidence, that many of those claiming disability related benefits were not really disabled and merely had ‘trivial injuries’.  Appearing to switch between talking about Disability Living Allowance (DLA)/PIP, which he has previously acknowledged is an important and ‘enabling’ benefit, and Employment Support Allowance (ESA), he said Britain had failed disabled people by not expecting more from them. This expectation appears to mean an expectation to work with Dr Duckworth asserting that, “It is far better to go back to work to get better than to wait to get better to get back to work. Use work as a therapeutic intervention.”

Aspire agrees that there are merits to working and that many disabled people currently not working should be. Being in employment, volunteering, education or training has repeatedly been shown as having mental and physical health benefits. However, just because someone is looking for work there is no guarantee they will find employment. Despite legislation like the Disability Discrimination Act and now the Equality Act, disabled people are more than four times more likely to be involuntarily out of work than non-disabled people. And almost 60% of adults with impairments experience barriers in the type and amount of paid work they do. In an already competitive jobs market, though, where discrimination is still being fought, the notion that employers should take on staff who are in need of paid ‘therapeutic intervention’ is hardly likely to improve things for disabled people. Indeed, the situation is already compounded by the threat that many disabled people who currently receive DLA will no longer do so under the new PIP system. DLA/PIP is, in Dr Duckworth’s own words, “an enabling benefit...that in part removes some of the additional costs, which are imposed as a result of the disabling barriers that society imposes” on disabled people. The government has said it expects 20% less people to receive PIP than currently receive DLA. This may prevent many of this 20% who currently work from doing so due not being able to mitigate some of those disabling barriers through receiving DLA/PIP. Perhaps this is something Dr Duckworth should be more concerned about rather than appearing to attempt to dismiss those receiving ESA as not ‘really’ disabled.

Because Dr Duckworth is himself disabled, his words appear to be given extra weight and this is problematic on several levels. Disabled people are not a homogeneous group and different impairments affect people differently. Even those with a similar impairment to Dr Duckworth may not experience the same barriers to employment or the same experience of impairment. For example, being able to afford a top end wheelchair can make both moving around and remaining in your wheelchair much easier than the sort of standard wheelchairs most people receive through NHS provision. Also not everyone with a SCI will experience the same levels of pain, spasms, mental health response to major trauma, bladder and bowel management, and so on. Unfortunately, Dr Duckworth appears to be being held up as a disabled role model, an example of how to ‘overcome’ disability. However, no two people’s lived experience of disability is the same and focusing on the structural barriers which can lead to the higher rates of employment amongst disabled people is crucial.

It is a shame that his comments add to the general public’s confusion over the difference between ESA, which is an out of work benefit, and DLA/PIP, which is aimed at alleviating some of the additional costs of disability regardless of whether someone is in or out of work. At the same time, his words add to the idea that if disabled people just tried harder they could work, and don’t address the more pertinent issues of what employers could do to enable more disabled people to work. Disability and employment is a hugely important discussion that has to take place. But if we’re to see sensible discussions with positive outcomes, then both those speaking and those reporting on the discussions have to ensure that they are coming from a position of sound evidence and clear understanding of the bigger issues.

GPs charging for medical reports needed for benefit appeals

News broke this week that many GPs are either refusing to provide medical evidence letters for appeals against Work Capability Assessment (WCA) decisions or charging people up to £130 for them. This comes not long after the government admitted that these assessments had major failings.

Earlier this year it was reported that GPs in Wales were told that people requesting letters of medical evidence for WCA appeals were an "abuse of NHS resources".  Now there is evidence that some GPs who will provide such letters are charging for them. With the Citizen's Advice Bureau reporting 54 per cent more people seeking support from them regarding Employment Support Allowance (ESA), this is very worrying. All the more so when you consider that disabled people are twice as likely to be living in poverty as non disabled people, thus making them less likely to be able to afford to pay for the letters.

GP's have argued that they simply don't have the time to deal with requests for appeal letters. They experienced a 21% increase in requests between January and July alone this year. Last week a "just say no" campaign to support GPs refusing to provide such letters was launched. All of this is worrying not only in terms of making appealing WCA decisions harder, but  also in the potential it has to create tension and hostility between disabled people and their GP. This is of particular concern given disabled people are more likely to need to visit their GP on a regular basis.  

The DWP guidelines state:

“Claimants should contact Jobcentre Plus or the Appeals Service, where appropriate, if they think that further medical evidence is necessary to support their claim or appeal. They should state clearly their reasons for believing that further evidence is necessary.

If Jobcentre Plus or the Appeals Service consider that further medical evidence is necessary, they will seek it. They will be responsible for paying any fee to the doctor providing the report.”

Going by what DWP have said, people should not need to pay at all. Instead they should provide reasoning when appealing on why they believe further medical reports is needed. If these reasons are agreed, then the Appeals Service should pay. However, a parliamentary briefing note reveals that of requests from the DWP for additional information from GPs, only 50% are replied to.

It is also unclear whether people appealing a WCA decision are made aware of the willingness of Jobcentre Plus and the Appeals Service to request and pay for additional evidence from their doctors, or what the process is if their case for obtaining this information fails.

So we have a failing assessment process, with decisions repeatedly being overturned on appeal, and the access to medical evidence which may help with any appeal in some cases being costly or outright denied. Aspire believe this makes the urgency for the Work Capability Assessment to be reviewed and changed all the more important.