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One thing this government doesn’t get is the difference between a person with Chronic Illness and Disability, they simply cannot join up the dots. Work is NOT a ‘Health Outcome’ if you are disabled or chronically ill!

What I mean is you can be well overall and have a disability but, by the same token, a person with chronic ill health will have to battle with much more and it this that disables them.

Reading the Green Paper for Health and Work Programme which the Government plans to inflict on JSA/ESA claimants in the faint hope it will half the disability gap is frankly a joke, given that the disability gap hasn’t changed in a very long time.  It is like trying to force a square peg into a round hole. It’s un-achievable because chronic ill health and disability are two seperate things for which I will explain my reasoning in more detail. This is a failure by governments over the last 4 decades to grasp, when trying to reduce chronic ill health and disability to mean minor obstacles to employment.  They are not minor on any level, when we still do not have accessible transport or access to buildings. Many disabled people who do work are now threatened with the loss of employment, which enabled them to be in work and sustain some independance,  as they are now having their Motability cars removed under PIP, thus preventing them from going to work and, lastly, for reasonable adjustments to be put in the workplace as standard procedure.

One thing for sure, it is blatantly obvious that it will be the same contractors/sub-contractors who are going to implement this false ideology.  It will just depend on what they choose to accept given the loaded options which they are in control of, it will be another work programme on the cheap. Fact is this government want the cheapest option for them, rather than seriously address the issues and invest in disabled people which would cost them an eye watering amount of money.  If they really wanted to support people into work, those that could work anyway and then just admit that a good proportion of people simply cannot work because of the barriers they face in doing so, as well as their chronic ill health means they are too sick to work. The rhetoric of the last 6yrs has been the idle,workshy,demonisation of people who with right support could work and want to work, but find they are locked out  of doing so. The general public swallowed the rhetoric hook line and sinker.

Why employers don’t take on sick & disabled people is due to the following:

1) Employers are concerned about employing disabled people due to sickness absences, and the liabilities that would need to be addressed such as  health and safety regarding sustainability, reliability, safely to maintain a 9-5  job 5 days per week.

2)Without the government giving them some assurances via incentives to take disabled people on, this could lead to bullying in the workplace as productivity is linked to profit margins.

3) The able bodied complaining about being paid same when the disabled counterpart produces less due to capability/disability, although this will not always be the case, causing discourse and resentment in the workplace.

The employer will always choose the able bodied over the disabled or chronically sick person.  Fact!

Now we don’t have a magic solution to all problems that could arise but what worries most people more than anything is the government’s plan to make this ‘mandatory’, which if you fall on your backside, then you are being set up for failure resulting in a waste of public money on another failed scheme, just so the figures look good to the public that they are helping people into work.

Yet again those with Mental Health are the main targets along with musculoskeletal group of claimants. This is why I think this government are targeting this Group. Not that this is acceptable as High Courts have already ruled regarding the discriminatory nature of this government towards this group of claimants.

So what are the proposed options? Lets look at these in more detail. Non are 100% satisfactory by any means. In fact, most are just another train crash to the participants who this will be inflicted upon, it just means the level of whether you survive it or not is the crux of these duplicitous proposals to the health and wellbeing of claimants and do they meet the Equality Act 2010? The following  are  taken from a Health and Work Report commissioned by DWP & the DoH in a joint collaboration.

RE:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/273433/psychological-wellbeing-and-work.pdf

Option 1: Embed vocational support based on the Individual Placement and Support (IPS) model in primary care settings. The key principles of IPS are specified and the model has been tested in secondary care settings for people with severe mental illness. This intervention would be accessed through services offering psychological therapy or even through GP practices.

What it means: Embed model vocational support based on the Individual Placement and Support (IPS) in IAPT or other suitable psychological therapy services. IPS is a fidelity/specified model and has been tested in secondary care settings for people with severe mental illness. IPS would be offered through IAPT (as currently is the case in some locations) and referrals to the IPS service would be made by IAPT therapists. A greater group of individuals with common mental health problems would be able to have access to evidence-based support that addresses both their mental health problem and supports them into employment. This option would also place more employment advisers (EAs) in primary care, and increase the number of EAs overall. On the basis of available evidence, we estimate a benefit-cost ratio of 1.41. This means that for each £1 spent to achieve an employment outcome, the Government would save about £1.41. This option has a relatively high cost per participant (about £750) and appears particularly effective in terms of achieving an employment outcome compared to the other options proposed. IAPT is open for individuals who are in and out of work and it creates incentives to move them off sick pay or benefits. While the route into IAPT is through referral by GPs, individuals can self-refer, and Jobcentres and employers may encourage people who need help to self-refer.

Option 2: Use group work in employment services to build self-efficacy and resilience to setbacks that benefit claimants face when job seeking. This intervention would be based on the JOBS II programme that has been tested in several countries but not yet in the UK. It would be accessed through Jobcentre Plus but delivered in neutral settings. Job Club In effect.

What it means: Use group work in employment services to build self-efficacy and resilience to setbacks that benefit claimants face when job seeking. This intervention would be based on the JOBS II model (also known as the ‘Winning New Jobs’ programme). The focus of JOBS II is to build resilience and inoculate the participant against setbacks in the job searching process. The approach has a supporting evidence base as to its effectiveness. The intervention could be offered through Jobcentres, whose advisers could assess participant suitability using an employment strengths and needs assessment tool or, if necessary, other agreed criteria. Other referral paths could be considered such as IAPT and the Work Programme. The intervention would target the Jobseeker’s Allowance (JSA) group or the Employment and Support Allowance (ESA) group before they enter the Work Programme. The programme will need to be modified for the ESA group. JOBS II costs around £875 per participant. The annual net benefit to the Government would be about £280 per employment outcome with an estimated benefit-cost ratio of 1.07. This means that for each £1 spent to achieve an employment outcome, the Government would save £1.07. This policy option has the highest estimated cost per participant of all options. It appears reasonably effective in terms of achieving employment outcomes compared to the other policy options proposed (though less effective than the estimated effectiveness of Option 1).

 

Option 3: Provide access to online mental health and work assessment and support. This intervention would build on models of online mental health assessment and Cognitive Behavioural Therapy (that have been tested). It would include a vocational element, which would have to be developed, and it could be open to the general population.

What it means: Provide access to online mental health and work assessments and support. This option would build on eHealth models of online mental health assessment and Cognitive Behavioural Therapy (CBT) (which have been tested) with a vocational element, which would need to be developed. The service could potentially be opened up to the general population (including the in-work group). People with common mental health problems often find it difficult to actively seek and obtain support. Providing online assessments and interventions will enable greater access to specialist services which have an inbuilt vocational element. This in turn could lead to better health and employment outcomes for these individuals. Careful consideration would need to be given to where the platform would be hosted and to its functionality. It could be hosted in the NHS. The platform could combine assessment of common mental health problems with signposting and potentially treatment (such as Computerised CBT). There is very little information on likely costs of the intervention. We estimate the cost between £200 and £400 per participant including set-up and licensing fees, though this per participant ratio is likely to fall as scale is increased. There are challenges with measuring employment impacts. This intervention is the least costly per participant, and is less effective in achieving employment outcomes compared to the other options

 

Option 4: Jobcentre Plus commissions third parties to provide a telephone-based specialist psychological and employment-related support. Telephone based services offered through this intervention would be very similar to the support provided by Employee Assistance Programmes and models designed for the Work Programme. It would be offered access through Jobcentre Plus.

What it means: Telephone-based services offered through this model would be similar to Employee Assistance Programmes and interventions designed for specialist service provision in the Work Programme. In this case, the intervention would be used for the JSA group or ESA group before they enter the Work Programme. Jobcentres would assess claimants using an assessment tool and refer them to the service. We estimate a benefit-cost ratio of 1.12. This means that for each £1 spent to achieve an employment outcome, the Government would save £1.12. Compared to other options proposed, this option has a low cost per participant (about £ 250), is not as effective in terms of achieving employment outcomes, but can potentially reach a good number of people with common mental health problems. Improving the employment outcomes of those with common mental problems is a complex issue. There is no single ‘one size fits all’ solution. It is likely to need a variety of interventions. The policy options proposed are complementary. Where we have data, the benefits to the Government are estimated to exceed the costs. They have slightly different aims and client groups. They offer different approaches, some more intensive than others. They have different estimated costs per participant and levels of effectiveness. They imply different models of integration, commissioning and funding. The aim should be to test of the effectiveness of each.

“These policy options are complementary – they serve slightly different objectives and client groups. They imply different models of integration, commissioning and funding. They have different estimated costs per participant but for most the benefits to Government are estimated to exceed the costs, providing a case for investment. In all business cases, we see an employment outcome as a person moving from sickness or unemployment benefits into employment for a period of at least six months. The four policy options combine different approaches: intensive individual case management; group support; online; and telephone-based intervention”.

Where is the evidence that work pays? It’s a falsehood. They can’t find jobs (750,00 current vacancies) for able bodied unemployed with 2.3 million out of work, let alone find employers to take on chronically ill and disabled people and all that goes with that.

I was privileged to attend the RI WORLD CONGRESS , 25–27 October 2016 Edinburgh International Conference Centre, Scotland.  What they all waffled on about was the ‘utopian view’ that disabled people are being sidelined and they wanted to change that, so disabled people would be treated the same in society and have same dreams and bloody aspirations as ‘Mr or Mrs Normal’ person to get work, be included in society and then they rolled out the olympic super crip video to inspire us all into action.

Well, real lives of chronically sick and disabled people are not like that. Most aspire just to survive the cruelty of the WCA or PIP assessments and be left alone to manage their complex lives the best way they can. It is amazing that a few chronically ill or disabled people achieve great feats and also  are very successful, that I would never knock, but we cannot all be super heroes either as they like to portray in the media hype.

There are some disabled people who want to work, 45% do successfully but very few chronically sick people work due to the complex nature of their illnesses which disables them. I thought I was in a twilight zone, envisioning all these wonderful jobs would be created  and mean that they were wanting to put in place all reasonable adjustments one would need if you could move towards work,  fabulous accessible transport would no longer be a problem and that accessibility to buildings and many other barriers would miraculously disappear. Then, someone caught my head with a clipboard in passing and brought me back to the reality of real lives of most chronically sick and disabled people.  The fact that some couldn’t even go to the toilet unaided, or get dressed without a care support package in place, or could only manage 2 hrs a day maybe due to fatigue or dialysis, chemo fog etc . I’m all for positive thinking, but I’m also grounded enough to know most people’s lives are just not that simple and neither are their illnesses or disabilities.

Yet with the support of charities, NHS, GPs and JCP Work Coaches this government is intending to find meaningful employment to suit those its intended for and half the disability gap overnight… Don’t let this worry you as you will all be miraculously cured.

One thing they fail to grasp is that this utopia doesn’t exist in reality for most sick & disabled people. When I recently met with Debbie Abrahams at her Disability Roadshow, only 112 employers were ‘disability confident’ to find employment for disabled people  which will mean low paid jobs with no chance of advancement in their careers.  Any training will be short lived at the bear minimum cost to the state, approx £50 per head, and CBT will be no longer than 12 weeks which won’t suit the majority of  those with even moderate mental health issues.  Most have already been there and it didn’t work, or was unsuitable for them, leaving them more depressed and anxious than before they started. The startling thing is that this is coercion by the back door, making it ‘mandatory’ to complete the twelve weeks with the indirect threat of loss of benefit for not engaging in the process as an incentive to comply. This perceived coercion is likely to increase mental health problems, not reduce them. The ongoing DWP tyranny against chronically ill people has already increased the numbers of physically ill people now adopting additional mental health problems, as their financial security has been removed, with the relentless DWP suggestion that many claimants are bogus.

The Government must make sure that all recommendations of the WCA reports and the UN  recommendations are implemented without further delay to meet its obligations to safeguard those whom are the most fragile group of claimants and does not cause harm to their mental health . Claimants health and well being cannot be sacrificed in such a manner without due regard to process under the law.

This alone must be against the grain for any civilised society,let alone breaking the Human Rights of claimants and failings of adhering the Equality Act 2010.Yet again this government is failing in its duty to ensure  preventable harm  that could be caused to what are very fragile group of claimants or in some cases prevent fatalities amongst this group of claimants, as they disengage with GP’s and other stakeholders which can have serious consequences to their health and wellbeing. Many claimants in this group have already lost their lives due to the stress and strain of the WCA processes, which left them unable to cope where they only option left is to take their own lives. This cannot be allowed to continue!

BASE  Blog By Huw Davies

“The Work and Health Programme is the headline act here though. We’ve requested sight of an equalities impact assessment, as we’re concerned that the decision to go with a single programme may not be based on any sort of analysis of the evidence. DWP appears committed to combining a programme that works, albeit with a limited group, and a programme that has patently failed(link is external).

The Work Programme offers a 4% chance(link is external) of getting you a job if you’re an existing IB claimant; 7.7% if you’re a new ESA claimant. Work Choice is nearer to 40% for IB claimants(link is external). Overall, Work Choice is delivering close to 60% job outcomes compared to 30% for the Work Programme where 70% of those referred are sent back to the Jobcentre after 2 years.”

http://base-uk.org/blog/work-health-programme-November-2015

This is why I reject this Report,not that my opinion will count for much being a mortal citizen,they have had 6yrs to make changes to get people into work,and its been a cruel dark road for many,yet again some ideological process to make work pay and lift people out of poverty is failing at a very high human cost.

 

If you have 5 mins please fill in this survey  http://surveys.parkinsons.org.uk/s/bigbenefitssurvey/?platform=hootsuite

Ekkelesia also did three reports http://www.ekklesia.co.uk/node/22112

 

The Green Paper ; https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/564038/work-and-health-green-paper-improving-lives.pdf

https://hansard.parliament.uk/commons/2016-10-31/debates/4450368C-0091-47F2-A2D9-D12BC86192CC/ImprovingLivesWorkHealthAndDisabilityGreenPaper

 

New plans were announced today in a Department for Work and Pensions media release and Green Paper, to help more people with long term conditions to “Reap the benefits of work and improve their health.” The plans proposed today include: a review of Statutory Sick Pay and GP fit notes to support workers back into their jobs faster, and for longer encouraging Jobcentre Plus work coaches to signpost claimants to therapy the launch of a consultation on Work Capability Assessment reform encouraging employers to work with their employees with long-term health conditions to stop them from falling out of work a wide-ranging debate about recognising the value of work as a health outcome. http://www.taen.org.uk/news/view/1555

National RA : http://www.nras.org.uk/-improving-lives-the-work-health-and-disability-green-paper-what-does-it-mean-for-people-with-ra-and-adult-jia-

National Employee Mental Wellbeing Survey results  http://wellbeing.bitc.org.uk/wellbeingsurvey

https://www.disabilityrightsuk.org/news/2016/november/improving-lives-work-health-and-disability-green-paper

http://www.disabilitynewsservice.com/dwp-issued-guidance-that-made-suicides-more-likely-then-lied-to-cover-its-tracks/

 

 

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Comments on: "The Health & Work Programme ~is Work really a ‘Health Outcome’ ?" (5)

  1. Reblogged this on sdbast.

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  2. Martin Hughes said:

    Thank you so much for such an interestiong & illuminating piece. It is, as you say, a long dark road for which this government should be deeply deeply ashamed (although they won’t be of course) Sadly an awful lot of the ‘general public’ will have bought into this evil regime – obviously being spurred on by equally evil right wing rags – however, there are a huge huge amound of able bodied people (me included) who are absolutely horrified & disgusted with what this dictatorship are trtying to achieve with their whole ‘work sets you free’ ethos. I’m now 60 years old and angrier than I’ve ever been with politically motivated mans’ inhumanity to man. Very angry. Take care, your articles are really interesting, thank you. Martin

    _____

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  3. jeffrey davies said:

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