Fearing the brown envelope: sickness benefits and welfare reform

"I try not to read about it cos it’s so frightening."

For the past three years, and at a time of increased anxiety for sick and disabled people given ongoing welfare reform, I have been studying the lives of long-term sickness benefits recipients in North East England as part of my PhD research.

Narratives revealed a huge amount of fear and trepidation over ongoing welfare reform. Participants spoke about worrying about the Work Capability Assessment (WCA) carried out by Atos on a daily basis, accompanied by a deep mistrust of the entire system. Below, Fred (all names are pseudonyms), 53, who has been receiving Incapacity Benefit (IB) for 9 years and suffers polyarthritis, gives his thoughts on the process:

I think it’s gonna cause breakdowns, possibly even the worst case scenario y’know topping yourself. If the Government could cut a penny in half, they would. I think if they could bring euthanasia in, they would. If they could find a way of getting round all the moral outrage they’d probably do it. Take all the lame ones out, just like a sick animal.

This is particularly noteworthy given that statistics suggest sick and disabled people have considered suicide as a result of fear over the assessment process. In a survey of over 300 people receiving IB, MIND found that 51 per cent of people reported the fear of assessment had made them feel suicidal.

Some respondents specifically mentioned their fear over receiving an official-looking brown envelope through their letterbox – a possible indicator of communication from the DWP. Sarah, 54, has battled with mental health problems all her life and is now dealing with a range of physical health problems such as arthritis and Reynaud’s syndrome, said of her daily dread of being selected for the reassessment:

When the postman comes with any sort of brown envelope it is really worrying… I try not to read about it cos it’s so frightening, it’s like 'oh my God they’ll send you to the dole straightaway' is what’s in your mind. Who will employ you, and what jobs are there? Where are the jobs? If they send me for a job 20 miles away, how do I afford the bus fare on minimum wage?

Aside from the obvious fear presented in the narratives, a feeling of stigma and shame was described as being created by political and mass media representations of the reform process. An increasingly unavoidable occurrence within government rhetoric and the media is the labelling of sick and disabled people who are receiving welfare benefits. There is no mention of the causes, symptoms, lack of diagnosis, treatment or support.

Upcoming Disability Living Allowance (DLA) reforms are poised to create further anxiety and distress for sick and disabled people. The Government has pledged to cut DLA by 20 per cent and are replacing DLA with Personal Independence Payments (PIP) which sees the end of the automatic entitlement of people with certain impairments and focuses instead on support for those deemed 'most in need' (pdf).

Iain Duncan Smith suggested that the 30 per cent rise for claims for DLA was a result of fraud in the system, despite the fact that official DWP figures estimate fraud is a mere 0.5 per cent. What is often unsaid is that DLA is not simply an out-of-work sickness benefit – it is intended to help people meet the extra costs of disability-related care and mobility whether in paid employment or not. In August the government announced that Atos will be responsible for carrying out the PIP assessment, a contract worth a huge £400m. Given that the handling of the WCA by Atos was "impersonal and mechanistic" and essentially deemed unfit for purpose, it can only be hoped that history will not repeat itself with the forthcoming DLA assessments.

Photograph: Getty Images

Kayleigh Garthwaite is a Postdoctoral Research Associate in the Department of Geography at Durham University

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Is anyone prepared to solve the NHS funding crisis?

As long as the political taboo on raising taxes endures, the service will be in financial peril. 

It has long been clear that the NHS is in financial ill-health. But today's figures, conveniently delayed until after the Conservative conference, are still stunningly bad. The service ran a deficit of £930m between April and June (greater than the £820m recorded for the whole of the 2014/15 financial year) and is on course for a shortfall of at least £2bn this year - its worst position for a generation. 

Though often described as having been shielded from austerity, owing to its ring-fenced budget, the NHS is enduring the toughest spending settlement in its history. Since 1950, health spending has grown at an average annual rate of 4 per cent, but over the last parliament it rose by just 0.5 per cent. An ageing population, rising treatment costs and the social care crisis all mean that the NHS has to run merely to stand still. The Tories have pledged to provide £10bn more for the service but this still leaves £20bn of efficiency savings required. 

Speculation is now turning to whether George Osborne will provide an emergency injection of funds in the Autumn Statement on 25 November. But the long-term question is whether anyone is prepared to offer a sustainable solution to the crisis. Health experts argue that only a rise in general taxation (income tax, VAT, national insurance), patient charges or a hypothecated "health tax" will secure the future of a universal, high-quality service. But the political taboo against increasing taxes on all but the richest means no politician has ventured into this territory. Shadow health secretary Heidi Alexander has today called for the government to "find money urgently to get through the coming winter months". But the bigger question is whether, under Jeremy Corbyn, Labour is prepared to go beyond sticking-plaster solutions. 

George Eaton is political editor of the New Statesman.