Off their backsides?

Observations on incapacity benefit

I have been doing incapacity benefit assessments for the past two years. The government now proposes to reform them, but has anybody considered the implications for the 152 assessment centres around the country? Some 650,000 disability assessments take place each year, of which most are for IB. The computer program is so complex that it takes three days' training to use. The 2,000 doctors involved - who need five days' basic training each - use a handbook of 141 pages, along with reams of associated forms and documents. All this will now be obsolete. The entire system must be refashioned from scratch.

The existing system seems crazy enough. The difference between the maximum jobseeker's allowance and the initial IB payment is only £10 a week. For assessing people's entitlement to the latter, says the private company Nestor (employed by the Department for Work and Pensions to recruit staff), doctors can earn £300 a day - or more in a day than the IB is worth per week.

The new system, demanding a definition of "more severe conditions" to qualify for payments, will be yet more unwieldy. Ministers have convinced themselves that people who suffer from back pain and depression, the two commonest reasons for claiming IB, would be better off back at work and, if they do not look for a job, they will be reduced to a jobseeker's pittance. But for many, the jobs are just not there. Someone in his fifties who has worked in a heavy manual job all his life, suffers wear-and-tear arthritis, and has lost income, social life and self-respect, is not easily re-employable.

Pain and depression are subjective, and are in truth impossible to assess by an observer, no matter how astute and well trained. There is a clear-as-daylight association between poverty and disability, which none of the assessments takes into account. Almost without exception, those who attend assessment centres find the experience stressful, demeaning, even terrifying. There is good reason for a doctor sitting near the door with a panic button.

Ministerial angst over the "work-shy" is based on primordial echoes of enforced community co-operation in hunter- gatherer societies. It is a psychological fluke the government should learn to discard. The first step would be to abandon incapacity assessment altogether and have a single-level benefit for all those of working age who are jobless. Most people are motivated more by self-esteem than by money. The unemployment figures would naturally rise. But governments might then pay more attention to job creation and skills training.