Is Labour abolishing illness?

The new rules on incapacity benefit stake everything on a major gamble: that a large proportion of c

Incapacity benefit has become one of this year's favourite scare stories. Hardly a day passes without a new headline deploring its soaring costs and the rising numbers of claimants who get "something for nothing", at the expense of decent, hardworking taxpayers. We are told that we are footing an outrageously escalating bill for 2.4 million people, a million of whom shouldn't be on the benefit at all, and each successive work and pensions minister vows to be more ruthless than the last.

The true picture is somewhat different. The unreported version, which can be culled from Department for Work and Pensions (DWP) data, is that only 1.4 of the 2.4 million actually receive any payment, the rest get national insurance credits only, and numbers have been falling since 2003. The basic benefit is worth barely £3,000 a year. After two small rises in the first year there is no further increase, other than index-linking. All those who get the benefit have to pass a rigorous "personal capability assessment" (PCA) with doctors appointed by the DWP; and they can be re-examined at any time. The audited estimate of fraud is under 1 per cent - the lowest of any part of the social security system.

Nonetheless, the 2007 Welfare Reform Act is now being implemented across the country. It replaces support, as of right, for illness/disability (one of the planks of our rapidly disappearing welfare state) with a new, conditional employment and support allowance. Claimants are held on a basic allowance until it is confirmed that their capability for work is limited. This is determined by a "work capability assessment" tougher than the old PCA. Those deemed capable of one day returning to work (and the arbiters are health professionals rather than doctors) must engage in a series of "work-focused" interviews and activities. These include, among other things, "condition management", which in practice is likely to consist of group sessions loosely based on cognitive behavioural therapy. All this brings an additional slice of benefit that can, however, be cut for those who do not engage in it without "good cause" - a potential loss of 40 per cent of income. Ultimately, any whose capability for work remains limited through failing to follow medical advice, or "any prescribed rules of behaviour", face a period of disqualification. (A further provision of the act, to be piloted in nine areas, is that people served with Asbos - antisocial behaviour orders - can face cuts in their housing benefit for refusing local authority offers "to help address any problem behaviour".)

A main selling point of the reform was the great savings it would bring. It would staunch the outflow of benefits and get many people into jobs where they would pay tax and provide for their old age. This government's cherished goal is an employment rate of 80 per cent of the working-age population - though it is difficult to find any reasoned argument in support of this since our present rate of 75 per cent is, with Canada's, the highest in the world. The government accepts that employers must be paid to take on people with an illness record and, for the time being, it has pledged not to cut the benefits of existing claimants. Any immediate savings, therefore, can only come from bumping as many as possible off the benefit, shaving future benefit levels (already well in hand), and making it harder for newcomers to get it in the first place. Delivery is being farmed out to private agencies paid by results - which means, of course, the setting of targets. The next few years will be a bad time to have a crippling accident or succumb to a serious disease, particularly a psychiatric or neurological one that does not have obvious outward symptoms.

Blaming the "cheats"

The reform of incapacity benefit has been over ten years in the making, leaving in its wake a dense trail of commissioned reports. A curious thing about this voluminous material is how little information it contains on the actual health conditions for which benefit is paid. This is no accident, for the reformers long ago made up their minds that claimant numbers are too high, therefore a large proportion - usually put between a third and a half, but lately upped to 70 per cent in some quarters - must be spurious. An appeal to history is repeated like a mantra that, back in 1979, only 700,000 claimed the old sickness/invalidity benefits. Since then, money has been poured into the NHS while health care, living standards and longevity have improved beyond all expectations. People must be healthier, which proves that huge numbers are exploiting a slack and obsolete system. Who is to blame, apart from outright cheats? It can only be the self-indulgent, who fancy themselves sicker than they really are, and complacent GPs who let them think they are too ill to work.

Crucially, the reformers bracketed illness with disability. The disability lobby had long argued that "disability" was a discriminatory label imposed by society, and it was bent on removing the barriers to work that excluded those so labelled and kept them in poverty. But the bracketing brought confusions - for those with disabilities may be extremely fit (consider the disabled athlete), whereas the able-bodied can be extremely ill. More confusion arises with conditions such as "stress", "anxiety" and "chronic fatigue" that sound trivial. As for "back pain", how unreasonable is it to take time off sick for something best dealt with by a stiff upper lip and the odd aspirin? It is easy for those in good health to pooh-pooh such things, agreeing with the government that "Work is the best therapy".

The government's declared mission is to "liberate" claimants, to bring them into its "reformed, coherent welfare state for the 21st century". It seeks to overturn a culture based on the "medical model" of illness that allows them to "drift" on to long-term benefits without realising that "symptoms, feeling unwell, sickness and incapacity are not the same" - hence the appeal of cognitive behavioural therapy, which it understands as a treatment that will talk the sick into believing they can lead normal lives.

Doctors - so often the refuge of desperate people trying to find out what is wrong with them - should as far as possible be excluded from the process. Even those working for the DWP have opinions that are "unfounded, of limited value and counter-productive", while GPs are "unaware of the importance of work, the absence of which leads to depression, poor health, higher rates of suicide and mortality, poverty, and social exclusion". (The quotations are from a 2005 study from the Unum Provident Centre for Psychosocial and Disability Research at Cardiff University, whose ideas and rhetoric infuse the reform. Unum Provident is an American firm, the largest disability insurance company in the world, which is currently in litigation in different countries for refusing to pay out on some of its policies.) A private agency has now taken over the running of its first GP surgery here, and doctors dealing with disability living allowance are advised not to invite patients to explain how their condition affects them.

Features of the reform are familiar from other policy areas. First, a demonisation of a needy or vulnerable group, followed by a rebranding: so claimants become not even "clients" but "customers" (as in the just published "Commissioning Strategy" document); incapacity benefit becomes employment and support allowance; sick notes are redrafted for doctors to certify, not what patients can't but what they can do. Next come "partnerships", on an unchallenged assumption that the public sector has failed. The new system is farmed out to for-profit or non-profit-making agencies paid by results. This entails targets, and where targets are set, sanctions follow, for any who "fail to recover".

There are features of the new programme that look intelligent and humane, doubtless owing much to the efforts of the disability lobby. They include a longer and more flexible bridging period (and a back-to-work grant) between benefits and work, and a broader view of "work- focused" activities. The crunch will come with those described as not able or prepared to engage "because [of] the nature and severity of their health condition, or more a matter of attitudes, perceptions and expectations which may or may not be accurate . . . It is a question of what the claimant cannot do vs what they will not do."

For the reform stakes everything on a gamble: that a large proportion of claimants, present and to come, are fit enough to work. There seems no way of proving or disproving this, other than trying it out, at the risk of much waste of public money, and much personal grief. Deliberate rejection of the "medical model" deprives us of all we might have learned (from the wealth of data available) of the impact of illness on our society.

I have scratched my head long and hard over this reform (among other things sending out lengthy submissions to all concerned during the long consultation phase in 2005-2006) because so much in its theory and rhetoric contradicts my own experience: of chronically and seriously ill family members and friends, of several years as a Mind volunteer, and further years of peripheral involvement in action groups for chronic fatigue conditions. All this has indelibly impressed me with the courage of many who live with horrible complaints, the sheer hard work involved in their day-to-day coping, their relentless search for any amelioration, let alone cure, often at costs hard to spare from limited resources.

I have witnessed, too, and at close quarters, the hurt and stress of living difficult lives as people have to do, in a perpetual culture of disbelief and threat, where some of the most valiant are blamed for their conditions and conflated with the alleged "can't work, won't work" unemployed. For the message of the reform that comes across, for all its fashionable rhetoric, is that a person is valued only as a productive unit. Compassionate cases aside, those too ill to work are outside society and money spent on them is wasted. Sickness, disablement and inability to work have no place in a modern society - they can't and shouldn't be afforded.

No one pretends that illness is not a blight, imposing personal and social costs going far beyond the financial; but - pace the government - no one as yet knows how to remove it from the human condition. Why waste valuable time and resources on an ill-founded reform, when they could instead be used to further understanding of the real impact of illness on our society?

Alison Ravetz is a professor emeritus of Leeds Metropolitan University who writes on housing policy and welfare reform

This article first appeared in the 05 May 2008 issue of the New Statesman, High-street robbery

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Electric dreams

How the “hippie tycoon” Dale Vince – a pioneer of renewable energy – plans to turn football and our motorways green.

In the hills above the tiny Cotswolds town of Nailsworth, on a road named Another Way, is an unusual football stadium. As you enter the New Lawn ground, the first thing you see is a pair of Nissan Leaf electric cars plugged into charging stations; on the reception counter are flyers for the Vegan Society. This is the world’s only meat-and-dairy-free football club, where players and fans enjoy Quorn fajitas, veggie burgers, cheeseless pizza and tea with soya milk.

Look out from the main terrace at the Forest Green Rovers club and you’ll see more curious sights. An array of 170 solar panels is positioned atop the south stand. Behind a corner flag is a large tank for storing water that has been recycled from beneath the organic pitch, which is fertilised with seaweed. Even the advertising banners stand out: the most prominent bears the white skull-and-crossbones logo of Sea Shepherd, the marine conservation charity.

It might all seem quaint and worthy, the vanity project of a hippie tycoon. But Forest Green Rovers are a serious club. The team of full-time professionals sits in the playoff places near the top of the National League, the fifth tier of English football. If they keep that up, they stand a good chance of winning promotion to League Two, for the first time in the club’s 127-year history. But the longer-term goal is to make it all the way to the Championship, just a step from the
Premier League.

That is why Forest Green Rovers are moving ahead with plans for an extraordinary new stadium near Stroud, in Gloucestershire. Designed by Zaha Hadid Architects, the firm that built the London Aquatics Centre for the 2012 Olympics, it will seat 5,000 people, with a capacity to expand to twice that. And it will be constructed almost entirely of wood. “That’s never been done before, anywhere,” said Dale Vince, who rescued the club from near bankruptcy in 2010 and is now its chairman. “It will be the greenest stadium in the world.”

We met in early November at the Stroud headquarters of Ecotricity, the renewable energy firm he founded in 1995, which runs 19 windfarms and two solar parks. Vince, who is 55, is not your typical corporate boss. He was wearing brown boots, ripped jeans and a black T-shirt. His hair is shaved on the sides, with a small ponytail on top, and his sideburns are long. A silver ring hangs from the tragus of his left ear.

Vince’s office is scantily furnished with two beanbags, a standing desk, a small, round table in the middle and a large, green Union Jack on the wall. If you didn’t read the newspapers, which drew attention to his wealth last summer while covering a legal battle with his ex-wife, you would have no idea he was worth more than £100m.

It is a fortune that has allowed him to spread his green dreams into areas beyond football. Before the 2015 general election, Vince gave £250,000 to Labour, £50,000 to the Liberal Democrats and £20,000 to the campaign of the Green MP, Caroline Lucas. But he may yet make the biggest difference with transport. Ecotricity has built what it calls the Electric Highway, a network of 296 charging points at motorway service stations which has made it possible to drive from Land’s End to John o’Groats in an electric car. Vince says he is trying to accelerate the demise of the internal combustion engine. “Our government is not the most ambitious on green issues but by 2030 it wants all new cars to be electric or hybrids. We think it could happen sooner.”

 

 

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Vince grew up in Great Yarmouth, Norfolk, in a two-bedroomed ­bungalow. His father was a self-employed lorry driver who worked hard yet worried about being able to pay the bills. “That’s why I decided to drop out and live like a hippie,” Vince wrote in the Daily Telegraph in 2009. “I didn’t want a career or a mortgage.”

He left his local grammar school at 15 and four years later became a New Age traveller: his first home was an old ambulance. He toured Britain and Europe, and along the way he got married, painted, learned to bake bread – and had run-ins with the police. He was part of the Peace Convoy, a confederation of anti-authoritarian travellers, and in summer 1985 he took part in the “Battle of the Beanfield”, when police trying to prevent a free festival at Stonehenge clashed with protesters. Some travellers were beaten and vehicles were smashed.

Vince, a tinkerer, built a small windmill on top of his van to power the lights. In the early 1990s, while living on a hill in Gloucestershire in a former army truck, he had an epiphany: what if he could harness the wind on a much bigger scale and change the energy industry? He decided to “drop back in” to society to set up Ecotricity, which claims to be the world’s first green energy firm. The model was simple: the company would produce as much renewable electricity as it could, buy in any extra fossil-fuelled power it needed, and use customer revenues to construct more windfarms until the operation was fully green.

“I built my first windmill in ’96, after a five-year battle with all-comers – Nimbys, bigots, planners, big power companies, you name it – and went to Kyoto in ’97,” Vince wrote on his blog, Zero Carbonista. “The rest is just more history.”

That windmill is still turning: its blades can be seen from the top of a stand at the New Lawn. And like the football club, which has doubled its home attendance in six years, Ecotricity is thriving. It has nearly 200,000 customers. Accounts filed at Companies House show turnover for the year ending April 2016 of £126m, up from £109m; pre-tax profit was £6.7m. Vince is the sole shareholder but the company does not pay dividends and he draws a salary of less than £150,000. The converted 18th-century fort where he lives with his second wife and their son is worth more than £2m, but he says he is not motivated by money.

Despite Ecotricity’s success, the firm faces several challenges, including the implications of Brexit, which Vince opposed. “We have not left [the EU] yet, but the pound has slumped and banks are thinking of leaving,” he said. “The process of leaving will be tortuous, and the idea that we can trade better outside the EU – that’s nonsense.”

A more immediate problem for Ecotricity is regulatory. The last Labour government introduced attractive incentives for companies and homeowners to produce renewable energy, especially wind and solar power. These subsidies amounted to billions of pounds – since 2002 Ecotricity has received £36m towards building windmills costing over £100m – and have helped make Britain a world leader in green power. In 2011, 9 per cent of Britain’s electricity came from wind, sun and other renewable sources; in 2015 the figure was 25 per cent.

But since the Conservatives won a majority under David Cameron in 2015, breaking free from the restraints of their coalition partners, the eco-friendly Lib Dems, the government has made it harder for green projects to secure planning permission. It has also reduced financial support for the industry. In December 2015, days after helping seal the Paris climate-change accord, which called on all countries to reduce their dependence on fossil fuels, the government announced a series of cuts to subsidies for renewables, which are paid for through business and household energy bills.

“They [the Tories] have smashed renewable energy with a sledgehammer,” Vince said. “And they’ve done it in a deceitful way, saying it was for the good of the industry. They’ve practically shut down solar and onshore wind in the UK. Bringing forward new stuff now – I don’t see it happening.”

At the same time, the government is promoting fracking, a controversial process that involves blasting water and chemicals into rocks to release trapped gas. Fracking has been suspended or banned in France, Germany, the Netherlands, Scotland and Wales because of environmental concerns. Official surveys show that fewer than one in five Britons supports fracking, yet in October the government overruled councillors in Lancashire and approved plans to explore for shale gas there. “[Fracking] is a big risk to take for a gas that we cannot afford to burn if Britain is to hit its carbon-reduction targets,” Vince said.

His proposed alternative is to produce “green” gas from grass grown on marginal farmland. Ecotricity will build its first grass-to-gas mill in Hampshire next year, and Vince says that in theory the green fuel could be used to heat almost all homes in Britain within two decades. His vision is unlikely to get much support from Theresa May, who, after taking office in July, abolished the Department of Energy and Climate Change and transferred its functions to an enlarged department responsible for business. “It’s ideological when it comes to green stuff,” Vince said. “The left embraces it and the right does not.”

That is why, in February 2015, he donated funds to Labour, the first time he had done so. What does he think now, with Labour trailing so far behind the Tories in the polls? “Jeremy [Corbyn] is a lovely man. He believes that he can lead the party to a general election victory. But if I were him I might be inclined to stand aside. The party seems so riven, and that is a real problem. The Tories are having a free-for-all.”

He believes that Tony Blair has a role to play in restoring the fortunes of the left. “I am against Trident and nuclear energy, and for social justice. But I’m also a practical person. What Tony Blair did with Iraq was disgraceful. But there was more that was right. I think Blair did a fantastic job, and rumours of his return excite me.”

Ask Vince what he would do if he were Energy Secretary and he reels off a list: ban fracking; rip up the Hinkley Point C nuclear power contract; spend “a billion dollars” on promoting energy efficiency; tax polluting power companies; perhaps renationalise the energy industry, from producers to suppliers. He would also give green vehicles a big stimulus, as has happened in Norway with marked results. Thanks to tax breaks and incentives – exemption from VAT and public parking fees, freedom to use bus lanes – plug-in cars now account for over a quarter of new car sales in Norway. “It’s economic signals that change behaviour,” Vince says.

 

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As a boy, Vince was astonished at how many cars there were on the road. Surely the fuel they were burning couldn’t last for ever, he remembers thinking. But the oil companies kept discovering reserves, so there was no incentive for manufacturers to develop green cars. In 2008, when there were fewer than 2,000 electric vehicles on the road across 40 of the world’s most developed countries – and barely any at all in the UK – Vince and his engineers decided to take the initiative.

“I’m a bit of a petrolhead and also a tree-hugger, which is a dilemma. I could not get an electric car at that time, so we bought the shell of a Lotus Exige on eBay and turned it into a supercar,” he told me.

The Nemesis, as it was called, broke the British land speed record for an electric car in 2012, clocking 151.6 miles per hour. By then, however, Vince had realised that building cars was a different proposition from generating energy. Instead, he had started rolling out the infrastructure that he hoped would hasten the take-up of electric vehicles.

“We wanted to break the chicken-and-egg scenario,” he said. Few people owned electric cars, so there were barely any motorway charging points in Britain, which in turn discouraged people from buying the vehicles. Ecotricity started with a three-pin-plug point at a service station in 2011. It took eight hours to charge a Nissan Leaf, a small, five-door family hatchback that at the time had a 73-mile range. “We knew it was not good enough, but that a massive increase in technological capacity was coming.”

Today, a Nissan Leaf, the world’s bestselling electric vehicle, can drive for 80 miles on a half-hour power-up at a service station, which isn’t a full charge. Most new electric cars can run for between 100 and 150 miles before they need to be plugged in. “Range anxiety”, which has been a deterrent for many potential buyers, is fading away. “In a few years’ time you’ll be able to drive 400 miles on a 15-minute charge,” Vince said.

The Electric Highway has encountered some bumps along the way. Early on, Ecotricity entered into an agreement with Tesla, the Californian electric car company run by the technology billionaire Elon Musk (who also plans to colonise Mars). But in 2014 Ecotricity claimed that Tesla had gone behind its back, negotiating with service stations with a view to installing its own chargers. Ecotricity sued Tesla, which then countersued; the companies reached an out-of-court settlement in June 2015. (Vince was involved in another settlement a few months later. His former wife, whom he divorced in 1992 when they had no assets, had claimed nearly £2m of his fortune, and was awarded £300,000.)

As with his early embrace of wind power, Vince’s bet on the Electric Highway looks a smart one. According to the International Energy Agency, there were 1.26 million either fully electric or plug-in hybrid vehicles on the road at the end of 2015, more than three times as many as in 2013. The IEA forecasts that by 2040 there will be 150 million plug-in cars in service. With petrol consumption accounting for nearly 20 per cent of all oil consumed, that has huge implications for the petroleum industry – and the planet’s climate. In November, Shell announced that overall demand for oil could hit its peak in as little as five years.

Ecotricity had allowed drivers free use of its motorway plug-in stations since 2011, but in July it introduced tariffs for the first time. A half-hour charge now costs £6. The move angered some motorists; but Vince, who says the Electric Highway should cover its costs this year, is unapologetic. “We don’t have to make money in everything we do,” he said, referring to the football club and the car-charging network – but however altruistic his motives might be, he is also a businessman.

Green cars remain relatively expensive in the UK – the cheapest model in the Nissan Leaf range costs more than £20,000. But prices are falling and choice is growing, with more than 40 electric or hybrid models on sale in the country.

“The stumbling block was the range of the cars and the cost. What’s happening is one is going up and the other is going down,” Vince said. “The technology is on the cusp of mass appeal. You will see the government jump in before long and claim credit for that.”

As for Vince, he doesn’t even own a car. On a beanbag at the office in Stroud are the helmet and jacket he uses when riding in to work on his KTM motorcycle. And yes, it’s electric.

Xan Rice is the features editor of the New Statesman

Xan Rice is Features Editor at the New Statesman.

This article first appeared in the 05 January 2016 issue of the New Statesman, Divided Britain