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  1. Politics
3 July 2015

Memo to David Cameron: I have all the incentives I need to stop being ill. It’s called “being ill“

Disease isn’t like a gas meter. It has no notion of economics. It doesn’t switch off because you’ve stopped putting money in.

By Rosie Fletcher

Another day, another rummage down the back of the benefits sofa to find a spare £12bn. This week: changing Employment Support Allowance to incentivise ill people to get back to work.

One problem: I already have the best incentive to stop being ill and get back to work. It’s called “being ill”.

I would love to go back to work because if I were able to work, I would no longer be sick. Long-term illness nibbles away at your identity from the edges, taking out chunks of the things that make you you: the friends you meet, the shops you wander into, the job you do. I would love to work, if only because it would give me something to use in small talk, a context in which to place myself, the grit around which an imperfect pearl of who I am can begin to re-form.

I would like to have a job. I would like to feel productive. I would like to do more with my day than clutch at cups of tea and switch on the radio because I can’t keep my eyes open for the television. But currently I can’t and I rely on ESA to keep me in teabags.

This proposal makes two fundamental mistakes: that illness and disability are a) passive and b) attractively lucrative.

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If you think I do not work for my benefits, you are wrong. Ringing the DWP at eight in the morning to find out why my benefits are a month late, only to hear a recorded message to tell me they are busy and that perhaps I ought to call back between eight and nine in the morning. The constant stream of sick notes I have to ask my doctor for, pick up from the surgery and post to the DWP, because the backlog means that if I wanted to get assessed in a reasonable timeframe, I should have applied for ESA roughly six months before I got ill. The sight of a brown envelope on the doormat makes my heart pause; I fear each one will contain a ransom note of sanctions. My doctor asks me what causes me stress. I can answer in less than three words. I can answer in three letters. Dee. Doubleyew. Pea.

Use of the word “passive” is nonsensical, as though one can be “active” for sickness benefits. Perhaps I could open my home to visitors and charge them to look at me. Come, behold the Incredible Chronically Ill Girl! She’s only 25, but she walks with a stick! See how she struggles to do her own laundry! GASP as her overwhelming fatigue prevents her finding the words to answer your basic question about tea!

Chronic illness often feels like a terribly paid admin job, chasing down missed payments, posting doctors notes, requesting repeat prescriptions, sending in bank statements. The rigamarole around being ill seems to tower, colussus-like, over the actual illness. The welfare state should exist to make life easier for those in need, to offer a helping hand in times of crisis, no matter how long those times last. Welfare isn’t lucrative. It’s enough to get by.

Disease isn’t like a gas meter. It has no notion of economics. It doesn’t switch off because you’ve stopped putting money in. This isn’t some kind of elaborate con I’ve been running, shutting myself away from the world to trick you out of the princely sum of £48 a week. Cutting my benefits won’t get me back into work. It will make my life smaller, more stressful. It will make me sicker.

Please do not be taken in by the weaselly misuse of the word incentive. Incentives are nice things, rewards, like cream cakes or that video of Michael Gove falling over. Cutting the money that sick and disabled people receive isn’t an incentive to work, it’s a disincentive and a punishment for being ill. You can paint it orange and call it a carrot as much as you like, but if you’re beating people into the ground with it, it’s still a stick.

This isn’t just a question of economics, of ideological war on the welfare state. This is the insidious, callous notion that sick and disabled people are ultimately not trying hard enough. This says what people with chronic illnesses and disabilities hear all too much from their friends, from their families, from even their doctors: we do not believe that you are ill.

If you think that eventually you can make people so sad and stressed and poor that they will “get over” being ill, that you can starve them out and they’ll end their little displays of sickness, then you are very much mistaken. We have all the incentives we need to get back to work; cutting ESA will only make it harder to do so.

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