When the Department of Work and Pensions announce, as they so often do, that they are perturbed by the amount chronically ill and disabled people cost them, I look at my long list of diagnoses, a veritable rap sheet of misfiring immune systems and chemical imbalances, and consider that truly, the condition that limits me the most is capitalism.
It is the social model of disability. Just as wheelchair users aren’t disabled by their wheels, but by stairs, I am not disabled by my inability to work, but by the insistence that that is all I’m good for. I long to see an end to Work Capability Assessments, but the DWP is reviewing them, not because they are cruel, but because they believe employment is a panacea for workshy malingerers like me. No discussion of health and disability comes without a contextual frame of employment. Exercise is also good for our health, but I do not have my medical status judged at every turn by the Department for Culture, Media and Sport. The political marriage of health and money must be dissolved.
The Chief Executive of Public Health England, Duncan Selbie’s, statements that “People in work generally have better health” is one of those glorious pieces of circular logic that sounds like it makes perfect sense until you realise that, no, it doesn’t make very much at all. People in work have better health because people in better health are able to be in work. People who eat nuts generally have lower rates of nut allergies, but we shouldn’t be cramming Walnut Whips down anyone’s rapidly closing throat in a bid to cure them. We mustn’t confuse some correlation with direct causation. For individuals without other health conditions, then yes, “a good job is good for your health.”
A sense of purpose, social interaction and not having to worry about paying the bills are going to be beneficial – but these are by no means guaranteed by a job contract. This mantra should be used to create good, decently-paid jobs for active jobseekers, not to force ill people back to work. And in a job market of zero-hours, short contracts and internships, how many workplaces would be willing to put in the adjustments individuals need to make their return worthwhile for their health?
I’m not, as Damian Green suggests, “sitting at home living on benefits”. I’m lying at home, often not living much at all. I have a full-time job just getting through the day. Green may not think this is “any good for people” but for those with chronic health conditions, neither is the stress of the next envelope through the door from the DWP, demanding more proof and or creating more loopholes.
The rhetoric that we are all lounging around on thrones of welfare is what fuels the doubts and disdain around us. It’s why we’re told that if only we tried a bit harder or pushed ourselves a bit further or just plain got over ourselves, we’d be better. When we take time off work to focus on our recovery, the department that should protect us financially as we do so should not tell us that we are only making ourselves worse.
While I welcome government policy acknowledging too often ignored mental health conditions, people with them, as with most chronic health conditions, are told that they just need to pull themselves together enough already. We do not need any more of the blame. Please, take it from me: this is not the easy option. It is not a stroke of good fortune that, aged 24, I took up my walking stick and hospital appointments. Disability isn’t cushy. Our social security payments aren’t benefits but consolations.
As with the removal of reassessments for lifelong conditions, a review of Work Capability Assessments doesn’t nearly go far enough. Until we discuss someone’s health without discussing their employment, there is much work to be done.