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The art of cruelty: why the Conservative attack on disabled people harms us all

No sick person responds to their diagnosis by thinking, “I can scam taxpayers for £73 a week!”

I really shouldn’t be writing a column this week. I’ve come down with a one-two punch of stomach flu and food poisoning and have spent the past 48 hours trying to keep my insides on the inside while the room spins suspiciously around me.

I’m obviously in no state to work. But the Department for Work and Pensions (DWP) would disagree. Between December 2011 and February 2014, 2,380 people died of a chronic or terminal illness shortly after being found “fit for work”. I doubt that it would make an exception for me and my norovirus. This is Tory Britain. You work until you collapse and then you work some more and you’d better be grateful. I’m just trying to move with the times.

The DWP fought to stop that figure being released and for good reason: it puts another number on the inhumanity of the new sickness tests, which had already been linked to between 40 and 80 suicides. I should say “fitness tests”, because nobody gets to be sick any longer under Iain Duncan Smith (so good at rebranding ideological cuts that they named him twice, once for each face). Navigating this system is humiliating enough for disabled people without them being lied to every step of the way. If the DWP would just come out and say that it doesn’t believe the state should help people who are ill, disabled or injured, it would somehow be more bearable. At least people would know where it stood. But the stated aim of the welfare changes is to “get people working”, because: “Work is the best route out of poverty.”

This is a fib on several levels. Not only is in-work poverty a larger drain on the benefits system than the unemployed, but most of the things that help disabled people get back to work have been cut. The Tories have slashed carer budgets and closed the Remploy factories that helped disabled people into the work so many of them desperately want to engage with but can’t. They got away with this by launching an all-out propaganda assault that portrays disabled and workless people as “scroungers”, “sponging” off the state, when presumably they should be grateful not to be left on a hillside to die as would have been done in the good old days.

The new figures prove beyond doubt that the “Employment and Support Allowance” system and personal independence tests are throwing people off benefits and forcing them to seek work that is either inconsistent or non-existent when they are not just incapacitated, but dying. It’s no wonder that the UN has launched an investigation into Britain’s disability benefits system for potentially violating the human rights of those who are forced to navigate the twisted system of forms, delays and outright lies.

Then again, numbers can only tell you so much, so let’s put this in context. I recently spoke to a woman with a rare disease, which keeps her bed-bound for days, even weeks at a time. The DWP told her that she was fit for work. When charity workers involved with her case came to check on her, they found bottles of urine stacked around the bed and piles of half-eaten ready-meals, which the woman had been consuming cold. She had been unable to reach the kitchen or the toilet. Caseworkers told her that her illness wasn’t that bad: because she was bed-bound for only three to 14 days at a time, she probably wouldn’t starve and she could technically survive lying in her excreta for that long. So why should the state give her any help? This is Tory Britain. You’ve got to lie in your own shit and piss for longer than two weeks before you’re considered sick.

“I feel like I’ve been robbed twice,” another young woman told me. She had spent a year and a half appealing to the DWP over benefit cuts and was then found ready for employment, despite collapsing with pain and being carried out of the interview room. “I’ve been robbed first by my health and then by the government, by not giving me the insurance I paid for. I’m now on suicide watch. I wasn’t suicidal before I applied. I am now.”

The benefit tests do not merely stop disabled people getting the help they need. They actively make people sicker. They plunge the already depressed into suicidal despair; they wear down the chronically and terminally ill with stress and bureaucratic exhaustion. Nobody’s first thought on being diagnosed with a serious illness is: “Hooray, now I can scam the taxpayer for £73 a week.” But claiming benefits has become so onerous and terrifying that many sick people are now too frightened to apply or appeal. They choose instead to drop out of the process after months or years and accept permanent poverty – and that is precisely the point.

The welfare state is being dismantled and rebuilt as a machine to manage and discipline the workforce into accepting precarious labour, low pay and no social safety net. Iain Duncan Smith is proud of this machine. The machine is not broken, as many critics have suggested. It is doing what it was remade and designed to do. It is efficiently driving all the hope out of a sickening and insecure labour class.

The Conservatives speak of delivering a smaller state but they are more than happy to use the mechanisms of state to grind all the fight out of the poor. This is the state weaponised against the vulnerable, to make them believe that they are less than human. This is the welfare state twisted into a tool to separate human beings from their social conscience. Simply getting rid of the welfare state would have been easier and cheaper, but this way the Tories can persuade the most vulnerable in society to accept their fate and the rest of us to believe that they deserve it. That is why the benefits system is a moral hazard to us all, whether or not we are sick. The UN is right to investigate and the government and the public should listen before it’s too late. 

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things.

This article first appeared in the 03 September 2015 issue of the New Statesman, Pope of the masses

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The overlooked aspect of patient care: why NHS catering needs a revolution

The NHS performs so many miracles every day – in comparison, feeding the sick should be a doddle. 

A friend recently sent me a photo from her hospital bed – not of her newborn baby, sadly, but her dinner. “Pls come and revolutionise the NHS” the accompanying text read, along with a plaintive image of some praying hands. A second arrived the next morning: “Breakfast: cereal, toast or porridge. I asked for porridge. She said porridge would be ‘later’. Never arrived. (sad face).”

Contrast this with the glee with which another friend showed me his menu at a Marie Curie hospice a few weeks later. He seemed to have ticked every box on it, and had written underneath his order for syrup sponge and custard: “extra custard please”. It wasn’t fancy, but freshly cooked, comforting food that residents looked forward to – “like school dinners”, he sighed, “but nice”.

To be fair, though budgets vary significantly between hospital trusts, a reliable estimate suggests £3.45 per patient per day as an average – only slightly more than in Her Majesty’s prisons, though unlike in prisons or schools, there is no legally enforceable set of minimum standards for hospital catering. As Prue Leith writes in the foreword to a 2017 report by the Campaign for Better Hospital Food, “this means hospital food is uniquely vulnerable to a race to the bottom in terms of food quality, and patient care”.

Plate after plate of disappointment is not only demoralising for people who may already be at a low ebb, but overlooks the part food has to play in the recovery process. Balanced, appetising meals are vital to help weaker patients build up strength during their stay, especially as figures released in February suggest the number of hospital deaths from malnutrition is on the rise. According to Department of Health findings last year, 48 per cent of English hospitals failed to comply with food standards intended to be legally binding, with only half screening every admission for malnutrition.

The Campaign for Better Hospital Food’s report, meanwhile, revealed that only 42 per cent of the London hospitals that responded to its survey cooked fresh food for children – even though the largest single cause of admissions in five-to-nine-year-olds is tooth extraction. Less than a third of respondents cooked fresh food for adults.

Once the means to produce fresh meals are in place, they can save trusts money by allowing kitchens to buy ingredients seasonally, when they are cheaper. Michelin-starred chef Phil Howard, recently tasked by the Love British Food organisation to cook their annual lunch on an NHS budget, explained that this, along with using cheaper cuts and pushing vegetables centre stage, allowed him to produce three courses rather than the two he’d been asked for. Delicious they were, too.

Andy Jones, a chef and former chair of the Hospital Caterers Association, who was there championing British food in the NHS, told me the same principles applied in real healthcare environments: Nottingham City Hospital, which prepares meals from scratch, saves £6m annually by buying fresh local ingredients – “I know with more doing, and voices like my small one shouting out, we will see real sea change.”

Unusually, it’s less a question of money than approach. Serving great hospital food takes a kitchen, skilled cooks and quality ingredients. But getting every hospital to this point requires universal legal quality standards, like those already in place in schools, that are independently monitored.

Nutrition should be taken as seriously as any other aspect of care. The NHS performs so many miracles every day – in comparison, feeding the sick should be a doddle. 

Felicity Cloake is the New Statesman’s food columnist. Her latest book is The A-Z of Eating: a Flavour Map for Adventurous Cooks.

This article first appeared in the 18 April 2018 issue of the New Statesman, Enoch Powell’s revenge