From driving a quiet horse to collecting bridge tolls: why benefits advice matters

In 1928 a furnace man had a stroke. He could no longer continue in his job so he claimed Sickness Benefit. He claimed benefit for several years but eventually the benefits decision makers decided that he was now fit for light work. They suggested that he could ‘drive a quiet horse and do goods delivery work of a quiet character’.  It was not clear how he was supposed to find a job where a ‘quiet horse’ was the main requirement. Fortunately for him, he was able to appeal this decision. At the hearing the appeal judges decided that he was unable to work and he was able to keep his benefit.

In my research on the meaning of ‘incapacity for work’ across the twentieth century I have found many examples of suggestions as to the kind of work that claimants might be able to do. It seems fairly simple. If someone was unable to carry on with their ‘usual work’, it was reasonable to expect them to consider what other work they might be able to do. When we look at the kinds of jobs that decision makers suggested we see that these suggestions were strongly influenced by social expectations about work.  In the early twentieth century almost all suggested occupations were different for men and women:  so men were frequently told that they could work as caretakers or watchmen while women were expected to do domestic work.  A few occupations were suggested for both men and women:  lift attendants, shop work and clerical work, although the language for these differed.  Men were told that they might be able to manage a shop, while women were told they could be shop assistants.  This is not at all surprising for the time but it illustrates that the definition of ‘incapacity for work’ was dependent on different assumptions about what men and women could do.  It was never suggested to men that they could work as domestic servants and it was never suggested to women that they could do the range of jobs usually expected of men.

Into the 1980s: bridge toll attendants and car park supervisors

Jumping forward to the late twentieth century and Invalidity Benefit decision makers began to use standardised suggestions for jobs which benefits claimants might be able to do.  From my own experience of working as a welfare rights officer in central Scotland in the 1980s and 1990s, the then Department of Health and Social Security often suggested that claimants could work as bridge toll attendants. No doubt the DHSS expected people to work on the Forth Road Bridge, which had staffed toll gates at the time.  Despite the fact that vacancies on the bridge tolls were probably few and far between, it was rarely the case that claimants were able to manage these jobs.  We often represented people with a range of back problems, which, combined with a lack of relevant experience or sometimes appropriate numeracy skills, made this kind of post particularly unsuitable. 

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In other parts of the country the jobs suggested would include attendants at car parks, swimming pools and museums, on the assumption that these were ‘sedentary’ jobs that would be manageable by people with a range of physical impairments.  Often these jobs were unsuitable because they involved sitting for long periods, lifting and bending, a range of numeracy and interpersonal skills and sometimes the need to act in an emergency as a first aider or security guard.  This is not to suggest that people claiming Invalidity Benefit could never do these jobs. However, in individual cases, the suggestions were often unsuitable.  With the help of advisers, claimants could challenge these assumptions when they appealed, using evidence about the reality of the work suggested.  This allowed people, who had great difficult in finding suitable work, to keep their much needed benefits.

Rules for incapacity benefits have changed dramatically since the 1980s and now we have the draconian Employment and Support Allowance.  There is still a pressing need for advice and the right of appeal against unreasonable decisions.

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Desperate measures

You may have seen the news items about a recent report on food banks Emergency Use Only: Understanding and reducing the use of food banks in the UK, published by The Child Poverty Action Group, Church of England, Oxfam GB and The Trussell Trust. It’s a shocking read but unsurprising given the current assault on benefits claimants. The report highlights particular problems with the benefits system, including the difficulties experienced by people trying to claim Employment and Support Allowance. It gives examples of people resorting to food banks because they had been found ‘fit for work’ under the ESA assessment system or because there had been delays in the processing of their claims or their appeals.

Refusals of benefits in the past

This set me to thinking about the people I have been researching who were trying to claim sickness and disablement benefits in the 1920s. These people had all appealed against refusals of benefits. Some were successful and were able to keep their benefits. Others were unsuccessful and were left with nothing. Even when people were unsuccessful, the appeal judges usually agreed that the claimants had health problems or were going to find it difficult to find work because of their impairments. When I read about these people who were refused benefit, I often wonder what happened to them. Did their health problems disappear and make it possible to work? Or did they take low paid, insecure jobs and hope that they could hold on to them, given their health issues? Or were they forced to turn to charities like the food banks of today? Or could they turn to family for support? The appeal papers do not always say much about the claimant’s wider circumstances but sometimes they show that claimants really had nowhere to turn.
For example, in a case from 1927, a woman was described in circumstances which seemed to be desperate. Her accommodation was:

‘dirty and insanitary and which from her account appears to be badly overcrowded. She is in arrears with her rent and is living at the present time on what she can borrow from her relations.’*

This woman was 49 and had been diagnosed with tuberculosis although she was now partially recovered. She had previously worked in factories and as a domestic servant. Her own doctor believed that she was unable to work as a domestic servant but that being in domestic service would at least give her better accommodation. He also thought that she could:

‘work in the fields in fine weather but thought that it would be dangerous for her to get damp’

The appeal judge decided that she was fit for work and said that she was:

‘quite capable of undertaking remunerative employment of a not too strenuous nature eg as a domestic servant, a shop assistant or an employee in a nursery garden’

I couldn’t help but wonder what job this was going to be. Did he really think that she could work in a nursery garden where she could only work in fine weather? Or find work as a domestic servant so that she could move out of her ‘insanitary’ lodgings but only do ‘light duties’?

Of course I don’t know what happened to her after her appeal failed but I can’t help but think that she would be unlikely to find work of this restricted kind.
In another case the claimant was a man aged 57 who had previously worked in print works although he had not done so for twenty years**. In the mean time he had worked as a messenger and had a newspaper stand. His doctor confirmed that he had rheumatism, bronchitis, emphysema and poor eyesight and had difficulty climbing stairs. The appeal judge decided that he was fit for work, based on the opinion of the government doctor, the ‘Regional Medical Officer’. The case papers do not give very much information as to why the Regional Medical Officer disagreed with the doctor but I can’t help but wonder what work it was that they thought he was going to be able to do and what happened to him next.

As with benefits decision makers today, it was not the job of the appeal judge to find solutions to the whole social circumstances of the people who appeared before them – only to decide whether they were fit for work or not. It seems that then, as now, once that decision had been made, it was up to the claimants to find solutions to their lack of income and lack of access to work by themselves or to turn in desperation to charity.

* National Archives PIN 63/1/410 1927
** National Archives PIN 63/3/487 1928

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Poverty and disability benefits: a view from the past

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This week is Challenge Poverty Week, organised by the Poverty Alliance and aiming to increase awareness of poverty in Scotland.  Poverty is unacceptable and is a continuing problem in modern Scotland.  As part of the week of action I contributed to a blog, along with other researchers on different aspects of poverty.  I thought I would share my post here.

Poverty and disability are closely linked

Researchers have shown that disabled people are more likely to be out of work, in poorly paid jobs and living in poverty than other groups in society.  As a result many disabled people find themselves claiming welfare benefits, including Employment and Support Allowance if they find it difficult to work.  My research concerns the history of incapacity benefits, that is, social security benefits for people who are unable to work because of sickness or disability.  As I set out to write this post, I wondered what the relevance of this work was for ‘Challenge poverty’ week.  After all, ‘challenge poverty’ is about today and anti-poverty campaigners sometimes have an uphill struggle to show that poverty is a problem today, with critics often pointing to the past to show how much worse things used to be.  Others on the challenge poverty blog can explain why poverty is such a problem today.

My task is to show how many of the debates about poverty today are rooted in questions which have been around since the beginning of the welfare state and beyond.  To show this, let’s have a look at some quotations about people claiming disability benefits.  Can you guess the date?

Guess the date of these quotations

  1. Against the continued advance of a tide of unjustified claims to [] benefit there are two main lines of defence. The first is the adoption of measures to secure that a proper standard is applied in the issue of medical certificates for incapacity while the second consists in strengthening the safeguards to be adopted by [decision makers] in connection with the supervision of claims
  2. A life of idleness is bad for [her], and in our judgment she would have no difficulty in the present state of the domestic labour market, in obtaining suitable remunerative employment which is well within her physical capacity. In her own best interests we strongly recommend the appellant to get work.
  3. A … person may be regarded as incapable of work because he is unable to travel to work, but it does not follow that because he is unable to travel to his former employment he is entitled to sickness benefit. It is the duty of a .. person to do what is reasonably necessary to regain his position as a wage earner and so overcome the effects of any physical disability which he may be under.

[answers at the bottom of the page]

 Implications for benefits today

These quotations show that policy makers have been worrying about how to define incapacity for work since the very first sickness benefits in 1911.  This concern has led to tough and intrusive mechanisms for checking up on people across the 20th century.  The continuing theme which we can see in the development of incapacity benefits is one of distrust:  that people cannot be trusted to claim benefits honestly and that there must always be mechanisms for checking up on them and keeping them in line.  There has also been a continuing argument that ‘work is good for you’ and that people have a duty to get back to work as soon as possible after illness or disability.

Critics of disability benefits policies today argue that access to benefits has become more difficult, first of all by the redefinition of ‘incapacity for work’ brought about by Employment and Support Allowance and, secondly, by the introduction of work requirements for claimants.  Both of these changes to benefits policy have made life more difficult for people claiming benefits but the ideas behind them are not new.

The relationship to poverty

So what does this have to do with poverty?  It is well established that people with health problems and disabilities find it more difficult to get work, to stay in work and to earn adequate wages and that these difficulties are intensified for people with low educational qualifications.  So ‘incapacity for work’ has a direct link with poverty.  If the benefits paid to people because they are unable to work (or to find work) are kept deliberately low, poverty becomes even further entrenched.  It is even worse for those who are refused benefits when the definition of incapacity for work is tightly drawn. Policy makers claim that they make it difficult to claim benefits and that they keep payments low in order to ‘make work pay’ and to encourage people get back to work.  That is all very well when decently paid work is available and the barriers to work are removed.  But so long as these barriers exist, people will need adequate benefit payments to keep them out of poverty.

Dates of quotations

  1. 1931 Ministry of Health circular ‘National Health Insurance control of Expenditure on Sickness and Disablement Benefits’
  2. 1920 Appeal hearing against a refusal of sickness benefit
  3. 1917 Annual report of National Health Insurance Committee 

Further reading

Bambra, C. (2011) Work, worklessness and the political economy of health. Oxford: Oxford University Press.

Roulstone, A. and Prideaux, S. (2012) Understanding Disability Policy. Bristol: Policy Press.

blog first published on the Challenge Poverty blog

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Mr Bingo

Should playing bingo stop your benefit? In my research in the National Archives I found a civil service file from the 1960s which included a press cutting about the case of ‘Mr Bingo’.  According to the Daily Mail Mr Bingo was claiming sickness benefit because of a back injury but he had hit a winning streak in his local bingo hall, bringing in an average of £50 a week for the previous four months.

His sickness benefit came to £7 a week and he was also claiming the means-tested National Assistance of around £3 a week. Civil servants of the day copied the press cutting and asked what should be done about him.  There were two problems: on the one hand he was claiming a means-tested benefit and they needed to decide how to treat his ‘earnings’.  Were they income or capital?  If they were income, his National Assistance should stop.  If they counted as capital he could go on claiming so long as his winnings didn’t go above the capital limits of £600 at the time.  The other problem was whether or not playing bingo counted as work.  If Mr Bingo was working, he was not eligible for sickness benefit.  The handwritten note in the civil service file says:

Does this put him in class II [in other words, is he self-employed]?  If so he would not be entitled to sickness benefit – not incapable of playing bingo – and we could reclaim the sickness benefit paid for days of bingo

 National Archives file PIN 35/72, memo dated 2 March 1965

I’m not sure if they were being entirely serious about Mr Bingo being a self-employed professional bingo player, but his story in the media did lead to his case being referred to the Regional Medical Officer to check that he was still incapable of work.  His case illustrates one of the problems that policy makers have to struggle with when making rules about incapacity benefits

Dealing with claimants who work

Most incapacity benefits have rules that prohibit claimants from ‘working’ when they claim.  This may seem like a simple rule.  It makes sense that someone who is incapable of work is not also working.  The problem is that, if you take that rule to its logical conclusion, claimants of incapacity benefits should do nothing at all.  We can see this happening today when benefits claimants are caught going on holiday or taking part in charity fundraising events.  These kinds of activities are clearly not work but they might be evidence that a claimant is not as disabled as they say.  Equally they might be evidence that claimants are trying to do useful things with their lives even when they are unable to find or hold down conventional jobs. Decision makers have always looked for ways of finding out if someone is claiming inappropriately. But are there some kinds of work that it would be reasonable to let a claimant do? Would it not be a good idea to let people to do some work to help them get back into the labour market or learn new skills? Benefits rules have often been developed to allow ‘therapeutic work’ for these purposes.  Policy makers need a definition of ‘work’ before they can apply such a rule.  In the early years of the sickness benefit scheme, policy makers struggled with what kind of activities might count as work and would therefore stop people getting benefits.  They were particularly concerned about women doing housework.  I’ve written about this before in ‘Researching the history of incapacity benefits’.  Women were often refused benefit when they were caught doing the laundry or doing more than the most insignificant amounts of housework.  But what other kinds of work might stop a claim?

In the appeal cases I have found a woman who was selling cigarettes in her husband’s shop, a man who was helping out with his brother’s shoemaking business, a woman who was teaching herself to type with her left hand after a stroke, a man who was working as a political organiser during an election campaign and a man who was selling second-hand furniture from his back door.  All of these people had their benefit stopped because they were ‘working’.  Some won their benefit back after appeal, by persuading the judges that what they did was not ‘work’ or that their disabilities were so extensive that they could not reasonably expect to be paid by an employer.  Others were not successful and were told that they were capable of work.

As the benefits system developed over the twentieth century policy makers and legal decision makers devised rules to decide whether or not such activities counted as work and how much work a claimant could do before their benefit would be stopped.

Today ESA has its own rules about ‘permitted work’ which limit the number of hours a claimant can work and the amount of money they can earn.  There are also complicated rules about special circumstances, including ‘medically supervised work’.  But the problem still remains for claimants who successfully navigate these complex rules, that participating in work or worklike activities might lead to an investigation into their incapacity for work and to a loss of benefit.

 

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Employment and Support Allowance – a flawed design?

A recent report on the UK’s main disability benefit, Employment and Support Allowance (ESA) said that the current system for assessing benefits was ‘flawed’. This report by the House of Commons Work and Pensions Committee Employment and Support Allowance and Work Capability Assessments First Report of Session 2014-15 HC302 brings into sharp focus the problems of attempting to measure people’s ‘incapacity for work’.

A controversial procedure

ESA was introduced in 2008 as the latest attempt by governments to find a way of assessing whether or not someone was unfit for work. ESA has been controversial since it was first introduced and concerns with it have multiplied as researchers, disability campaigners and support organisations for people with long term health conditions have shown how the system has impacted on real people. For many people it has meant a loss of much-needed income, leading to hardship and distress. Even when people have successfully claimed the benefit, the assessment procedures and delays have caused considerable anxiety and financial hardship for claimants.

Demonstration against cuts in disability benefits

Much of the criticism of the system has been directed at ATOS, the organisation contracted to carry out assessments but this report reminds us that implementation by ATOS is only part of the problem. There are fundamental problems with the policy itself, which a change to a different provider in late 2014 will not solve. One of the key difficulties has been the way in which a points based system of assessment, where people are awarded points for different levels of impairment, cannot take account of the complexity of people’s experience in the real world of work.

Looking to the past

If we look at the question in its historical context we can see why this is. Ever since the first introduction of sickness benefits in 1911, policy makers have worried about how to assess whether someone was ‘really’ unfit for work. In 1951, after forty years of attempting to define what ‘incapacity for work’ meant, legal decision makers came up with a working definition:

‘A person is incapable of work … if, having regard to his age, education, experience, state of health and other personal factors, there is no work or type of work which he can be reasonably expected to do. By ‘work’ in this connection we mean remunerative work that is to say work whether part-time or whole time for which an employer would be willing to pay, or work as a self-employed person in some gainful occupation’ [National Insurance Commissioners’ Decision R(S)11/51, para 5]

This definition was not perfect and the benefits system in the mid-twentieth century left many disabled people without access to income but at least it attempted to take account of the varieties of social experience which combine with poor health and disability to make finding work difficult.

Taking account of the real world of work

The current system which is used to assess Employment and Support Allowance cannot do this. The House of Commons report makes this point by emphasising that many people who are found ‘fit for work’ (and refused benefits), or who qualify for benefits but are expected to look for work, are being failed by the system. The procedure does not take account of the support that they would need to find work in the real world. The report says that the statement that someone is ‘fit for work’ should be ‘conditional on this support being available’ (para 141). While criticising the current assessment process for ESA and calling for a fundamental review of the mechanisms, the report does not suggest replacing the points system altogether. It continues in its search for an ‘accurate’ measurement of people’s incapacity (p3) but it does this within an understanding that real people’s experiences of attempting to find work depend on a range of social circumstances which go a long way beyond the simplistic measures that a points system can assess. The report also recognises that refusing people benefits is not the same as helping them to find work, a first step in moving beyond the current government’s view of the problem.

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Researching the history of incapacity benefits

Claiming incapacity benefits

If you claim Employment and Support Allowance in the UK today you will undergo a medical test to assess whether or not you are ‘capable of work’. If you are found capable of work you can appeal against this decision.  Not everybody appeals of course but many of those who do are successful, raising questions about whether the medical tests are fair.

Looking to the past

These debates are not new.   I have been looking at similar questions about how to assess people’s capacity for work right back at the beginning of the welfare state in the early 20th century.  In the National Archives in London there are records of appeal hearings against refusals of sickness benefits.  These include the case of a former miner, who could no longer work in the mines.  He was that told there was nothing wrong with his voice and he could work as a public speaker.  This man used the appeal procedure to get the decision overturned.  Another housebound disabled woman was not so lucky as the appeal judges told her that she could take in lodgers, echoing some of the debates we hear today about the bedroom tax.

My research shows that decision makers used an assortment of measures to check whether people were capable of work, ranging from sick visitors who spied on claimants to state doctors who provided second opinions on cases.  Like today, people were often unhappy with these decisions and appealed against them.  These cases involved ordinary working people who had little experience of dealing with paperwork or the law but somehow they made their way through this process to have their cases heard.

What do we mean by ‘incapacity for work’ and how has this changed?

If people qualify for benefit because they are ‘unable’ to ‘work’ then we need to have a common understanding of what we mean by work and who is expected to perform it. Looking at these appeal cases shows me that there were a whole lot of social assumptions about ‘work’ and particularly about men and women – so men were expected to do manual labour but not domestic work like cleaning or taking in washing.  Women, on the other hand, could have their benefit stopped because they had been caught doing the laundry – if they could do their own washing, then they could go out and do someone else’s; they were capable of work

I’m looking at how these ideas changed – or possibly stayed the same – across a hundred years, from the first sickness benefit scheme in 1911, the effects of mass unemployment in the 1930s, the introduction of the modern welfare state following the second world war, then the changes brought about by European laws on gender equality in the 1970s and up to the Employment and Support Allowance reforms today.

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