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

All mod cons

Can you imagine a world where married women had to prove that they were unable to do housework before they qualified for benefits?  This was the UK in the 1970s.  Yes, you read that correctly.  Not the 1920s or even the 1950s. In 1975, at the same time as the Sex Discrimination Act, legislators in the UK came up with a social security benefit which made specific rules barring married women from claiming unless they could prove that they could not do the housework.  This was Housewives Non-Contributory Invalidity Pension (HNCIP).  To be fair on the legislators, the idea was to make a benefit available to women who had been unable to collect enough national insurance contributions to qualify for Invalidity Benefit because they had been out of the labour market.  But the main benefit Non-contributory Invalidity Pension (NCIP) was only available to men and single women. Married women had to pass the extra ‘housework’ test.  The thinking was that married women did not expect to work outside the home, that they would be financially dependent on their husbands and that they should only qualify for a state benefit if they were unable to do their ‘normal work in the home’.

So what did these housewives have to do to show that they couldn’t do their housework? The claiming process was the same as for everyone else trying to get an invalidity benefit:  they needed a certificate of ‘incapacity for work’ from their doctor but then they also needed to fill out a lengthy claim form.  This form included questions about ability to dust, iron, stand in a queue, keep the home clean and tidy and other such ‘normal household duties.  It also asked whether the claimant need to use any ‘special appliances’ to carry out such duties.  Critics of the scheme pointed out that it was not clear at all what a ‘special appliance’ meant and whether or not it included such things as hoovers and automatic washing machines.

Disability campaigners and feminists at the time recognised the discrimination in this system and published detailed criticisms of it*.  Eventually, as a result of campaigning by various organisations, the practical difficulties identified by the policy makers and increasing pressure from equal opportunities policies, HNCIP was abolished and replaced by a non-contributory benefit which the same for all men and women: Severe Disablement Allowance (SDA) in 1984.  This benefit had its own problems which I’ll write about another time.

All mod cons or living in a slum

While HNCIP still existed, policy makers took the whole problem of assessing capacity for housework seriously and conducted inquiries and reports into whether it was possible to make the household duties test work better.  In one of these reports the authors pointed out that questions about the ability to carry out ‘normal household duties’ depended very much on the social circumstances of the claimant:

‘In the matter of shopping, a definition would have to cover the different requirements of a housewife with a car and a telephone on the one hand and on the other hand of another housewife living in a tower block half a mile from a bus stop with neither car nor telephone.  Similarly a definition of cleaning duties would have to embrace the cleaning required not only in a modern purpose built bungalow full of mechanical aids but also in a slum tenement with neither hot water nor inside toilet facilities’

National Insurance Advisory Committee (1980) Report of the National Insurance Advisory Committee on a question relating to the household duties test for non-contributory invalidity pension for married women, London: HMSO. p10

 

This may seem very dated to us today but illustrates very well how the social model of disability is better able to describe the challenges that disabled people have than a purely medical one.  It is obvious that someone living in a bungalow with ‘all mod cons’ will be more able to keep their house clean than someone living in a slum and that a woman with a car and a phone can more easily do the shopping than another woman living in a high rise flat without these.  If only policy makers could see that the same issues apply to assessing people’s ability to do paid work.

*For example, Lister, R. and Loach, I. (1978) Second Class Disabled – a report on the non-contributory invalidity pension for married women, London: Equal Rights for Disabled Women Campaign.

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.

 

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.

Making links across time and space

What links German peasants in the 1500s, travelling people in Sweden in the 1960s, and applicants to special educational needs appeals in the USA today?

These groups of people were all discussed in papers at conferences which I attended recently. One of the great things about conferences is the opportunity to hear about research that you wouldn’t immediately think was relevant to your own but which allows you to make links across time and space and topic. So what did I learn about this group of  people from very different times and places?

Disability and social welfare in Germany in the 1500s

It was at a European conference on social history  that I went to a session on ‘Disability in early modern society’, which focussed on times before 1800. Angela Schattner from the German Historical Institute in London talked about her research on Public welfare in Germany in the 1500s. She observed that access to welfare only became available when all other sources of support had fallen away. Such welfare was pretty limited and might amount only to the right to beg. The definition of incapacity in her cases had nothing to do with impairment as such or the ‘ability to work’ but people’s ability to provide for themselves, which included access to family resources.  In those days, before the welfare state as we understand it today, there was less of a concern with ‘incapacity for work’ and more of a concern with ‘inability to have enough money to live on’, which are two slightly different things.

Travelling people in Sweden

Ida Ohlsen Al Fakir from Linnaeus University in Sweden talked about a social initiative in Sweden in the 1960s which attempted to provide medical and social services to ‘Swedish Gypsies’. A campaigning doctor of the time, John Takman, carried out a mass study of everybody classified as a ‘gypsy’, which involved medical examinations, home visits and advice on social needs, including housing, education, health needs and job advice. The study was organised by the Swedish Labour Board and its purpose was to integrate the Gypsy people into mainstream Swedish community and for them to find work . When I first saw the title of this paper I did not immediately think it had any relevance to my research but I was struck almost straight away when Ida introduced the paper, describing the Swedish gypsies as ‘socially handicapped’ and ‘partially able-bodied’. These were not her words but (translations of) the words used at the time to describe the travelling community. Here was a link between her research and mine. Although the group of people that she is interested in were discriminated against on the grounds of ethnicity rather than disability, the problems they were experiencing were framed in the same way as those of people who have difficulty finding work because of disabilities or health issues.
As with many government attempts to provide services for disabled people, the survey and its consequences were not entirely positive and there have been many criticisms of it. What I learned from this though, was that a social model of ‘labour market disadvantage’ can encompass both physical or mental impairment and social disadvantage because of ethnicity and social background … but the views of professionals, in particular medical professionals, can still carry very heavy weight within this model.

Thanks to Ida Ohlsen Al Fakir for this information, also available on her University website

The secret law of disability?

And, finally, at the Law and Society Association conference  Jasmine Harris from the American University Washington College of Law gave a paper on the ‘Secret Law of Disability’ where she argued that legal hearings on social security, special educational needs and mental health should be held in public rather than in private. We tend to think these kinds of hearings should be private to protect people’s privacy but Jasmine Harris argued that they should be public so that issues concerning discrimination against disabled people would be more publicly debated. That connects to some ideas that I have been having about the ethics of using people’s names compared with keeping them anonymous in historical research. As a social scientist, the codes of ethics that I follow usually emphasise the importance of anonymity but historians tend to use people’s real names, and sometimes photographs if they are available. I’ve been wondering where the boundary lies.