Posiition Statement.

This is for my uni work. Ultimately it will end up on my blog anyways, but this is just a first draft, that I am really wanting some peer feedback on. It is a position statement against this debate motion: The government’s proposal to use independent medical professionals to decide who does and doesn’t get the new DLA is the best solution.

Please read it, and if you want to make any comments please do. It will be fully referenced (I know, bad student who references AFTER they write the thing). I am really struggling with negative thinking at the moment and so I really need some unbiased opinions on it. Would it convince you that its a bad idea to go ahead with the medical exams? Go on, be a tory... see if I can convince you :)

The inevitable, inescapable future is that Disability Living Allowance is going to be replaced with a new benefit called personal independence payment. One of the big changes will be in the application process. No longer will disabled people have to fill in a 60-page tome about every depressing aspect of their existence, but according to the government anyway, be free to have a 'chat' with an independent assessor to determine eligibility. Sounds great right? No, no it isn't. The government might have dressed it up to look good, but the reality of this idea, and the fear that people have is deeply entrenched thanks to the Work Capability Assessment, the new medicals for the new incapacity benefit. Although the government says they are 'learning' from the mistakes of this, they still intend to use this model in the new benefit delivery.  That would be the medicals that even the designer and creator have condemned to the rubbish heap. So, what are the problems?

Firstly, the problem is that the governments definition of independence seems to have found from a dictionary that none of the British public are privy to. True independence can only be found when a person is doing something without influence from another person. This is not the case with the government’s proposals. As with the previous incarnation of the new style medical, the likelihood is that this work will be outsourced to a private company. It is in this monetary transaction that independence is traded in for profit. Think about it. The company’s clients are the government, their contract is with them, and it is in their best interests to comply with their client’s orders. As it is the stated aims of the government’s new Personal independence payment to reduce the caseload and expenditure, that is what will also be the company’s aims, and the statistics will reflect this. (As has happened with the new sickness benefits)

By implication, the government’s proposal casts doubt on the independence of the current system. In fact, they have even alluded to this themselves. Apart from the detailed, 60 page form that claimants have to fill in, there is also room for a 'statement from someone who knows you best', (something the government is getting rid of in the new process) and the opportunity for a person to nominate a medical professional to present evidence. In fact, by obtaining evidence from all these sources reduces the risk of a bad decision being made, and increases the independence and equality in the process. There is even provision for another medical assessment to be made in house by the DWP if the decision maker doesn't feel able to make a decision based on the evidence they have. I would argue that the current application process is more independent that what is being proposed, and that if the governments aim was that of true independence then they should simply expand their in house medical services, but keep the ethos of the current benefit, where the claimants needs and voice are placed firmly in the centre.

The second thing that is at risk with the proposed changes to Disability Living Allowance is autonomy and authenticity. Although the current system can not be classed as wholly autonomous or even authentic, what it does do is directly involve disabled people and values their voice in making a decision about eligibility. The phrase ‘nothing about us 

without us’ has become one of the key principals of the disability movement and it is increasingly being adopted by different areas in society including this application process for DLA. The current ideology around this is that the claimant and their own medical professionals are the most authentic agents to provide a true picture of how their disability affects them. Contrary to popular opinion the application process is complex and uses many different pieces of evidence to support a claim. The focus isn’t medicalised, but the effect of impairment on a person’s life. The medical professionals current role is to simply verify the authenticity of the impairment and to provide any additional supporting evidence. The claimant has the autonomy to define their own experience within the confines of the other evidence gathered, and as a result the system is very effective with only a 0.5% rate of fraud.   The proposals to take away the claimants automy in the process will result in a shift of power to the medical professionals.

It is this shift in the power balance that is the third fatal flaw of this proposal that needs highlighting.  

This was another concern raised in the responsible reform report. For disabled people, the ability to be in control and have some power over their lives is key to their independence. The concept of self-determination is another key principal in the disability movement and it is another thing, which is under threat by the government’s proposal to give decision-making power to ‘independent’ doctors. This distinct shift in power away fro the claimant has been justified by the government with fairness in mind. However, what will result is an unbalanced and rigid system of medical professionals unable to cope with the complexities of a disabled persons experience, whose sole responsibility is to determine eligilibty. By reducing the ‘gatekeepers’ to the benefit to just independent medical professionals increases their power, responsibility and control exponentially. This will increase the risk of mistakes and poor decision-making. According to the Spartacus report the fear is that this proposal is too similar to the current sickness benefit system that has been widely acknowledged as failing (40% appeal success rate is evidence of this). Important decisions need to be made with as many stakeholders as possible. This reduces power to one agency and spreads it more evenly. This results in the claimant with some degree of control over their own experiences. The model that social services use is just one example of this.

Ultimately, the decision to use independent medical professionals to determine who does and doesn’t receive disability benefits is fatally flawed, and is widely feared. With the governments publicly declared aim to reduce the caseload by 20% when the fraud rate is at 0.5%, 500,000 disabled people will be taken off a benefit to which they were previously entitled. To use independent medical professionals will unfairly target people with certain impairments who find it difficult to define, easily shape and share their experiences. It will be a shift away from a benefit with disabled people at the centre of the decision making process and will result in a loss of power, control and ultimately a persons ability to live.