Book Review: Cash Not Care: The planned demolition of the UK welfare state

4th August 2018 / United Kingdom

By Karen Mogendorff – Independent Academic Scholar: Cash Not Care is a self-published work by Mo Stewart (a pseudonym) about the disastrous welfare reforms, aka the austerity politics in the United Kingdom in recent years. Mo Stewart is a former healthcare professional, veteran and self-styled independent researcher without professional research training. She is a veritable whistleblower who over six years persistently tracked and exposed the way the UK government and insurance companies deploy the biopsychosocial model or Work Capability Assessment to decrease welfare costs and, by doing so, condemn disabled citizens to poverty and starvation.

According to Stewart, British austerity politics is part of Thatcher’s legacy and designed to demolish the welfare state – welfare cuts are motivated by politics not financial necessity. Additionally, Stewart’s work suggests that the vilification of benefit applicants in politics and in the media has reached new lows in the United Kingdom.

Cash Not Care is unique in its setup, style and tone of voice. In addition to 10 chapters, an abundance of footnotes and six appendices, the report boasts a foreword by emeritus Professor Beresford and illustrations by Dave Lupton of Crippen Cartoons. Journalistic work and reports are most often referenced by Stewart, but Chapter 9 focuses on research. The book is primarily written for disabled Britons unfamiliar with the academic world.

Stewart’s message needs to be heard but is hard to listen to – welfare reforms do not only lead to poverty but also cost lives, as suicide statistics show. Moreover, vilification by the media may have increased public support for welfare budget cuts and negative sentiments towards disabled Britons. Cash Not Care is not only a difficult read because of its content, but also because of Stewart’s non-standard way of wording her insights and referencing her work.

The tone of voice in the book is strongly opinionated; she does not shy away from blunt negative assessments of specific individuals and organisations. Her uncompromising style together with its unsettling content may put the author unduly at risk despite the use of a pseudonym for retaliation and may tax readers emotionally.

Of interest and concern is also that reforms in other welfare states display similar developments as described in Cash not Care, although the level of vilification of welfare recipients and the manner in which the medical diagnoses of applicants are ignored in Work Capability Assessment may be unique to the United Kingdom. For instance, in her classic The Disabled State, Stone (1984Stone, D. A. 1984. The Disabled State. Philadelphia, PA: Temple University Press.10.1007/978-1-349-17753-0[Crossref], [Google Scholar]) concluded that the disability category is primarily a result of political conflict about distributive criteria and the appropriate recipients of social aid and less about the difficulties disabled people face in everyday life. Additionally, the tendency in eligibility assessments to focus on disabled citizens’ theoretical work capabilities and not on people’s realistic job market prospects is not limited to the United Kingdom. Finally, the focus on cost reduction instead of enabling societal inclusion of disabled people and the predilection to substitute disability benefits with unemployment support is also found in other European welfare states.

Given the undesirability of the developments in the United Kingdom from disabled citizens’ perspective and the similarities in reform trends between the United Kingdom and other welfare states, Stewart’s work is not only relevant to Britons but to welfare state residents and welfare reform scholars generally. Cash Not Care underlines the urgency of two questions for welfare states: How to curtail excesses? And how to best shape just, stable and (political) viable welfare policies and practices that enable disabled people to live full lives as valued citizens across the life course?

Stewart has been notably successful in generating attention for, and interest in, her various reports on the harrowing consequences for disabled citizens of the UK austerity politics. Her work has resulted in a wealth of information and insight in welfare politics of value to disabled citizens, disability and welfare scholars and other interested parties. Moreover, Stewart’s six-year dedication and investment of personal resources to research welfare wrongs by itself demands respect. Academic researchers, however, may find that the author’s claims are not always sufficiently substantiated by argument for scientific purposes, although it is clear from Cash not Care that there is something fundamentally wrong with the UK Welfare State (reforms) from a disability (studies) perspective, as also the inquiries in British parliament and by the United Nations signal.

Cash not Care demonstrates the added value of citizen science or user involvement in policy research. Stewart’s work raises important questions about social justice and the relationships between policy, politics and research and between commercial ventures and politics. As such, Cash not Care is a wake-up call and a valuable resource for anyone interested in welfare reform or citizen science. Last, but not least, Stewart’s courage and six-year dedication begs the question of how citizens who seek to investigate policies that greatly affect the lives of people like them, may be optimally supported in their endeavours. It took Stewart six years and great risk and personal costs to herself. Perhaps Stewart and others like her with appropriate support may do their valuable work in a more time-efficient manner and with less cost to themselves.