The Public Health Crisis Created by UK Social Policy Reforms

18th August 2022 / United Kingdom

By Mo Stewart, Fellow of the Centre for Welfare Reform and the Research Lead for the Preventable Harm Project. Her research paper ‘The Public Health Crisis Created by UK Social Policy Reforms’ has just been published online and she as written to the Disability Unit in the Cabinet Office to alert members to the public health crisis created by the Department for Work and Pensions when using the Work Capability Assessment: “To justify the adoption of harsh and unnecessary austerity measures, which were introduced without ethical approval, the Coalition administration elected in 2010 vehemently challenged the integrity of the chronically ill and disabled community and routinely accused disability benefit claimants of fraud; whilst failing to produce evidence to support their claims. Their often hostile rhetoric encouraged a 213 per cent increase in prosecuted disability hate crimes, and successive administrations disregarded the thousands of deaths directly linked to the Work Capability Assessment, which was adopted using a discredited and dangerous biopsychosocial model of assessment to restrict access to long-term disability benefit. Influenced by corporate America since 1992, the UK social policy reforms guaranteed that many of those in greatest need were destined to die when, covertly, killed by the State”.(1)

Writing in my capacity as a former healthcare professional and as the research lead for the Preventable Harm Project (2) that I led for ten years (2009-2019), it remains a cause for serious concern to note that successive administrations continue to disregard the volumes of published evidence demonstrating the growing public health crisis directly linked to the flawed disability assessment model, as adopted by every administration since 2008 to restrict access to long-term disability benefit.

Academic research published long ago (3) exposed the Waddell-Aylward research used to justify the adoption of the Work Capability Assessment (WCA) as being ‘policy-based’ research and not evidence-based. The Waddell-Aylward research was identified as ‘revealing a cavalier approach to scientific evidence’ (3) and therefore not genuine research data. Yet, the adoption of the fatally flawed WCA was introduced when based on this Waddell-Aylward biopsychosocial (BPS) model of assessment, which was influenced and funded by corporate America.

As a consequence, the identified public health crisis linked to the adoption of the WCA, which successfully removed what had been the past psychological security of the welfare state, and the WCA ‘was introduced without prior evidence of its potential impact or any plans to evaluate its effects…. Given that doctors and other health professionals have professional and statutory duties to protect and promote the health of the public, our evidence that this process as potentially harming the recipients of these assessments raises major ethical issues.’(4)

Ably supported by the Civil Service DWP Ministers have a tendency to make remarkable claims of success, which are not based on peer-reviewed evidence, and they continue to disregard the identified and growing public health crisis created by the adoption of this dangerous assessment model, adopted due to ideology and totally unrelated to care, concern or support (5) for those in greatest need, with an NHS report identifying that almost 50% of ESA claimants had attempted suicide at some point (6)(7)(8), yet this disturbing report was not released to the media.

The political resistance to the inevitable public health crisis created by the adoption of this flawed assessment model is demonstrated by the DWP, whose ministers and civil servants work very hard to continue the rhetoric that the WCA is offering ‘help and support’ to the disabled community, which is not the experience of the disabled community, as identified in the response to the recent green paper(9):

“What is constantly overlooked is the fact that the disabled community’s experience of this DWP “help and support” is via the politics of fear using the WCA. The assessment is conducted by an unaccountable American corporate giant, with the fatally flawed WCA using a discredited BPS model which failed all academic scrutiny. Every clinical lead in the UK demanded that the WCA should be abolished, including the Royal College of Psychiatrists, the Royal College of General Practitioners, the British Medical Association, and the British Psychological Society, who all identified the WCA as being ‘unfit for purpose’. They were all disregarded by the DWP, as is the growing mental health crisis directly linked to the fear of the next WCA, and the constant DWP threat of sanctions. To date, the DWP have disregarded all published, independent academic research which identifies the ongoing and inevitable public health crisis created by social policies adopted since 2010.” (p7) (9)

There is also detailed evidence that the DWP resisted warnings from its own thinktank, prior to the introduction of the WCA, who warned against using the assessment at the risk of an increase in mental health problems. This expert panel’s opinion was disregarded and the WCA was introduced, demonstrating that the influence of corporate America with the DWP was valued much higher than the opinion of genuine experts.(10)

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As long as the national press refuse to update the public regarding this government-induced public health crisis, the DWP can continue to terrorise those in greatest need when masquerading as offering ‘help and support’ (9), and many, many more chronically ill and disabled people will die due, entirely, to the WCA or the pending threat of having to have another WCA often for chronic ill health conditions that can’t ever improve.(11)

“The only guarantee is that with each passing year more preventable harm is created by the UK government for those in greatest need, who have got the message that they are nothing more than a financial burden on the state. Their needs are considered to be cost-prohibitive to a government where cost is the only concern, and any and all costs will be reduced by the adoption of dangerous social policies regardless of human consequences. Testimony of need by the disabled community is invariably challenged by the DWP, at a cost of £1.6billion over a three year period for private contractors to conduct disability assessments. No-one is held to account for the manipulation of the British public by politicians who lie for a living. They are very experienced and successful, as they manipulated Parliament to adopt social policies which were guaranteed to cause preventable harm, destitution and death when, quite literally, ‘killed by the state’. Where are the political debates against this ongoing state-sanctioned atrocity by well-informed politicians who know about the corporate influence of Unum Insurance since 1992 with UK social policy and the planned future demolition of the UK welfare state? (11)

The past ‘culture of welfare expectation’(1) has been successfully changed in the UK. Now those in greatest need simply live in fear of the DWP (5) .

We have an identified growing public health crisis in the UK which is demonstrably linked to the adoption of the WCA, and the relentless persecution by the DWP who feel the need to use intimidation in every contact letter they send to disability benefit claimants. By definition, the persecution of those in greatest need by any administration is a tyranny. The continued tyranny by successive administrations is an atrocity, as identified as ongoing in C21st UK. It’s time for this atrocity to end, and it’s past time for the DWP to acknowledge the public health crisis created by successive social policy reforms, which was a political choice to create preventable harm in advance of the adoption of private income replacement health insurance. (2)