The Care Bill: The road to more private medical assessment injustice?

The Bill

At a time when almost one million carers, older, disabled and sick people are not receiving the care and support they need, the Care Bill is currently meandering its way through the chambers of Westminster. It is described as:

A Bill to reform the law relating to care and support for adults and the law relating to support for carers, to make provision about safeguarding adults from abuse or neglect, to make provision about care standards, to establish and make provision about Health Education England, to establish and make provision about the Health Research Authority, and for connected purposes.

The aims of the bill are:

  • Create a cap on care costs
  • Extend the current means test threshold for financial assistance
  • Ensure nobody has to sell their home in their lifetime to pay for residential care
  • It will merge sixty years of care and support law into a single Act, which according to the government will be “built around the person not the service”
  • Enshrine in law the right for carers in England to receive support from their local council
  • Ensure that people requiring care can be moved between local authority areas without fear that their care will be interrupted
  • Provide a new legal entitlement for everyone to a personal budget , which they can opt to receive as a direct payment to give them more control where desired
  • Clarify in law what protection will be put in place to ensure care is not disrupted if a care provider goes out of businesses
  • Establish Health Education England and the Health Research Authority as non-departmental public bodies, to give them the independence to carry out their roles

With the principle of introducing a capped cost social care partnership model set out in the Care Bill, the next step will be to resolve the Pandora’s box of issues that need to be resolved in time for April 2016. From then on, people’s qualifying social care costs could count towards reaching the cap of £72,000, after which the state will help towards the cost of the person’s care.

Concerns about the Bill

The heads of 38 leading charities including Age UK, the Alzheimer’s Society, Scope and the British Red Cross, have sent a letter to the Prime Minister warning that a change in how needs are assessed could strip 135,000 frail and vulnerable people in England of state-funded care on which they currently rely.

The charities have warned David Cameron that almost 900,000, who already have to pay if they want help with basic tasks such as washing and dressing, would not be able to benefit from a cap on the cost of care.

They say that the Care and Support Bill, which will usher in a cap on the cost of care to prevent people being forced to sell homes, should transform the system for future generations. But they add that they are now “seriously concerned” that when the final details of how the system is to be implemented are worked out, huge numbers of frail, elderly people will still be left without any help with their care.

Under the current system, only elderly people with assets, including their family home, worth less than £23,500 get help with the cost of care. Even then, only those deemed to have the greatest physical needs qualify.

Those are assessed on a four-point scale ranging from “low” to “critical” with just people above a threshold — decided by local social services – getting help.

In recent years, with funds squeezed, councils have tightened up criteria, meaning that in most areas only those deemed to have “substantial” needs qualify — usually meaning they can no longer live on their own.

Concerns about Assessments and the private providers

Another area of major concern is a part of the Bill introducing a national assessment framework to assess people’s eligibility for care, and also to have the associated costs count towards the cap. This gives local authorities the power to contract out the assessment process of people – to determine how bad their care needs are and what services they might need.

Over the last few years we have seen similar processes adopted via Work Capability Assessments (WCA) of the disabled and sick with contracts awarded to companies such as Atos. If you are aware of these assessments, no doubt, you will also be aware of the hundreds of accounts of people who are clearly unable to work due to health problems being declared “fit for work”.

Even if we are to take the giant leap of ignorance and put aside the obvious injustices suffered by many, many individuals, the use of companies like Atos being used to assess the needs of care raises many concerns, including:

Dr Greg Wood, a former Royal Navy doctor, resigned from Atos in May after working as an assessor for the company for two-and-a-half years. He said said the system was “skewered against the claimant”. He also stated that a number of the tests were staged in such a way as to find people fit for work and an excuse cutting their benefits.

Last year Atos – which in total earns £1.6billion in Government contracts – ‘won’ a government contact, worth £184 million, for London and the South of England on the promise of a tender stating that it had a network of 740 assessment sites across this area.

However the Department of Work and Pensions (DWP) has now admitted that Atos only has “up to” 108 centres available that meet its requirements.

The boss of Atos, Thierry Breton, has been awarded a £280,000 pay rise after his firm helped to heap misery on thousands of disabled people who are deemed fit for work. His total package of pay, bonuses and perks is now £2,329,250. For the same period in 2011, Breton received £2,049,250.

The parent company of Atos is American based “Unum Provident”, a company that makes its cash selling sickness insurance policies. Their “medicals” have been declared illegal in the states and branded “disability denial factories”.

Part of the WCA process is that people are allowed to seek advice and take another person with them to the interview. However there have been numerous accounts that this right is often challenged or refused at Atos centres. At an assessment centre in Liverpool recently, Atos staff called the police to remove a demonstration that was “threatening and upsetting people”. It subsequently transpired the ‘demonstration’ consisted of 2 Councillors handing out leaflets giving advice to people attending assessments and the Atos staff also refused to carry out an assessment after a person being assessed requested one of the ‘demonstrators’ to attend the ‘medical’ with them.

We all need to ask ourselves, would we entrust the determination of our own care needs, or those of our parents, to companies such as Atos? And at the same time we must remind ourselves, and make everyone aware, that hundreds of thousands of disabled and sick people have already had this inflicted upon them and suffered the utter despair and injustice that goes with it.

Sources:
Care Bill [HL] 2013-14 – Parliament.uk
Million ‘at risk’ from Care Bill – Telegraph
DWP finally reveals ‘shocking’ number of Atos PIP assessment sites – The Fed Online
Fury as boss of Atos gets £280k pay rise while thousands of Scots are plunged into poverty by their benefits assessment tests – Daily Record
Queen’s Speech 2013: Care bill – Politics.co.uk
Police called after welfare experts offer advice to disabled ahead of Atos sickness benefit assssments – Liverpool Echo

Related links:
Stop Atos Work Capability Assessments
Video – Filming of an ESA Assessment Carried Out by French Firm ATOS
Video – Simon Hickmans Atos assessment
The Hardest Hit
How To Deal With Benefits Medical Examinations
Victory as judges rule controversial disability benefits procedure is unfair

DPAC Report into abuse of statistics by the Department for Work and Pensions and UK Government Ministers

At the end of June, the Department for Work and Pensions will be releasing their Annual Report.

Iain Duncan Smith and his hench-ministers will no doubt be touring the TV studios to deliver more propaganda about worklessness and disability.

Disabled People Against Cuts (DPAC) have released their own report of the DWP.

The report outlines 35 cases where Ministerial claims using statistics on the subject of Work and Benefits have fallen short of the standards expected of Government Ministers. DPAC believe that this demonstrates a consistent pattern of abuse of official statistics by Ministers of the present Government to paint a false picture of benefit claimants in the UK in support of policies which are aimed at cost cutting to the detriment of jobless, sick and disabled people.Within the document, each case is presented, and fully referenced to source material throughout.

When you next see Iain Duncan Smith on the TV News, ask yourself – is he lying? or is he simply making it up out of thin air again?

We’ve decided that he’s lying.

dpacDPAC is a grass roots campaign body. It was formed by a group of disabled people after the first mass protest against the austerity cuts and their impact on disabled people held on the 3rd October in Birmingham 2010, England. It was led by disabled people under the name of The Disabled Peoples’ Protest. DPAC has over 15,000 members and supporters and works with many anti-cuts groups, Universities, Disabled Peoples’ Organizations, and Unions

Chancellor’s spending plans are toxic

Another Spending Review, yet more bad news for public services, the people who work in them and benefit claimants. TUC General Secretary Frances O’Grady said: ‘This is a toxic mix of bad economics, nasty politics and dishonest presentation.

‘The last thing our struggling economy needs is further cuts to spending to try to close a deficit made worse by the Chancellor’s earlier cuts. When the medicine is not working and side effects are choking the patient you need a change in treatment not more of the same.

‘Many services will be hard hit. Worst of all is a new attack on some of the most vulnerable in our society through the seven day wait and other conditions for social security payments. The Chancellor may think attacks on welfare go down well with voters, but these will lead to parents not having enough cash to feed their children.

‘And for all the talk of new investment, the truth is that the overall capital spend in 2015 will be exactly the same as the Chancellor forecast in his Budget earlier this year.’

Public service pay and jobs squeeze goes on

The Chancellor announced ‘further reductions in the number of people working in the public sector’ – a cut of 144,000 jobs. Looking at the small print of the OBR’s March 2013 report (p79), this appears to be a confirmation of the OBR projection made back at the time of the Budget. So, as they predicted, an average of 36,000 public service jobs a quarter (395 a day) will still be being cut in 2015-16 as a result of government policies, on track with their estimate of a total of 1 million job cuts from the beginning of 2011 to the start of 2018.

He also confirmed another Budget announcement, that there would be a further year’s 1 per cent cap on pay increases in the public sector, following the two or three year 1 per cent cap and two or three year freeze (depending on where you work). What this means in practice, of course, is living standards falling further and further as real terms pay cuts bite. TUC research published earlier this week showed the impact this had had on households, pushing 180,000 children with a parent in the public sector into poverty.

Seven days wait for family and housing benefits for unemployed claimants

Full information on what the new ‘seven day waiting period’ for unemployed claimants will mean is not yet available. But from what’s available so far it doesn’t look good for people who lose their jobs, or their families. The CSR policy costings document specifies that the policy will:

Introduce seven waiting days in Universal Credit for new claimants that have not had a Universal Credit claim in the past six months, where at least one person in the household is subject to conditionality. This costing assumes a 2015-16 start date for the measure.

The measure is forecast to save around £250 million a year, and is calculated on the basis that:

From April 2015 new awards of Universal Credit in each month for claimants who would be subject to conditionality are reduced by the average amount of Universal Credit claimed per claimant per week.

UC claimants ‘who will be subject to conditionality’ includes a very large group of claimants currently on Jobseeker’s Allowance and could even be taken to mean that those on Income Support (a benefit claimed primarily by lone parents with very young children), or those subject to the benefit cap, are included. Today’s announcement that lone parents will have to start preparing for work once their children are three underlines this point. People in these groups face conditions, just not to actively apply for jobs. More details on which conditionality regime this new policy will apply to is needed before we can rule certain groups out of this new process. We do know that at least those claiming Employment and Support Allowance and contributory JSA will not be affected.

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It is also not just unemployed claimants who are affected, those ‘not earning as much as the government expects them to’ will also see their income fall. This means people earning less than the NMW at 35 hours a week (or whatever their specific rule is – requirements will be less for those who are only required to seek part-time work). Households who are working, but see their income fall, will now have to wait a week to claim UC even if they remain in work with reduced hours during this period.

But the most worrying point is that Universal Credit will bring together all cash benefits into a single payment – so a delay in UC can also mean a delay in benefits currently classified as child and working tax credits, housing benefit, council tax benefits and many more. This policy sounds as if it will do far more than simply affect access to £71.70 of JSA for unemployed claimants (hard as that would be by itself) – it looks as if it is also their rent, their bills and their children’s food costs which won’t be met.

The Macroeconomics of the CSR

James Plunkett, director of policy and development at the Resolution Foundation, stated the £11.5bn of cuts for 2015/16 have been pencilled in for sometime and today was more about getting the detail than the direction of travel. James also noted:

The Chancellor needs a further £13bn in both 2016-17 and 2017-18 on top of today’s cuts in order to meet his deficit targets.

In other words, under the current fiscal framework, there is a lot more pain to come.

So the bigger questions today should be about that fiscal framework. It has utterly failed. The triple A rating has been lost, austerity has been extended from 4 years to at least 8, debt/GDP will still be rising at the end of this Parliament and the fiscal rules have either been broken (falling debt/GDP) or proved meaningless (the rolling structural deficit target).

Sources:

Public service pay and jobs squeeze goes onAlice HoodTouchstone Blog Copyright © 2013 Trades Union Congress

Seven days wait for family and housing benefits for unemployed claimantsNicola SmithTouchstone Blog Copyright © 2013 Trades Union Congress

The Macroeconomics of the CSR
Duncan WeldonTouchstone Blog Copyright © 2013 Trades Union Congress

Child Poverty Action Group Monthly News and Views – June 2013

Shown below is the “News from CPAG – Child Poverty Action Group e-newsletter, a monthly round-up of our news and views”. If you would like to subscribe to CPAG news, please click here.

Latest child poverty statistics

The newly-released annual statistics for 2011/12 showed no change to relative poverty, but 300,000 more children in absolute poverty. The relative poverty statistics also showed that two-thirds of the children below the relative poverty line are now from families in work. Read more on the statistics

Alison Garnham’s blog: ‘We are leaving our children utterly exposed’

Child poverty costs UK £29 billion a year

New research commissioned by CPAG has estimated the cost of child poverty to the UK. It is currently £29 billion a year – or £1,098 for each household – but would rise to £35 billion if Institute of Fiscal Studies projections on the impact of the government’s cuts prove to be correct.

Read Alison Garnham’s blog on this research.

Public backs more action on child poverty

A new poll shows more than 8 out of 10 people believe that tackling poverty should be a priority for government. And two-thirds of people believe the current government is not doing enough. This backing for action on poverty came from supporters of all the main parties. The poll is published by the End Child Poverty coalition, hosted at CPAG. Find out more

Help monitor the impact of benefit changes in London

We are looking for help to monitor the real impacts of welfare reform, particularly housing benefit. If you advise London families please use our quick and easy to use online tool to provide information on how the benefit changes are affecting your clients. Individuals can also use it to tell us about their own experience. We will publish a report this autumn as part of our Trust for London-funded project, and will let you know when it’s available on our website.

Welfare rights conference 2013: Surviving Welfare Reform

Under two weeks to claim your early bird discount, offer closes on Monday 1 July. Places booking fast, book now to avoid disappointment.

  • The Northern Conference in Manchester on Thursday 5 September.
  • The Southern Conference in London on Wednesday 11 September.
  • Further information and booking

Exhibition space: if you are interested in exhibiting your work, products and services at our conference, contact Naomi Jessop – njessop@cpag.org.uk.

Last-minute places available: Virgin London Triathlon and the British 10K

Test your endurance and champion the work of CPAG by signing up for one of these two fantastic events today. Limited spaces are available and all support will be provided by the London Legal Support Trust. To find out more email natalia@llst.org.uk, stating that you’d like to run, ride or swim (or all three!) for CPAG. The British 10K is on Sunday 14 July and the Virgin London Triathlon is Saturday 27 and Sunday 28 July.

Meanwhile, cycle fever has officially hit CPAG! Housing specialist Keepmoat have organised a fantastic Doncaster to Manchester Cycle Challenge in support of us. And Simon Veit-Wilson and friends will be taking on the Pashley & Chopper C2C Challenge. Please support all our cyclists generously!

Film news

Remember the story last month about the new CPAG film? It’s in the editing suite right now so expect to see something exciting in our next e-news! Or follow us on Facebook or Twitter to see it as soon as it’s released.

Meanwhile if you want to be a cinema ‘angel’, the new documentary based on The Spirit Level is accepting pre-orders to fund the UK leg of the filming. Find out more.

We welcome any comments on this newsletter – send your feedback to Liz Dawson – ldawson@cpag.org.uk

With best wishes from everyone at CPAG.

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Child Poverty Action Group is a charity registered in England and Wales (registration number 294841) and in Scotland (registration number SC039339).

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Bournemouth Council give no assurances not to evict for Bedroom Tax rent arrears

Shown below is a public question submitted to Bournemouth Borough Council full council meeting on 18th June and the council’s response. BPACC are currently considering the council’s response and will be responding soon.

Public Question from Mike Cracknell

“The Government has introduced the Welfare Reform Bill which limits the total amount of Welfare benefits with an increase capped at 1%. This coincides with the introduction of the Social Housing Size Restriction policy equating to a reduction of 14% for one spare bedroom and 25% for two spare rooms which is monetary terms equates to circa £14/15 per vacant bedroom in Housing Benefit for tenants occupying social housing. Will the Council give an assurance that if the rent debt is accrued because of these factors there will be no eviction of tenants?”

Reply from the Leader of the Council, Cllr John Beesley

Tenants who are affected by the Social Housing Size Restriction policy (also referred to as the “Spare Room Subsidy”) will be of working age, receiving Housing Benefit and here in Bournemouth will be either local authority tenants or housing association tenants.

There are 577 Housing Benefit recipients affected in Bournemouth, of whom 328 are Local Authority tenants and 249 are in Housing Association properties.

All those who are affected and are Local Authorities tenants were written to twice by the Housing Benefits team with an explanation of how their Housing Benefit could change. The Council’s Housing Management team has been most proactive in contacting these tenants in order to discuss their options. They have been provided with information and advice on downsizing, applying for Discretionary Housing Payment, maximising income, returning to work and taking in lodgers. The Housing Management team is working closely with the Allocations team to ensure that all tenants wishing to downsize are placed on the ‘gold band’, significantly increasing their chances of winning a bid on a suitable property. tenants who wish to downsize will also be encouraged to arrange a mutual exchange of tenancies with other social housing tenants.

The Council is currently reviewing the incentives that it pays to tenants who wish to downsize to smaller properties in order to provide more assistance with the costs associated with moving, such as replacement of carpets, removals and decorations. The Council is also considering the level of practical assistance that it can provide, such as help with the connection and disconnection of white goods.

One of the Council’s 8 Housing Strategy priorities for Bournemouth is to ensure that we are making the best use of all our existing housing. The Social Housing Size Restriction policy forms part of this strategic priority by freeing up much needed family accommodation to help meet the housing needs of many who are on the Council’s waiting list. In April this year there were 3,177 households on the waiting list. 933 of these needed 2 bedroom accommodation and there were a further 645 who needed 3 bedrooms or more. We have reduced the waiting list from the 9,425 who were on it a year earlier through a much stricter allocations policy and are doing all we can to increase the number of new properties available to those most in need. It seems only fair therefore that we use our existing and future housing stock to best suit the needs of tenants, through downsizing where appropriate, in order to free up larger homes for those who need them and who are included on the revised waiting list, in the main through having a Bournemouth connection.

The Council’s policy in dealing with tenants who fail to pay their rent is available on the website. The policy is flexible enough to ensure that each case is dealt with on its own merits by specialist and experienced staff. They will become involved in cases of non-payment quickly in order to provide assistance and advice and have been successful in helping tenants who experience problems in paying their rent. However, if a satisfactory arrangement to manage the rent account cannot be agreed, the Council would take action to recover the property, nut only ever as a last resort.

In the Budget statement, the council recognised that Welfare Reform would be likely to cause hardship for some. Although there is no direct requirement by the government for us to do so, in Bournemouth we made provision in the Budget of £1.0 million for this year (2013/14) to establish a Local Welfare Assistance Fund. Bournemouth residents can apply can apply for emergency one-off payments through this fund to help with their living expenses where they are struggling financially. This fund is therefore very much targeted to those who are are most in need of support. In addition, the Council has also created a new earmarked reserve of just over £500,000 to further address the impact of the changeover to Universal Credit as the next stage of the governments Welfare Reform programme. This will provide an additional safety net for the most vulnerable local people here in Bournemouth. It should be stressed that neither of these additional funding streams are required by the government to be provided by the Council, but were nevertheless contained in our Budget Statement in February. They were introduced because we wanted to protect the most vulnerable local people and because it was simply the right thing to do.

Poole Council give no assurances not to evict for Bedroom Tax rent arrears

Shown below is a public question submitted to Borough of Poole full council meeting on 18th June and the council’s response. BPACC are currently considering the council’s response and will be responding soon.

Public Question from Kevin Smith

“The Government has introduced the Welfare Reform Bill which limits the total amount of Welfare benefits with an increase capped at 1%.  This coincides with the introduction of the Social Housing Size Restriction policy equating to a reduction of 14% for one spare room and 25% for two spare rooms which in monetary terms equates to circa £14/£15 per vacant bedroom in Housing benefit for tenants occupying social housing. Will the Council give an assurance that if rent debt is accrued because of these factors there will be no eviction of tenants?”

Borough of Poole Response from, Leader of the Council, Cllr Ms Atkinson

Response in respect of properties where the Council is the Landlord

The Council and it’s partner Poole Housing Partnership (PHP) are working hard to address the issues raised by the governments welfare reform programme. Planning for these changes has taken place over a long period and a package of assistance is now offered to residents effected by these changes. Everyone in a PHP property who has lost benefit because of the under occupation penalty and the benefit cap regulations has been contacted by PHP and offered assistance. Advice has been given about how tenants can move to more appropriate sized accommodation either by way of a transfer or by exchanging their home with another social housing tenant. We have also changed our transfer incentive scheme to give a greater emphasis on people effected by welfare benefit changes. In addition we offer tenants advice about how to maximise their income by either accessing the jobs market or ensuring that they are receiving all the benefit to which they are entitled.

We are committed to working with residents affected by these changes to ensure that they retain access to appropriate secure accommodation. We are not able to give an assurance that no one will be evicted because of arrears that have arisen as a result of welfare benefit reform, each case will be considered on it’s merits.  However we can confirm that tenants will be offered every possible assistance to deal with such problems and that eviction will always be the very last resort.

Response in respect of properties where the Council is not the Landlord

Again we are not able to give an assurance that no one will be evicted because of arrears that have arisen as a result of welfare benefit reform as the decision will be made by the respective private sector landlords. However the Council has a Discretionary Housing Payment fund, that is limited by Government grant, which it is using to help mitigate the impact of several welfare reforms taking place in 2013. Any claimant on housing benefit who is unable to meet the reduction in award can make a claim for additional financial assistance from this fund.

The Government grant is not enough to meet every claimant’s housing benefit shortfall and to prioritise awards from this fund payments are made in accordance with the Council’s Discretionary Housing Payment policy. The Council’s policy is designed to support the implementation of the Government’s welfare reforms whilst making sure we have a process in place to protect our most vulnerable residents, sustain tenancies where we can and prevent homelessness.

Where an application is made and it is established that the claimant cannot afford the housing benefit shortfall awards may be made to financially support claimants whilst they take action to change their circumstances so they can afford their accommodation in the longer term. Each application is considered on a case by case basis, and the length of award will vary. The policy expects claimants who make applications for the additional financial support to engage with relevant support services, such as work programmes, budgeting and debt advice agencies, health programmes etc. and, where appropriate, take steps to be able to afford their accommodation in the future.