The British establishment's herd mentality and obliviousness to suffering

 Review of The Department: How a Violent Government Bureacracy Killed Hundreds and Hid the Evidence, by John Pring, part two

 There is always a TV documentary. Just as the Department for Work and Pensions readies itself to make disability benefits harder to get – for example by disallowing mobility problems  or the inability to cope in social situations from counting towards a successful claim – a documentary magically appears on state television (Channel 4 in this case) explaining why the changes must be made, and in fact probably don’t go far enough.

The country faces bankruptcy because of the mounting benefit bill, we are told on Spectator journalist Fraser Nelson’s film Britain’s Benefits Scandal; millions of people are being ‘written off’. I think I’ve heard this story somewhere before …. Ah yes, it was under the post-2010 Cameron coalition when the assault on the ‘unsustainable’ benefits bill resulted – as Pring documents in his book – in hundreds of deaths.

Curiously, the person invoking the horror of the government running out of money is a spokesman for the Centre for Social Justice, the think-tank set up by Iain Duncan Smith who, as Secretary of State for Work and Pensions, oversaw the previous round of culling. And so the baton passes to a new generation.

The shallow propaganda is on show almost from the first frame. There was outrage in the 1980s, Nelson recalls with a darkened face, when unemployment hit 3 million or more, so where’s the outage now when similar numbers are on “long-term disability benefit” (whatever that is)? But the outrage in the ’80s was about so many people being unemployed, not that they were on unemployment benefit. The only outrage about that emanated from Thatcher’s Cabinet and the Adam Smith Institute.  The equivalent outrage today would lead to asking why so many millions are physically and mentally sick.  But posing that question seems to be exclusive province of niche publications like Pring’s Disability News Service.

Oddly, among its vanishingly small valid points, Nelson’s documentary inadvertently makes the case for Unconditional Basic Income. Benefits are too generous, we are told, and thus people have no incentive to take jobs. This is because if you do go into work, all your benefits are instantly removed. But unconditional basic income – as opposed to the hugely conditional (and meagre) income support we now have – would not be removed whether a person had three jobs or spent every waking hour reading analytic philosophy. Thus it would ‘make work pay’ in a humanitarian way. This point was made by John McDonnell’s former economic advisor, Guy Standing (so obviously it’s extremely suspect and probably anti-Semitic).

But to return to the reality we unfortunately inhabit, it is a sight to behold the way British political mono-thinking instantly clicks into gear without any orders having to be given. Thus the cross-party Economic Affairs committee of the House of Lords (a body whose members are funded by taxpayers to fall asleep) solemnly intoned in January that the Work Capability Assessment “isn’t rigorous enough”, and that their lower conditionality means people have an incentive to apply for disability benefits. Meanwhile, Number 10 and Number 11 are apparently “pulling their hair out” over how long it is taking the very right-wing Labour secretary of state for Work and Pensions, Liz Kendall, to make welfare cuts. Faster! Faster!

As if to throw some meat to the baying hounds, Kendall has announced a resurrection of Rishi Sunak’s plans to rifle through the bank accounts of sick and disabled people suspected of (virtually non-existent) fraud, without even having to apply to the courts for permission. As an added touch of vindictiveness, driving licences may now be taken away. It is now clear – if it wasn’t before – that to the political class, of whatever shade of rosette, there are certain classes of very vulnerable people to whom it is possible to do anything, no matter how callous and draconian.

At this point you may be forgiven for wanting to hide under a rock (although we need to eradicate the incentive for misusing rocks in this way), but one of the many virtues of Pring’s book is that it reveals how we’ve been down this road before. With all due respect etc., the path to hell can also be paved with very bad intentions. But it helps to know that the unheavenly choir we are forced to listen to has a very limited, though up to now astonishingly effective, repertoire.

On three separate hinge points – when all this began in the dog days of Thatcher, when the Blair government wanted irrefutable evidence it was no longer ‘old’ Labour, and when the coalition was itching to pin the budget deficit on “shirkers” cheating the system – the media was on call to spread the message.

And by the media, I don’t just mean the usual suspects at the Sun or the Express or Mail. I also mean the more ‘liberal’ media like the BBC or the Guardian, or other broadcasters. For example the 1996 documentary The System on BBC2 hinted at widespread fraud and described Invalidity Benefit (the then the out-of-work disability benefit) as “known to cynics as the bad back benefit”.

In 2007, when Labour was introducing the Work Capability Assessment, The Guardian newspaper, now on board because it was Labour who were doing it, gave the floor to Matthew Elliot of the right-wing Taxpayers Alliance to bemoan the fact that many claimants were “taking advantage of the good nature of their GP”.

And of course we now have the obligatory documentary, urging the government to do what it already wants to do, on state-owned broadcaster, Channel 4.

What these others, the non-right-wing media, do is to ‘close the loop’. If even the Labour party is saying fraud is a massive problem in the benefit system, then it must be. Actually, it’s virtually non-existent. If even a cross-party House of Lords committee says the Work Capability Assessment isn’t strict enough, then it must be letting the lazy enjoy a life on benefits. Actually, as Pring shows, there have been hundreds of deaths (at least) because the Work Capability Assessment is so callous.

This process will end in a human disaster, and it already is for people who have no choice but to eke out an existence on disability ‘benefits’. We are now entering the surreal territory of the Labour party claiming, in the pages of The Sun, that the Tories weren’t tough enough towards claimants and allowed the ‘benefits bill’ to spiral out of control. Poor Iain Duncan Smith, he tried his best but it wasn’t good enough! But, says Rachel Reeves, Labour will act.

The system does not preclude any dissent. Channel 4, to be fair, did broadcast a film three years ago on The Truth About Disability Benefits (now interestingly only available on YouTube). But like bison deciding where they want to move to, the direction of travel is indicated and everyone in the establishment herd instantly knows what to say without having to be told. And as demonstrated by what happened to the outsider Jeremy Corbyn between 2015 and 2019, if anyone not in the group finds themselves, by some freakish accident, in a position of power or influence, the hostility is unrelenting.

If this is freedom, as we’re told it is, then freedom desperately needs some pluralism.

 

Here is part one

Reflections on the Work Capability Assessment when its days may be numbered

I was recently interviewed by the New Statesman about government proposals to scrap the Work Capability Assessment. Given the suffering the latter has caused, you might think this is a cause for celebration. But the new plans will simply hand job centre work coaches the power to "determine what, if any, work-related activities an individual can participate in". And they will doubtless be armed with the power to dish out sanctions for anything they regard as non-compliance. Given that sanctions are currently at an all time high, the prospect is frightening.

I didn't know the details at the time of the interview

 

Tell me about when and why you first applied for Employment and Support Allowance?

 In the summer of 2010 I suffered a brain haemorrhage and subsequent stroke in the operation to deal with it. When I left hospital after a few weeks, I applied for ESA but it took some time to go through because the form (and the doctor’s certificate) was lost twice. I couldn’t write at the time so I had to get a friend to fill it out on my behalf – three times.

 How long into claiming that benefit were you asked to do a Work Capability Assessment?

 It was probably the standard time, about 3 months, maybe a bit longer. The assessment took place in December 2010.

 Can you describe your memories of the assessment, and how you were physically and mentally at the time?

 The effects of the stroke were still very real. My sense of balance was shot through (balance is one of those things you don’t appreciate until it’s damaged), my speech was slurred and got worse the more I spoke, I became breathless after the slightest physical exertion and tired very easily. In short, I wasn’t in a fit state to do any job I’m aware of.

The assessment was quite brief. I was invited into an office and was asked various questions about my daily routine and what “tasks” I was able to perform. I remember when I left and walked down the corridor, I glanced back and could see “medical professional” observing me.

A few days’ later I received a letter saying I had been awarded zero points. I had been deemed “fit to work” and was not eligible for Employment and Support Allowance. I could apply for Jobseeker’s Allowance if I wished.

(I appealed and over a year later a tribunal awarded me 18 points which classed me as not fit for work and put me in in the Work Related Activity Group. However by that stage, I was working as a part-time (very part-time) freelance journalist.)

How did it make you feel?

 Angry. There was no genuine attempt to find out what was wrong with me, nor what I could do – not just once or twice but multiple times, in line with what jobs in the real world actually require you to do. It felt like a tick box exercise aimed at finding any excuse for culling you from the benefit rolls.  I think I could have dropped down dead and no-one would have been bothered.

 A few years’ ago, an academic described the WCA as reminiscent of the First World War medical tribunals that returned shell shocked and wounded soldiers to the front. That seems an apt analogy.

 With the news that the government may be scrapping WCAs, what are your reflections on the process and what it tells you about how the government treats people and its attitudes to the welfare system?

 I don’t know what they're proposing but I’m very sceptical. Sanctions doled out to the benefit claimants are currently going through the roof so I don’t see many signs of a change of heart. What any humane benefit system for sick and disabled people has to take on board is the deep fear that the Work Capability Assessment generated – that you’d be left destitute and unable to actually do a job to cope with the fact that your income had been taken away. And many were put in precisely that position (not just people found fit for work but those in the Work Related Activity Group, thousands of whom were also sanctioned).

What sick and disabled people need is the peace of mind that comes with security of income. I remember a person I knew who attended Headway’s Life with Brain Injury group with me (Headway are a brain injury charity). He had no peripheral vision and was certified blind (he got a Guide Dog when I was there) and wanted to take up a volunteering opportunity. He was reluctant to do so, however, because he feared the DWP would say ‘aha, this is proof you can do things’ and take his benefit away. This was a sign of a sick (no pun intended) system and makes a mockery of the claim at the time that pre-WCA system just abandoned people to live isolated lives on benefits.

The only politician I’m aware of who really understood the fear induced by the callousness of the WCA was Jeremy Corbyn. The faction who now control the Labour party certainly don’t. They created the WCA in the first place. Ironically, the 2017 and 2019 Labour manifestos promised to scrap the Work Capability Assessment, which is what we’re told will happen now, but I doubt that will be mentioned much in the ensuing debate.

 

 

 

The illusion of independence

I think it’s an unspoken rule of politics that the person who claims to be unideological is the most ideological of all. Thus one of the central assertions of the newly formed “Independent Group” (IG) of British MPs is that while the blinkered automatons to their Right and Left see everything through an ideological prism, they, by contrast, do not pre-judge but look at every issue dispassionately and according to the evidence.

Thus when asked by Andrew Marr last Sunday whether the IG would support the renationalisation of the railways and the water industry, former Tory MP Heidi Allen replied: “My gut instinct is no but it needs to be based on evidence and, rather than just choosing ideological solutions, what will work and what we can learn from other countries.”

If you have that strange feeling of déjà vu, that’s because an insistence on ‘what works,’ as opposed to ideological prescriptions, was a staple of the New Labour years. Ministers could get way with claiming they judged everything according to the evidence because the evidence they relied on was produced by people whose ideological biases were so ‘baked in’ they thought they didn’t exist.

You’re only ill because you think you are

This can be seen most clearly in the story of the Work Capability Assessment (WCA), the tick box questionnaire that determines whether sick and disabled people can receive benefit and, if so, what conditions are attached. Judged in terms of the amount of misery it has generated – it was revealed in 2017 that the number of disabled claimants attempting suicide had doubled over the lifespan of the WCA – I think the assessment has no equal among post-war domestic government policies.

But its introduction was surrounded by mountains of evidence that it was the correct policy, medically and socially. In fact that it would be grossly unfair, it was claimed, to leave disabled people ‘parked’ on benefits and shut out from the health-giving qualities of work. In 2005, for example, the DWP commissioned a report called the Scientific and Conceptual Basis for Incapacity Benefit. Co-written by the department’s Chief Medical Officer, Dr Mansel Aylward, the paper recommended something called the biopsychosocial (BPS) model. This assumes that disability is caused in part by the disabled person’s attitudes. Illness was a belief, said the authors, and people could think themselves well.

They recommended, therefore, a “functional” non-medical assessment for all claimants on Incapacity Benefit, one that ignored diagnosis, prognosis and medical history. This became the WCA. The opinions of doctors weren’t mysteriously overlooked when the WCA came into being in 2008, they were deliberately ignored.

A year after the ‘Scientific and Conceptual Basis’ for the WCA was established, the DWP started funding a group of academics to run something known as the PACE trial, which compared the effectiveness of different treatments for Chronic Fatigue Syndrome or ME. The results from the trial were published in 2011 and were presented as demonstrating the visible success of BPS interventions such as Cognitive Behavioural Therapy. The then Conservative-Lib Dem government was miraculously bowled over by the evidence, with minister David Freud telling the House of Lords that “we have gone for the biopsychosocial model” which had “garnered very significant academic support”.

In fact, the research was very seriously flawed. An analysis by the Centre for Welfare Reform revealed that the supposedly “strict” standard for recovery was so loose that you could actually deteriorate and still be classed as having recovered. Another analysis of the whole BPS model concluded that it was “riddled with inconsistencies, misleading statements and ‘unevidenced’ claims”.

But so entrenched is the government’s faith in the ‘evidence’, that even Mansel Aylward, the man responsible for the adoption of the BPS model, admitting in 2012 that he now found it “unsatisfactory” and incapable of meeting the needs of disabled people, had no effect. The WCA steamroller, now over 10 years old, just continues on, oblivious of the collateral damage it causes.

I’m a banker so listen to me

But the WCA needed more than BPS philosophy – the idea that claimants were divided between real sufferers and malingerers – behind it to really fly. It also needed the evidence that there were legions of claimants who were ‘work ready’ and in fact, unjustly, left to rot on benefits. This was provided by David Freud, a millionaire and former investment banker, who despite admitting he knew nothing about welfare, produced the independent 2007 report Reducing Welfare, Increasing Opportunity: options for the future of welfare to work’, commissioned by Tony Blair just before he left office.

The ‘Freud Report’ was hugely influential – New Labour accepted its recommendations as did the Cameron government that followed. In fact, Cameron was so impressed he ennobled Freud and made him a junior minister in his government. The Freud Report achieved a ‘cross-party’ consensus. As a former Labour DWP minister put it in July 2010, “the Labour government’s regulations are now being tabled by a Tory minister who inspired them when he was a Labour adviser”.

Not only did Freud advocate using the private sector to conduct the assessments required to receive sickness benefit, and introducing sanctions, he also asserted that the 2.68 million people on Incapacity Benefit could and should be reduced by 1 million.

This number was subsequently cited endlessly ministers but, as geographer Danny Dorling pointed out, it was based on fiction. Freud “got his numbers” wrong by claiming the remarkable success of government ‘Pathways’ projects in getting Incapacity Benefit claimants into work could be replicated nationally. In fact, the success of the pathways projects was based on recent claimants only, not long-term ones.

 But this didn’t affect the Freud Report from becoming the lynchpin of government efforts to ‘reform’ the welfare state. The reason was not his academic rigour but who he was. As Dorling explained:

David’s report is titled Independent but was commissioned and published by the DWP. Independent no longer means independent. The point of independent reports to government and ministers is that they are not written by people who are independent of government but by folk whose lives and connections are intimately wound up in the machinery of government and elite civil society.

The fallacy of independence

Ironically it was Heidi Allen who confessed that, on becoming an MP, she was “staggered” that minister were not , in fact, experts in their field and MPs were handed “bits of paper” indicating what they should say to the media. But the fact that, in truth, they don’t know very much just reveals how reliant on outside evidence they are.

And that evidence is never unideological despite fervent claims to the contrary. While in 2007, a former investment banker was hired to produce a report arguing that sick and disabled benefit claimants needed to be reassessed into work, two years later the government commissioned two reports – Bischoff and Wigley – insisting the competitiveness of London as a financial centre had to be maintained at all costs. Group members and expert witnesses came overwhelmingly from the City of London. Finance, as one outside analysis pointed out, was reporting on “finance by telling stories about finance”. But all three, in eyes of the Westminster bubble, constituted ‘evidence’.

In truth, nothing is unideological and there is no such thing as pure, neutral evidence. Pretending you’re above the fray just reveals how deeply ensconced you are in its web – so much so that you don’t even notice.

Another Country

A review of ‘Cash not Care: the planned demolition of the UK welfare state’, by Mo Stewart

‘I want my country back!’ wailed Brexiters across the land during last year’s Referendum. But reading this book you realise that ‘your country’ – England, Britain and all parts thereof – was lost years ago and the capital of Belgium had nothing to do with the theft. Stewart painstakingly shows how hundreds of thousands of sick and disabled people have been prodded like cattle through a system deliberately designed to override the opinions of doctors and medical diagnosis, and leave them destitute. Currently, more than 2/3^rds of people who appeal to a tribunal against a decision of this system to rule them ‘fit for work’ are successful. The Work Capability Assessment, to give its proper name, betrays (in the words of one commentator) “a failure of compassion, unacknowledged incompetence and injustice on a massive scale”. And yet, far from acknowledging this tragedy the government wants to intensify it. No wonder one of the chapters of Stewart’s book is entitled, The Shame of Britain.

However, it is not this knowledge that imparts the strong sensation you are living in a foreign country. That unnerving sense creeps up on you through the realisation that the Work Capability Assessment is a replica of the non-medical assessment model of an American insurance corporation branded an ‘outlaw company’ for the way it has systematically denied ‘meritorious’ pay outs to sick and disabled claimants.  It was to Unum, labelled the second worst insurance company in America, and accused of running ‘disability denial factories’, that successive British governments turned in their desire to ‘reform’ the welfare state. You can read the whole shameful saga here.

But rather than summarise the story, I want to reflect on four things it says about the parlous state of this country in 2017:

1 We have a media problem

Stewart’s book is peppered with mounting anger that the story she is telling is unknown to the vast majority of the British people. “The entire national press, collectively,” she writes, “refused to expose to the British people the confirmed involvement of Unum (Provident) Insurance with the UK welfare reforms claims management since 1994.” There were isolated exceptions – Private Eye ­– for example. But almost exclusively it was left to minority publications, such as the Disability News Service, to tell the story. But, with the best will in the world, they have a limited market so “the vast majority of the abled bodied British people …. remained in total ignorance.” Academic research which lifted the lid of what was happening was only read by other academics or activists.

In short the steady undermining of Britain’s welfare state has been able to go on unimpeded because the media failed in its basic duty to inform the public of what was happening. It has been found that, among the public, estimates of incidence of benefit fraud range from 10 to 70% when, in reality, fraud stands at 0.3%. (I know that what the public means by fraud probably involves not really being ill as opposed to official definitions of fraud which involve outright deception but the gap is still enormous). On this and on other issues, media-formed perceptions are wildly inaccurate.

“We lack knowledge of the world beyond our direct experience … vast swathes of state-corporate activity are unreported,” Dan Hind wrote in The Return of the Public. The alternative media, though it has undoubtedly grown in recent years, cannot reach enough people to burst the bubble of the perceptions set by the mass media. The problem is exacerbated by the fact that public service media, such as the BBC, increasingly echo government priorities and see their role as reporting what ‘mainstream’ political currents, all claiming to represent the centre ground, agree to disagree about. The problem is the ‘centre-ground’ is a home for extremist political thinking and all three main political parties in this country have been utterly complicit in what has gone on. The perfect cover.

There is a justified air of fatalism about Stewart’s book – stemming from an awareness that, despite the moral imperative of its writing, it will likely not break through media fantasies. The same is true of any number of other urgent, seemingly hopeless situations – the nature of the environmental crisis, the likelihood of renewed financial breakdown – for example. Given the character of our media set-up, things will almost certainly get worse.

Improvement, by contrast, depends on changing the way reality ‘out there’, reality beyond day to day experience, is described. The existing media, not just tabloid newspapers, but also the BBC and liberal broadsheets, have a structural problem, and aren’t just guilty of moral failings. Dan Hind’s idea is for the public to decide, through a fund diverted from the BBC licence fee, what issues they want to see investigated. Thousands of journalists would be employed on researching subjects which the media would have a duty to report. The truth of what has happened to the British social security system could be one of those subjects. This may sound weak in the face of the problem but we have to accept – as Stewart’s research demonstrates – that the problem exists and that preaching ever more loudly to the converted is not going to dent it.

2 Our political parties have been thoroughly corporatized

“Sadly, these are policies that tarnish all three major political parties,” says academic Peter Beresford in the introduction to Stewart’s book. You couldn’t get the proverbial Rizla paper between New Labour and the Tories on welfare ‘reform’.   Way back in 1994 Unum were first appointed official government advisers by Conservative social security minister, Peter Lilley. When New Labour was elected, the desire for ‘active welfare’ intensified. Unum and Atos were both included in technical working groups that ironed out the details of the non-medical assessments that would determine who was eligible for disability benefits. “Approved doctors were trained in Unum’s approach to claims management”. A stringent ‘all work test’ was introduced, followed by Personal Capacity Assessment, described by the OECD as “one of the toughest in the world” – but evidently not tough enough. The 2008 Work Capability Assessment, defiantly focused on what ill people can do (such as raising their hands above their head in a tell-tale sign of work readiness), despite what ill-informed doctors might protest, was the culmination of this process.

When the Coalition entered government two years later, it made the WCA tougher still and carried through on applying it to existing Incapacity Benefit claimants – with the unwavering support of Labour, now in opposition.  The Conservatives now back “making workers pay into flexible savings accounts to fund their own sick pay” and enlarging the number of workers covered by employer ‘Group Income Protection’.

By coincidence, Unum has for years attempted to hawk both its individual and employer insurance products on the grounds that state benefits are becoming harder and harder to get.

But clearly welfare and disability is not the only area where corporations exert a decisive impact on UK government policies.  As the 2009 Alternative Report on UK Banking Reform noted, the City of London ‘has co-opted the leadership of both main political parties’. Not only did this monopolisation of views determine the climate of deregulation before the financial crisis, it also ensured that post-crisis nothing would be done to inhibit the ‘competitiveness’ of the UK as a financial centre.

Government policy has become thoroughly corporatized across the board. Corporate taxation heads inexorably downwards, subsidies go up and it is deemed as simply natural that public services are privatised or contracted out. Challengers to this state of affairs are branded left-wing populists but, in reality, they present isolated cases of politicians who haven’t been recuperated by this system and espouse policies that would have been considered quite tame and mainstream a few decades ago. They are not examples of dogmatic socialism against capitalist wisdom but pluralism in the face of a narrow corporate logic.

3 Chronically ill people are treated in a way that would shock us if it were meted out to the acutely ill

Britain can still muster outrage over the mistreatment of acutely ill people – those left on trolleys in hospital corridors or suffering prolonged abuse of care. But when it comes to mistreatment of the chronically ill – those affected by strokes, cancer, heart disease or ME for example – such empathy miraculously vanishes. At the root of the conscious cruelty inflicted by the WCA lies a stubborn conviction that these people aren’t really ill. According to the biopsychosocial model, the claims management ‘philosophy’ beloved of Unum and the Department for Work and Pensions, illness is a belief. With the right attitude (and convenient withdrawal of financial support) the temporarily ill can overcome their impairments. Just as, under neoliberalism, the unemployed, are responsible for their unemployment, so the sick are now responsible for their sickness. But this, frankly, is unscientific baloney – illness is real, whether acute or chronic.

And the idea that the UK is suffering from some kind of epidemic of psychosomatic illness just won’t wash. The amount spent by the UK on disability benefits is half what it was at its peak in the mid-90s and the benefits population is ‘static if not falling’.

In truth, what lies behind the mammoth injustice of the WCA is a refusal to accept the consequences of class. People in poorer areas die sooner and spend more of their lives contending with a disability than those in wealthier areas. In fact, the gap in disability-free life expectancy between low and high income groups is 13 years. The book, The Spirit Level, reports a study of civil servants which found that low job status was related to ‘some cancers, chronic lung disease, gastrointestinal disease, depression, suicide, sickness absence from work, back pain and self-reported health’. The authors conclude that ‘there is a sickness gradient in health running right across society … those above us have better health, those below us have worse health,  from the very bottom to the very top.’ If you want to change those outcomes, you have to change society, not tell those at the bottom, living with very real illnesses, to get their act together.

4 You might think the Work Capability Assessment is monstrously unjust but those behind it fervently believe they are fighting for social justice

I think we have to accept that, though the WCA is based on disbelieving people with actual diagnosed illnesses, Iain Duncan Smith’s tears are real. He genuinely believes he has helped the ‘disadvantaged’ by declaring the ill ‘fit for work’ and removing all financial support from the unemployed for a maximum of three years. This, as fellow partner in crime Chris Grayling once put it, is ‘tough love’. And insufferable moral worthiness is not limited to the Conservatives. Labour’s Yvette Cooper, who as DWP minister in the last Labour administration actually introduced the WCA, chided the incoming Coalition in June 2010 not to abolish the medical assessments in their zeal to cut spending across the board. To do so would be ‘deeply unfair’, she said. Yes, really.

This impenetrable sense of do-goodery stems, in my opinion, from a conviction that work is fantastically good for you. Getting more and more people into work, despite the fact that they might be seriously ill, thus becomes a matter of social justice. But when Iain Duncan Smith, or Yvette Cooper think of work, they always imagine the self-actualising, well paid kind – the kind, in fact, that they do.  But low-paid, temporary, exploitative work – the kind that people who go through the WCA are forced into – is not always good for you. In fact it can be very bad for you, as the fact that in our work-saturated society the most common reason to apply for Employment and Support Allowance is having a mental health problem, attests.

Work is not good for your health, illness is real. Apart these minor tweaks government policy towards the sick and disabled in this country makes perfect sense.

If you want to understand how politics in this country works for minorities who are never going to constitute an electorally important group, read this book. You’ll never be quite the same again.