Monday 14 May 2012

An open letter to the Telegraph: get your DLA facts straight

Dear Daily Telegraph,

You had the scoop of the decade with MPs expenses. You are clearly a paper that employs excellent journalists with great research skills. It is a shame these skills weren't utilised when you interviewed Ian Duncan Smith yesterday about the changes to DLA.

Here are the basic mistakes in your article;
1. The subheader says IDS is going ahead with changes to DLA to "rid the system of abuse and fraud". The Government's own figures show DLA fraud is 0.5% for 2010/11. To start the article as you did just cements the idea in the mind of the public that all disabled people are scroungers and consequently kindles negative attitudes towards disabled people.

2. IDS says the number of claimants have risen by 30%. This isn't true. According to IDS's own department, the claimant case has risen by 16% amongst working-age claimants, to whom these changes will only apply, once population growth has been taken into account.

3. "The rigorous new process being introduced by Mr Duncan Smith could lead to those without limbs, including former soldiers, having their payments reduced as their everyday mobility is not undermined by their prosthetic limbs". If you read the Government's draft qualifying criteria for Personal Independence Payments (that is replacing DLA) you'd have realised this statement is disingenous. It clearly says that even if your everyday mobility is severely limited through amputation, under the new system you'll receive minimal support to help with this. Case study 7 says "Andy is 50. His left leg was crushed and had to be amputated above the knee and his right leg was also injured.The scar on his left stump has not healed very well so he has difficulties with his prosthesis and his right leg is weak. He finds it very tiring if he walks more than 40-50m so he often uses a wheelchair if he is going outdoors. Mobility activities = 10 (standard rate Mobility component)". This means that the Government recognises that Andy cannot walk more than 50metres, that, to use IDS's terminology, his 'everyday mobility' is undermined but will only award him 10 points. This means he will no longer be able to access the motobility scheme which allows him to rent a car to give him the freedom that his body no longer allows him.

4."In the assessment, lots of people weren’t actually seen. They didn’t get a health check or anything like that". To get DLA you are medically assessed by the doctors and hospital workers that see you regularly. They need to provide supporting evidence to the DWP that your disability or illness is as you have described it. The DWP regularly contacts doctors who have provided supporting evidence for extra information before it makes a decision. This is why it is actually very hard to be awarded DLA and why the fraud rate is so low.

5."Something like 70 per cent had lifetime awards, (which) meant that once they got it you never looked at them again". This 70 per cent figure may be true and it is very high, but to suggest that some people should not receive lifetime awards shouldn't automatically mean that no-one receives lifetime awards. Many claimants have degenerative incurable illnesses such as Parkinson's or, like me, Cystic fibrosis, or are permanently paralysed. We can't get better, so if we are found to need help this year then the same will be true in four years time. It is a waste of taxpayer's money to reassess all claimants every few years.

6. You quote IDS as saying "Tony Blair’s government tried to attack DLA, just to restrict it. We’re not doing that". Actually IDS is. The Government declared in its Budget 2010 policy costings document that it intends to save 20% from its DLA budget by changing the way it is allocated - this is the very definition of restricting DLA.

There are other things I do not agree with with this article, but as they are matters of tone not fact you have a right to editorial control over these issues. I appreciate that the Telegraph is right-leaning and therefore broadly supportive of the current Government, but by swallowing every fact uttered by IDS without question, this piece reads as a poor advertorial for the Government's cuts, and not as a strong, piece of quality journalism.

Yours sincerely,


p.s. All links go to DWP or Government documents freely available on the web, so you could have easily found such reputable sources yourself.

Wednesday 9 May 2012

NHS could be the real problem for the coalition come election time

After last week’s wake-up call at the local elections, the Coalition is under pressure to re-examine how its policies reflect voters’ expectations. While there is much debate about the merits of Lord reform, gay marriage, austerity targets and growth policies, the two parties would do well to turn their attention to recent passing of the Health and Social Care bill.

Yesterday’s decision by the Government to veto the information commissioner’s legal demand to publish the risk register reminds us all what a controversial bill this truly was. The Government is still not keen to reveal to the public the extremities of the risk assessment, although an early version of the register, leaked in March, suggests that the worst case scenario of these reforms would be that “the Bill proceeds, without assurance that the whole system is affordable." The document continues: "There is a risk that costs of the future system cannot be controlled."

No wonder the bill received such widespread criticism in the run-up to it becoming law.  In February this year, eight significant health organisations fully opposed the bill, two opposed it in its current form and three were neutral. On top of that a YouGov survey showed the 65% of NHS staff wanted the bill withdrawn in its entirety.

I repeat these statistics as it shows the uphill battle the Government has to secure good outcomes from such a fiercely unpopular policy.

Since the bill became law there has been on-the-ground confusion on how best to implement its policy’s, a situation not helped by aggressive private companies there were waiting in the wings ready to take advantage of this initial knowledge vacumn. Virgin now controls 18 NHS contracts across 15 counties, and Labour back-bencher Dr √Čoin Clarke estimates that £2 billion worth of NHS contracts have now been given to private companies.

Despite this plethora of contracts there is no evidence that such outsourcing of NHS contracts will deliver better services, increased choice or long-term control of costs. Indeed, the first NHS hospital to be completely privately run, Hinchingbrooke in Cambridgeshire, has recently caused a furore by announcing it intends to make a profit of £60 million in the next decade despite concerns that to do so would mean making 'eyewatering cuts'. On top of this there are ludicrous stories of physiotherapists who aren’t allowed to touch their patients following a new contract agreed by Principia clinical commissioning group (replacing the local Primacy Care Trust) in Rushcliffe, Nottinghamshire.

If a patient is unhappy with the care they are offered they can complain to Healthwatch, but they’d have to wait five months as, despite the fact that the bill is already on the statute books, it doesn’t launch until October this year. Once this organisation does finally get round to opening, it can then pass on complaints to the Care Quality Commission (CQC) which is now responsible for ensuring that private health providers are honouring the quality expected of them. This is the same CQC that has been overseeing private social care providers since 2009 and has twice been humiliated by BBC Panorama revelation's of abuse at care homes that the CQC had already inspected multiple times and declared acceptable. Despite clearly struggling in its current role, the Government expects the CQC to more than double its workload with 30% less staff.  The public may accept private providers profiting from NHS work, but in exchange it will expect the service it receives to be better than what is currently on offer and it is clear that the systems in place to manage this are already found wanting before they get off the starting block.

It isn’t even clear that in the current rush to implement these reforms the basic principles of free market capitalism are honoured, a principle that is the bedrock behind the spending decentralisation of this Tory-led Government. Despite health secretary Lansley’s much vaunted initiative of giving GPs the budget and power to buy services for its patients, it is alleged one local commissioning group in West Sussex weren’t told about a new contract award to Virgin healthcare until after it was signed off.  The commissioning board were therefore not able to consider the merit of the bid in comparison to other interested parties – a clear failure of the health bill’s objective of tendering-out NHS work to help achieve better value for money for the taxpayer.

After such a turbulent month the Government most probably couldn’t bear the horrendous headlines that would result if it revealed what risks it is truly taking with our beloved NHS. But whether made public or not, those risks outlined by the risk register still remain. No doubt the Government is hedging its bets that the new Health Bill would have bedded in by the time an election is called in 2015, and any initial concerns by the public would have been proved false. Three years is also enough time for the NHS as we know it to have unravelled, for charges for non-urgent surgery or treatment to be mooted, for waiting lists to grow, for private companies to make large profits while limiting the contact patients have with doctors. And the first few months of policy implementation don't embue one with confidence that the NHS is in safe hands.

So Cameron and Clegg be warned: the battle to push the health bill through parliament could prove miniscule compared to the battle on voters’ doorsteps in 2015 to convince them that you can be trusted with the NHS.