For the taxpayer’s sake, halt the introduction of disability benefit PIP

In response to every criticism of the Government’s austerity drive, the Coalition insists there is no alternative to the cuts and yesterday morning was no different. Speaking on the Today programme, Work and pensions minister Chris Grayling again argued that it was in the taxpayer’s interest for the Government to press ahead with disability welfare cuts despite last night’s dramatic defeat in the House of Lords of three proposed welfare reform changes. Yet as the debate shifts to other aspects of the welfare bill, it can be argued that key elements of the proposed reforms in fact short change the taxpayer.

The Government is intent on scrapping DLA and replacing it with Personal Independence Payments (PIP), despite the fact that only 7% of organisations that took part in a recent DLA consultation were fully in support of this change. The reasons given by the Government for abandoning DLA struggle to stand up under scrutiny, as this week’s excellent Responsible Reforms report by disabled campaigners highlight, but what is clear is that the Government has estimated it will cost £675 million to scrap DLA and introduce PIP.

In addition, despite fierce opposition from disabled people and, at 0.5%, DLA having the lowest fraud rate of all Government benefits, the Government is still intent on introducing a medical test for all potential recipients of PIP. It is suggested it would operate along the lines of the Working Capability Assessment (WCA) administered by private company Atos healthcare for those currently applying for Employment Support Allowance. Frankly, this assessment isn’t currently fit for purpose. 40% of decisions that people are ‘fit to work’ are overturned at the appeal stage, and these original decisions are very heavily based on the findings of the WCA. Atos has not yet been given any financial penalty for any inaccurate report it has produced despite the fact that the hefty appeals process for ESA has cost the taxpayer a staggering £80 million to date. On top of this, the Government is already paying Atos £801 million over a ten year period and one can only presume the contract will increase in size were Atos to be asked to also undertake the medical assessments for PIP eligibility.

In its ‘Budget 2010 policy costings’ document, the Government highlighted a desire to cut DLA payments by 20%. Currently annual DLA payments amount to £12.6 billion, so a 20 per cent saving on this figure would come in at £2.52 billion annually. The up-front PIP implementation costs plus a medical assessment contract similar in size to Atos and any subsequent appeals expenses would eat up half of these savings.

In an age where we are continually told that every penny counts, the Government must justify these costs, including whether it is in the taxpayers interest that 100% of DLA recipients will be forced to attend a medical, even those that have an incurable, end-stage illness. Wednesday's successful House of Lord’s amendment to the welfare bill to exclude cancer patients from being subject to the one year ESA time limit, and therefore implying a medical test for such patients would be redundant, suggest there isn’t the public appetite to impose stressful health tests on the seriously ill who are trying to claim benefits in their hour of need.

The Government also has an obligation to the taxpayer to ensure its money is sensibly spent. The medical tests for PIP eligibility are set to begin in 2013, despite the fact that the latest Harrington report, which examined the practical implementation of the WCA medical test, states it will take at least three years to see if its recommendations have improved the accuracy of the medical test in identifying real need.  Until the Government manages to get WCA appeal rates under control, there is little point adding another hefty bill to the taxpayer’s purse to extend the number of ill people required to undergo similar assessments. Indeed the Government should be obliged to go further and ensure the taxpayer is getting value for money from existing medical assessment contracts by forcing financial penalties on those companies making repeated mistakes for which the taxpayer is currently picking up the bill to rectify.

Don’t get me wrong, I’m not in favour of an arbitrary 20% cut in DLA and I’ve written before voicing my concerns that people who need genuine Government help will be deemed ineligible in order to meet a pre-decided budget cut. But it seems to me that the Government is simply scrapping DLA only to replace it with a similar benefit at great cost to the taxpayer to avoid the PR fall out of being seen to take money away from the long-term sick. In an age of austerity there cannot surely be any spare cash to help the Government save face.

If the Coalition wishes to reform or cut DLA then it should have the courage to makes its case in a fair and democratic manner and make changes within the current benefit. It should not hide its agenda behind a name change or ‘independent’ medical assessments. The introduction of PIP should be recognised as a waste of money which cannot demonstrate any clear benefit to the taxpayer. It should be halted now, before it too becomes a disastrous, administrative nightmare like ESA is now proving to be.

Three reasons to sign the 'Save the NHS' petition

I've been watching the progression through parliament of the Health and Social care bill with alarm. This is a major piece of legislation that MPs don't seem to have given proper time to and it has been waived through the Commons despite mounting protests from GPs, consultants and public demonstrations.

The Bill is now in the House of Lords and the vote is expected to take place tomorrow on whether it will approve the Bill. Below are three reasons you should sign the petition by 38 degrees.This is our last chance to halt the reforms and demand a proper consultation with open explanations of the Bill's intentions. The list below is not comprehensive so please do add more in the comments section.

1. We live in a democracy and the way this Bill has been handled is thoroughly undemocratic. I've posted on this Bill before, but in short the Bill looks to give GP commissioning powers and open up the NHS to'any willing provider' (although this has recently been amended to 'any qualified provider'). Yet these crucial changes are already being enacted across the country with Health Secretary Lansley saying that 97% of the country is now covered by GP commissioning and current Primary Care Trusts are tendering out health contracts to 'alternative providers' (i;e. private companies). This has all happened while the Bill was officially 'paused' by David Cameron. It is unacceptable that any elected Government enacts controversial reforms without the approval of an elected parliament. I would hate the Health Bill to set a dangerous precedent. There is also the glaring fact that these reforms do not have an electoral mandate as they did not figure in either Coalition parties election manifestos.

2. The Bill does not have the backing of the majority of the medical profession. They believe it poses a fundamental risk to patients' health and to the NHS. This should be a major warning sign to us all. After showing patience with the Government, engaging in two consultation processes and cooperating with the Government on suggested changes to the Bill, the community has now come out in desperation calling on the whole Bill to be suspended. If the doctors working in the NHS are against this Bill, then we must question the motivations of the Government to pursue such changes. Either they are arrogant and believe that MPs know the NHS better than people who have dedicated their lives to working in it OR these reforms are nothing to do with improving the NHS.

3. The future implications of the Bill are far from clear. Cameron has promised not to privatise the NHS but the more I think through the proposals this seems like clever word play. The White paper gives commissioning powers to GPs who are officially private employees with NHS contracts. The paper does not say whether giving them commissiong power means that they will automatically becoming employees of the state. The Bill is pushing for the NHS to operate on free market principles in which providers compete for patients, and the Government funding they bring with them. This might explain why the Bill states that all hospitals are to become 'social enterprises' (i.e free from state control) and that those hospitals that can't manage their finances properly will be allowed to fail.

Adding this up in my head, it seems that the Bill is moving us to a state insurance system in which the UK Government doles out cash to private providers yet ultimately will one day not own any hospitals or pay for any staff. This ultimate aim may well be why the Health Bill in its current form doesn't explicitly state that the Health secretary will have ultimate responsibility for the NHS - how could he if the 'NHS' just becomes a pot of money that is divided out between private companies? Would an insurance system be better for the UK? Who knows because there has been no open debate about it as the Government has been so quick to push the Bill through parliament and refused to be honest about where this legislation is leading us.

Please sign the petition. The Government claims that the NHS must reform if it is to remain able to care for an ever increasing and elderly population. That may well be true but this isn't the way to manage such reform. We elect our Government and in turn they should be honest about the problems the NHS faces and the potential ways to manage healthcare in the future. Pushing through undemocratic reforms, which lacks the support of the medical profession and the understanding of the public treats the NHS and the voting public with contempt.