The Department for Work and Pensions (DWP) has announced further plans for co-working with the NHS. The proposals will allow GPs to refer chronically ill and disabled people to “employment support“. Currently, the scheme will be voluntary. However, the programme represents yet another move by the DWP to get its claws into NHS settings. Moreover, it further pushes the false narrative that ‘work is good for your health’.
DWP: getting more disabled people back to work
The DWP said on its website that:
More than 25,000 people with health conditions will be helped to start and stay in work thanks to over £58m in new government funding.
As the Daily Record reported:
Those on the scheme, called the ‘Individual Placement and Support in Primary Care (IPSPC)’ programme, will be given employment support alongside their normal health treatment. The support will cover 12 areas across 41 local authorities in England, and participants will be referred to the service by healthcare professionals such as GPs.
Outsourcing more NHS contracts
Details are still sketchy, as the DWP only started the scheme in April. It says the Individual Placement and Support in Primary Care (IPSPC) programme will be “providing on-the-job “place and train” employment support and advice”. The scheme is voluntary, and it’s open to people NHS professionals identify as eligible. Participants don’t have to be claiming benefits. However, they do have to meet certain criteria. The DWP says people can either be:
Out-of-Work Participants who require assistance and support to move into sustainable employment, [or] In-Work Participants who are employed and either off sick or struggling in the workplace due to their disability.
Of course, the scheme isn’t actually being run by the NHS. Local authorities are applying for funding from the DWP. Then, they can use the cash to outsource the running of IPSPC to private companies or charities. For example, Greater Manchester Combined Authority has already done this. These new organisations will then integrate into the NHS.
Private providers once again getting public sector contracts in the NHS is privatisation, in everything but name. But aside from that, the DWP’s IPSPC scheme is littered with problems.
IPS: hardly a resounding success
First, and the DWP has based IPSPC on a US model of healthcare-based employment support – the Individual Placement and Support (IPS) programme. This was designed for people living with serious mental health issues – not chronic illness or physical impairments. The DWP and NHS already implemented IPS for people living with mental health issues in the UK.
The creators of IPS claim it’s evidence-based. However, one study found IPS only got people into work for a limited time. After six years, there was not a significant gap in employment outcomes between IPS and people who had standard psychiatric treatment. Moreover, the success of IPS in the UK is questionable, too. Between January 2016 and March 2019:
- 31% of IPS participants started a job.
- 22% kept that job for at least six weeks.
- 12% kept that job for at least six months.
Hardly a resounding success. It’s debatable whether outcomes for chronically ill and disabled people would be any better.
Then, there’s the issue of the DWP once again invading the sanctity of the healthcare environment. The IPSPC scheme ‘integrating’ “employment support and advice… with [a patient’s] normal health treatment” is wholly inappropriate. As professor Helen Stokes-Lampard previously told the Independent regarding the DWP wanting to access patient’s medical records:
We are doctors, whose first interest is the care of our patient: we are not border guards, and we are not benefits assessors.
Work is good for you, apparently
However, perhaps the most damaging part of the DWP’s IPSPC plans is its central claim that work is somehow good for you.
The DWP says that the basis of the IPSPC scheme is:
Recognising employment as an important driver of health and wellbeing
Likewise, the founders of IPS claim:
Work is the best treatment we have for serious mental illness (i.e., people with schizophrenia spectrum disorder, bipolar, or depression)… Being productive is a basic human need. Working can both be a way out of poverty and prevent entry into the disability system. Competitive employment has a positive impact on self-esteem, life satisfaction, and reducing symptoms
Most of this is demonstrable nonsense. For example, saying work is a ‘way out of poverty’ is untrue in both the US and UK – as in-work poverty rates show. But it’s the IPS’ founders’ key claim that work acts as a health treatment that’s most damaging – and it’s a claim that the DWP also repeatedly makes.
Fulfilling the capitalist dream
The idea that working is good for your health is simply not true – especially in the UK. As researcher Kitty S Jones wrote, the DWP itself helped create this fallacy:
There is plenty of evidence that indicates government policy is not founded on empirical evidence, but rather, it is ideologically framed, and often founded on deceitful contrivance. A… [DWP] research document published back in 2011 – Routes onto Employment and Support Allowance – said that if people believed that work was good for them, they were less likely to claim or stay on disability benefits.
So a political decision was made that people should be “encouraged” to believe that work was “good” for their health. There is no empirical basis for the belief, and the purpose of encouraging it is simply to cut the numbers of disabled people claiming… [benefits] by “helping” them into work.
Clinical psychologist Dr Jay Watts previously told the Canary that by saying work is good for your health the DWP is reinforcing:
the message work is the central goal of a meaningful life. This increases the shame, guilt and anxiety disabled people already feel. Even more so under a welfare system that equates worklessness with worthlessness. It is exacerbating mental health problems. The goal of mental health services has always been to improve quality of life and reduce distressing symptoms…
This ‘back to work’ obsession places huge demand on patients to fulfil the neoliberal dream. One whereby health is linked to how much one can contribute to the public purse. But this is foreclosing the reality of long-term disability. We do not, would not, hear that chemotherapy is worth funding because it helps the public purse through getting people back to work.
The DWP and NHS: pushing a lie
While the DWP’s IPSPC said to be voluntary, this ignores the reality of chronically ill and disabled people’s lived experience. If a medical professional tells you that something may help you feel better, you’re likely to believe them and accept it. We’ve seen this before with the disease myalgic encephalomyelitis (ME) and exercise therapy. This treatment actually made patients worse when they carried it out – yet because of dishonest research, doctors were pushing it onto patients anyway.
However, the bigger picture here is that once again, the DWP is manipulating both patients and some medical professionals into thinking that engaging in what will likely be low-paid work is somehow good for chronically ill and disabled people. As is often the case, it’s doing this to cut costs.
In reality, it’s a lie that work is a blanket solution to chronically ill and disabled people’s problems. What they need is proper medical care, a social security system that doesn’t penalise and stigmatise them, and a society that is fully accessible. The DWP is none of those things – nor is this latest scheme.
Feature image via the DWP – YouTube and the NHS – Wikimedia
