Improving Lives: Fears over strategy’s ‘unacceptable’ work and health links

The government’s “cruel” and “unacceptable” emphasis on linking health and job outcomes in its new work, health and disability strategy will have a significant negative impact on people in mental distress, say campaigners and experts.

The Department for Work and Pensions (DWP) and the Department of Health released their joint 10-year Improving Lives strategy last week, and it repeatedly stresses the need to “join up work and health”.

The strategy includes proposals across social security, the workplace and healthcare, in response to a consultation that produced about 6,000 comments, including more than 3,000 emails.

David Gauke, the work and pensions secretary, described the strategy as “ambitious” and said the aim was to secure jobs for one million more disabled people by 2027, increasing the number of disabled people in work from 3.5 million to 4.5 million by 2027.

Among the plans on healthcare are to more than double the number of employment advisers sent in to work within Improving Access to Psychological Therapies (IAPT) services, which provide treatment for people with anxiety and depression.

The strategy – which contains the government’s response to last year’s Improving Lives work, health and disability green paper – also says the government is already running trials to test different ways of delivering “joined up health and work support” in settings such as GP surgeries.

It claims that “many healthcare professionals recognise that good work generally improves health and act positively on this knowledge”, but adds that there is “more we need to do to ensure this practice is better embedded across all healthcare professions”.

And it says it will work with NHS England “to explore opportunities to increase, where appropriate, the focus on work as a route to improved health and wellbeing, and to embed employment outcomes into evaluation measures”.

But ‘Rita Bins’, a spokesperson for the user-led group Recovery in the Bin, said the strategy was “more of the same disastrous and cruel work as cure ideology” and represented a continuing emphasis on forcing people off disability benefits.

Bins added: “It is also dishonest [because] there are twice as many unemployed people as vacancies, so a million jobs for disabled people would need government to create those jobs, government refuses to do so and its own growth forecast shows it can’t.

“So in reality what this means is not a million more disabled people in work, but really a million more disabled people being cut off benefits.”

Ellen Clifford, campaigns and policy manager for Inclusion London, said: “Concerns about the dangers of conflating work and health have been ignored, with proposals to put more employment advisers in IAPT and invest in research to support policy linking health and work.”

Dr Jay Watts, a consultant clinical psychologist and a member of the campaigning Alliance for Counselling and Psychotherapy, said the government had been “obsessed with the idea that work is the true goal of life for a number of years”.

She said that although the strategy’s intention was supposed to be to “improve lives”, there was no commitment to halting benefit sanctions, despite the UN’s committee on the rights of persons with disabilities calling in August for a review of their “detrimental impact” on disabled people. 

Disabled activists have repeatedly highlighted the deaths of disabled benefit claimants they believe were linked to the government’s sanctions regime, including those of David Clapson and Alan McArdle.

And DWP admitted in 2015 that 10 of 49 benefit claimants whose deaths were subject to secret reviews by the department had had their payments sanctioned at some stage.

Only last week, DNS reported “shocking” NHS statistics that showed almost half of the people in England claiming the main out-of-work disability benefit, employment and support allowance (ESA), had attempted suicide at some point in their life.

Campaigners believe that those figures – uncovered by Watts – highlight the need for DWP to abandon its hard-line approach to forcing disabled people off benefits and into work through damaging rhetoric and unforgiving sanctions, but there was no sign of such a shift in the new strategy.

Watts called last week for DWP to start treating ESA claimants with “dignity and respect” and shift from a regime of punishment “to a culture that encourages things like voluntary work which are good for mental health, but too frightening a possibility for many claimants who fear any sign of activity will be used to stop their benefits”.

She said this week: “The pressure to pursue work makes many people feel like failures when they are not well enough to work, when there are no jobs available or when they are forced to accept jobs that are demonstrably bad for mental health.

“Everyone I speak too feels guilt and shame at not working, with disastrous effects on mental health.

“This is a direct cause of the current mental health crisis, and a direct result of government policy that situates the workless as worthless.

“Both Improving Lives and evidence from the influential New Savoy Partnership suggests therapists will be under increasing pressure to ‘encourage’ patients into jobs. This is simply unacceptable.

“Therapists must not follow the money, but clear the therapeutic space away from any demands other than listening to patients, and focusing on the goals they, rather than the government, set.” 

One mental health professional has already resigned in protest at links between the organisation she is a member of and the government’s work and health agenda.

Patricia Murphy, an independent therapist who practises cognitive behavioural therapy, said on Twitter that she had resigned as a member of the branch liaison committee of the British Association for Behavioural and Cognitive Psychotherapies (BABCP), after almost 20 years serving on various BABCP committees.

She said she felt she was being “co-opted to get people back into employment” and was “disappointed and dismayed” that BABCP was “engaging so actively” with DWP.

Both BABCP and Murphy had failed to comment on her resignation by noon today (Thursday).