Tuesday, 15 January 2013

And the PIPs will squeak! Groundhog day for personal independence payments.

Here we go again. Groundhog day. From April  new rules are to be set for qualification for disability allowance or personal independence payments (PIPs) as they are to become in April. The new assessment according to the Department for Work and Pensions (DWP) "will focus on an individual’s ability to carry out a range of key activities necessary to everyday life." Information will be gathered from the individual, as well as healthcare and other professionals who work with and support them. Most people will also be asked to a face to face consultation with a trained independent assessor as part of the claim process.  From the experience of the Work Capability Assessment, it looks like another recipe for pain and suffering. 

I often wonder who it is that draws up disability or capacity criteria. What kind of person is it that decides if you can go up two steps without being in pain you are 'fit'? What about the third and fourth or subsequent steps? Of course I do like being optimistic; positive thinking is better than negative. "What can you do?" seems a reasonable question to most people. But it isn't; or at least it isn't in isolation. And here is the problem with the parametrics of disability.

 Disability isn't simply an aggregate of each individual parametric; they interact in often unpredictable ways. They have qualitative as well as quantitative features, and often whilst the latter are easier to 'measure' the former is sometimes what makes any problem disabling. It is how it affects the person.

The problem with what can be measured is that it tends to squeeze out the subjective. "We'll measure this because we can" becomes an underlying principle. Furthermore it appears to be objective.  It is they say 'fair' because it is objective, a yardstick applied to everyone, consistently. Everyone will be 'treated the same'. It sounds fair, but it isn't. Treating people 'the same' isn't at all fair. We are different. People are affected differently depending on circumstance and how any given parameter impacts on their lives. The subjective makes a difference.

The criteria for the 'descriptors' to be used were established after a period of consultation.  Yet, those criteria are already being changed. For example, it has now been decided that those unable to walk greater than 20m will qualify, which has shaved a full 30 m off the previous qualification. I guess that is in the Olympic spirit. We are all for breaking records. But 30 m difference suggest something fishy is going on. it will clearly have a major impact on the numbers qualifying.

Government ministers say it will target those who need it the most. Which is all very well but what about those who simply need it, not 'the most' but do really need it? Those for example who whilst they can walk 20 m would nonetheless be severely unwell if the walked say 30 m?

 Disability is not something that can be measured by a simple yardstick. It is usually multifaceted and affects people in different ways. Circumstances matter. The DWP specifically rules out using 'key factors' such as pain, nausea, breathlessness, motivation, in assessing the 'descriptors'. Most healthcare professionals would be appalled at such an egregious folly.

By including lists of symptoms the DWP says "we might unintentionally narrow the scope of the assessment."  Unintentionally? By leaving them out it intentionally narrows it. They are not only an essential ingredient,  but most often  they are also the critical factors that physically and mentally limit capability. They are of course difficult to measure; how much pain, what type of pain, where is the pain and how it affects function would need to be assessed. But, however difficult they should not be ignored. It would not be ethical to ignore them. Difficulty is not an excuse for poor judgement.

The government are as usual being disingenuous with estimated uptake. The DWP says that 'broadly' the same number of people will receive the benefit. This is an odd calculation when they expect to save a staggering £2bn.  Either those receiving the help will get less or far fewer people will qualify.  Broadly takes a lot of defining. The government can't have it both ways.

2 comments:

  1. "The DWP says that 'broadly' the same number of people will receive the benefit. This is an odd calculation when they expect to save a staggering £2bn. Either those receiving the help will get less or far fewer people will qualify. Broadly takes a lot of defining. The government can't have it both ways" Spot On Thanks

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    Replies
    1. Tanks Jayne. It is what it is all about really isn't it? Cuts.

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