In this second guest post – a follow-up to What’s What Councillor Watts? An open letter from Mental Health Resistance Network to Councillor Watts – Mental Health Resistance Network respond to Richard Watts’ comment on their open letter. Councillor Watts’ comment is reproduced below, after MHRN’s post. For more on the protest on 4th March and our reasons for opposing the ‘Working Better’ scheme, see the Facebook event, this co-written article on the DPAC website and this letter from a GP about work cures and the duty to #DoNoHarm.
Dear Cllr. Watts
As service users and survivors of the psychiatric system, we are accustomed to people in suits ignoring our real concerns, talking down to us and believing that they are acting in our best interest even when we are telling them differently. Sadly, your comment does little to persuade us that you are going to offer us a different trajectory.
It seems you are determined to ignore the problematic issues that your pilot scheme has created, and that you are somehow incapable of comprehending how horrendous it would be for someone to find a DWP funded Employment Coach from the Maximus ‘family’ in the surgery where they seek treatment for a condition that has been exacerbated by a perverse decision in the ESA or PIP sham assessment processes, or a benefits sanction which has removed their very means of survival and independence. Unfortunately such events are now everyday occurrences in your borough, and the areas to which your pilot is intended to spread. It seems we all have to somehow get used to these injustices because all the safeguards appear to have failed. Rather than providing effective opposition to these outrages, you and your pilot seem set on adding to the misery.
We told you that we would meet with you when you are ready to have an adult discussion with us. You are clearly nowhere near ready to do that. I suspect that rather than genuinely reaching out to us, your comment is merely public posturing in the hope that some people will be persuaded by your whitewash.
As we noted in the Open Letter, your Assistant Chief Executive confirmed that this scheme is specifically aimed at claimants with Mental Health issues. You attempt to play this down by telling us that claimants do not even need to be on benefits to participate in the scheme. This is clearly you dodging the issue, as your signature appears on a document which states (at page 17):
“The Council has agreed an ambitious target to reduce the number of people claiming ESA by 2,660 by March 2019”.
In an Islington Employment Commission document, the aim of targeting those on benefits is also made explicit:
“This will mean triaging and focusing the majority of our time, support and resources on those claiming Employment Support Allowance (ESA), Income Support and people who have been claiming Job Seekers’ Allowance or not claiming any benefits and who have not worked for a long time.”
We simply do not believe that there are many people who are long term unemployed and not claiming benefits, although we are painfully aware that Tory welfare reforms have led to the disappearance of a large number of claimants.
We are not convinced or reassured by your claim that “none of the personal patient information from the scheme is, or ever will be shared with JCP or the DWP” bearing in mind that your own council has made it clear that Remploy/Maximus Job Coaches will “add updates directly onto the patient’s medical record”. How do we know they will not pass on information? Unsurprisingly, we have no interest in being part of any scheme that gives corporations direct access to our personal medical records, and we find it shocking that your council and the CCG have adopted so cavalier an approach to patient privacy.
You single out Disability Action in Islington, and quote them as calling for making “current employment, apprenticeships and volunteering support services accessible and inclusive to disabled people”. Nothing in that quote suggests that this means they support the idea of GPs being prompted by a computer screen to nudge their patients towards employment coaching by Remploy/Maximus staff in the surgery. In any case the word ‘current’ can hardly be used to describe a pilot which would not have been current at the time. Perhaps you should approach all the DPOs in the borough and ask them specifically if they are happy with a scheme that runs the risk of replacing health care and treatment with ‘prescribed’ job seeking aimed specifically at getting 2,660 people of ESA? In fact, we may well do that ourselves……..
When the pilot was announced, you said that the aim of the scheme was to “promote the idea of employment for people with health conditions”. Later, your Assistant Chief Executive stated: “Considerable attention has been paid to using this service as an opportunity to embed employment into the ‘wiring’ of the healthcare system” Promoting the idea of work appears to be a far stronger motive than making services more ‘accessible and inclusive’. It shows that the pilot is part of a policy agenda which sees the only relevant indicator of someone’s health and worth being whether they’re working or not.
We have come across another document which seems to be undated – and appears to be an attempt to defend the pilot from our criticisms. That document, like your reply claims:
“The pilot is entirely voluntary. People can opt out at any point. Once begun there is absolutely no obligation to continue.”
You fail to tell us what steps have been taken to ensure that patients understand that the scheme is ‘entirely voluntary’ and that they do not have to take part in it. Many patients would feel compelled to do what their doctor suggested, for fear of being seen as a ‘difficult patient’ if they declined. Most patients would be unaware that the doctor was being prompted by their computer via an Islington scheme to promote the pilot, and if made aware of that fact and the fact that they could say no without fear of being flagged as difficult patients , we suspect you would find take up to be very low , especially if they were also made aware that joining the scheme would give staff of the Remploy/Maximus group direct access to their patient records.
Here is a bit of history for you:
In July 2014, the Tories were already publicly discussing stripping claimants “of their state allowances if they refuse to undergo treatment for anxiety and depression”. They announced plans for a trial which involved hiring “specialist private organisations outside the NHS and welfare system to take control of providing a combination of psychological and employment support to claimants”
In May 2015 your party failed to win the general election and the Tories gained overall control of parliament.
Four months later your Borough, in partnership with the DWP, started a pilot which placed Remploy/Maximus staff in GP surgeries. Your trial did not even include provision to ensure that psychological support would be provided to those claimants who became part of the scheme.
So, even if it is true that participation in your scheme is voluntary at this time, and even if that is being made clear to patients, you are in no position to reassure us that when the pilot is rolled out further, without any formal evaluation having taken place, that conditionality will not be introduced at that stage.
You chose to ignore our points about in work poverty, and the fact that current working conditions in many jobs would be detrimental to many claimants with Mental Health issues. They still stand, and until they are addressed, your reassurances that Islington “has a long and proud history of being on the side of our disabled and vulnerable residents” in no way proves that this scheme is good for us, or that it will not undermine the GP/patient relationship, or that it will not lead to sanctions/workfare and conditionality for disabled people.
Your Labour council should be resisting the Tory attacks on claimants with Mental Health issues, and not mirroring their policies or assisting their implementation.
We will definitely be demonstrating against the pilot on March 4th and we will continue to fight it thereafter.
The Mental Health Resistance Network
In his comment on the open letter from MHRN, to which this post from MHRN is responding, councillor Richard Watts said:
I have just been sent the link to this blog post and wanted to take this opportunity to clarify our position and again extend an invitation to meet with you to discuss your concerns over our ‘working better’ programme.
I want to start by again reiterating that ‘working better’ is an entirely voluntary scheme. This is a service that is available for patients to join voluntarily if they feel it would be beneficial, it is absolutely not forced on them. Once a patient starts seeing an employment coach there is no obligation that they have to continue and finish. They also do not have to be claiming any benefits to be part of the scheme and once again, it is in no way linked to benefits or sanctions.
I would also like to be very clear that none of the personal patient information from the scheme is, or ever will be shared with JCP or the DWP.
We initially piloted ‘working better’ as a result of the recommendations from the Council’s Employment Commission after listening extensively to disability groups locally.
During its research the Commission heard that disabled people or those who have a long-term health condition or are recovering from illness may need more support and some practical adjustments to enter the workplace.
It also heard how there are some groups, including disabled people that continue to face discrimination in their job search – many of whom just want to be given a chance to show what they can do.
The commission heard from Disability Action in Islington, who called for: making “current employment, apprenticeships and volunteering support services accessible and inclusive to disabled people”
The commission’s final report, called for establishing employment support services where people with extra needs already went – such as GP surgeries.
The scheme is not about work being a ‘cure’ or ‘fix’ for people’s impairments and health conditions. It’s about doing more to break down barriers and help make employment support services more accessible and inclusive to the disabled people who want to benefit from them.
While I do understand your concern over workfare and the sanctions regime – both of which I share, I do believe your opposition to ‘working better’ is misguided.
Islington council has a long and proud history of being on the side of our disabled and vulnerable residents. In 2013 we were the first council in the country to declare a vote of no confidence in ATOS because of their work capability assessments locally. We were the council who led the charge to save the Local Welfare Provision fund, which provides a vital safety net for some our most vulnerable residents. We have also just ring-fenced vital financial support for vulnerable disabled residents who were previously supported by the Independent Living Fund.
I would very much welcome the opportunity to meet with you and discuss this further.
You can contact me on email@example.com
I look forward to hearing from you.
Cllr. Richard Watts