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Archives for April 2011

The truth about sicknote Britain

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Mark Easton | 14:45 UK time, Thursday, 28 April 2011

According to one screaming tabloid headline today: "Blitz on benefits: 887,000 fiddlers exposed". Echoing stories in many of this morning's papers, the Daily Express says that three-quarters of Incapacity Benefit (IB) claimants are "workshy spongers feigning serious disability". Shocking, if true.

But it isn't true.

pills on a prescription

The red-top press has worked itself up into a lather of indignation and fury over statistics that are variously described as evidence of "Britain's sicknote culture", "greedy skivers" and "benefit cheats". So, let's examine the facts.

The source for all this is the latest batch of data from the Department of Work and Pensions (DWP) on applications for Employment Support Allowance (ESA), a benefit introduced two-and-a-half years ago by the Labour government. Today's figures relate to the period between October 2008 and August 2010 - a time, for the most part of course, when Labour was in power.

The key point, though, it that these are new applicants - people applying to see if they might be eligible for additional financial support.

Some will be trying it on, knowing they are quite well enough to work but hoping to hoodwink the assessors into giving them sickness benefit. But I suspect many are simply individuals who don't want to miss out on a welfare payment to which they may be eligible. There is nothing 'dodgy' about seeing if you meet the criteria for something.

The DWP exhorts the public to ensure their full benefit entitlement. For instance, the department has regularly encouraged people to ensure they "don't miss out" on council tax benefit while the Mayor of London also has a scheme called "Know Your Rights".

So, it could be argued, that applicants for ESA are doing what they are told. Unsurprisingly, many people learn that under the tough new medical assessments, they do not qualify. Others, on realising that they have to undergo detailed checks, withdraw their application.

Are these people really workshy spongers? One can easily imagine someone who believes their depression or back pain has contributed to their unemployment and wanting to see if their condition entitles them to the slightly more generous payments under ESA than JSA (Jobseekers Allowance). That would seem to be common sense, not greed.

Government campaign image

Some newspapers, though, appear to have misunderstood the point. The Daily Express, for instance, says the figures "suggest that more than £4billion of taxpayers' money is wrongly paid out" to scroungers. But, of course, nothing has been paid out to any of the applicants because they are not yet receiving the benefit.

Extrapolating the data from new applicants to those already receiving IB risks comparing apples and oranges because those in receipt of IB have already been through an assessment.

The government has just begun rolling out its programme for re-assessing existing IB claimants amid controversy over the fairness and accuracy of the medical checks, but it would be a surprise if the proportion deemed "fit to work" was anything like the 39% of new applicants who have not been previously assessed.

To recap then: the figures reflect the results of a Labour welfare reform for new applicants to a relatively new benefit. This has nothing to do with a coalition "blitz on benefit cheats" or a "government crackdown on welfare scroungers", however much Ministers would like to spin the stats. I would also note that today's stories bear an uncanny resemblance to reports six months ago on the previous tranche of ESA data which said almost exactly the same thing.

Far from providing evidence of sicknote Britain, the figures could be seen as evidence of citizens following government advice to ensure they "don't miss out".

Moral welfare

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Mark Easton | 11:54 UK time, Thursday, 21 April 2011

Quiet morning? Banish boredom with some hand-wringing about alcoholics, drug addicts and obesity patients receiving incapacity benefits!

It is one of those hardy perennial stories to be wheeled out on a dull news day, a chronic "scandal" that media and Ministers alike know will press the button marked "moral outrage".

herion addict preparing to inject heroin


But hold on. Today's version says 80,000 addicts receive welfare payments and yet in 2006 the story was that 100,000 were on incapacity benefits. In 2008 it was more than 100,000, last August it was nearly 90,000, by November it was more than 100,000 once more.

I haven't seen any stories saying that the latest figures represent a 20% fall in just five months. I wonder why.

I also wonder why this particular group of incapacity benefits claimants is picked out from the data. The suggestion seems to be that people suffering from diseases like alcoholism, drug dependency and obesity are morally culpable for their condition.

John Humphrys articulated just this point on the Today programme
this morning. When Don Shenker, Chief Executive of Alcohol Concern suggested alcoholics were often unable to work "through no fault of their own" he was interrupted. "No fault of their own?" he was asked.

One can understand why the question is asked but once society starts introducing the idea of "fault" into the issue of welfare, the debate enters dangerous territory.

Let us assume that the reason for all these stories about drug addicts, alcoholics and obesity sufferers receiving state support is that some people regard them as "undeserving": what about these people?

  1. The smoker who knew the risks and developed lung cancer
  2. The non-smoker who lived with a smoker, knew the risks and developed lung cancer
  3. The horse-rider who knew the risks of the sport and suffered brain injury after a fall
  4. The spinster who ignored her doctor's advice to lay off the sweet sherry and developed debilitating diabetes
  5. The man whose refusal to follow health and safety advice resulted in a disabling industrial accident
  6. The driver who crashed into a tree after three gin and tonics and was never able to work again

To be fair to the government, ministers have always couched the debate in terms of supporting and encouraging people back into work through treatment or other help. There is also a legitimate public discussion to be had about individual responsibility and whether the state should tailor welfare provision to encourage pro-social behaviour.

But let's be honest: this familiar debate is really about providing ammunition for those who insist it is possible to take a moral stance on welfare; that we can divide up potential recipients in terms of deserving and undeserving.

The trouble with this argument is that it would necessitate some kind of "morality officer" charged with deciding whether incapacity was the "fault" of the individual. Who would we recruit for this job? What questions would be asked?

The alcoholic whose condition has led them from well-functioning citizen to welfare-dependency - is it the role of government to investigate the case and apportion blame?

What if it emerged that the individual had suffered serious child abuse which had led to severe mental health problems which in turn had led to the bottle? Should the abuser face sanction rather than the abused? Should the retailer who sold the cheap cider knowing the customer had a drink problem? What about the drinks company promoting sales of high-strength low-cost booze? And do the institutions and politicians who failed to protect the abused child and supported the drinks industry shoulder any responsibility?

A thought for a quiet morning...

PS: My list of incapacity benefit addict stories was an illustration of how this tale gets re-told and re-packaged at regular intervals. The Sun story from November relates to figures obtained under a Freedom of Information request from the previous year and so my 20% fall point should be taken with the stroke-inducing pinch of salt with which it was intended to be consumed. Incapacity benefits closed for new claimants last August of course.

Happy evangelists take on the cynics

Mark Easton | 00:01 UK time, Tuesday, 12 April 2011

"I promise to try and produce more happiness in the world and less misery."

As a statement of intent, the above pledge, made by those joining the new movement Action for Happiness launched today, seems uncontroversial

But we live in the UK, a country which has won gold medals for cynicism, and I am prepared to guess that among the posts which follow this article will be suggestions that there is something deeply un-British and probably underhand about a campaign to spread joy and reduce suffering.


Britain is more distrusting of politicians, the media, public institutions and each other than most other countries. We seem hard-wired to question the motives of anyone who steps into the public arena and so it was no surprise that when I mentioned the Action for Happiness launch to colleagues at the BBC there were more than a few who said they suspected it was all part of some plot by the government to brainwash us out of austerity gloom.

Actually, I think it is far more interesting and ambitious than that. Action for Happiness says it "hopes to inspire a mass movement for fundamental cultural change". One of its founders, the economist and Labour peer Professor Richard Layard, told me he thought it was needed because of the failure of organised religion to turn back the "tide of narrow individualism".

He believes the evidence-based principles of the organisation might help deliver the ideals of the Enlightenment, when great British thinkers, including Jeremy Bentham and John Stuart-Mill, were arguing that "the good society is one where there is the most happiness and the least misery".

The suggestion that happy science offers a more effective route to personal and social wellbeing than religion might be controversial in some quarters, but there is something evangelical about the movement. The pledge I quote at the top is a prosaic form of many solemn and sacred oaths. And the "ten keys to happier living", shown above, have echoes of the Decalogue, although the encouragement to "find ways to bounce back" perhaps lacks the majesty of the Ten Commandments.

But there is another echo for me - my time in the Scouts. Just as I promised to "do my duty", to "be prepared" and "do a good turn daily", so Action for Happiness encourages volunteering, resilience and awareness.

Lord Baden-Powell's mission was, like so many of the initiatives spawned as the 19th century ticked over into the 20th, to encourage community well-being at a time of great change. The founding of the Football Association is another example, part of a flowering of social entrepreneurism that David Cameron would like to see repeated today.

Action for Happiness is not a political organisation in the sense that it is linked to government or opposition. It does, though, want to profoundly to change the way people behave. Its rejection of the idea that more cash would lead to a happier country inevitably raises eyebrows as Britain tightens its belt. But the organisation's founders were preaching the same message in the boom. Arguably, it is a message that has been around for at least two-and-a-half thousand years.

The movement attempts to counter contemporary cynicism with practicality, offering simple ways to give our own lives and those of our friends and neighbours greater fulfilment and meaning. There is certainly a growing body of science to back up many of the ideas, but that won't stop many people assuming some ulterior motive.

So, do you want to spread a little happiness? Here are a few ideas the experts reckon might work:

Action for Happiness - list of ideas for a happier life

Why statisticians measuring wellbeing are unhappy

Mark Easton | 17:00 UK time, Friday, 8 April 2011

Compared to nurses, police officers and binmen, statistics probably seem like a bit of a luxury. Certainly Communities Secretary Eric Pickles has suggested he thinks the data collection business is pretty much the definition of back-office, rather than front line.

Eric Pickles

"The money being spent on form fillers and bean counters could be far better spent helping elderly people to stay in their homes," he said last year, adding "or almost anything, in fact." True to his word, he recently announced he was scrapping the Citizenship Survey, a piece of work that has been conducted by the government every two years since 2001.

Roughly 10,000 adults in England and Wales (plus an additional boost sample of 5,000 adults from minority ethnic groups) were asked questions about their role as citizens: about their volunteering and participation, their faith and their feelings about their community. It was, in many ways, a measure of just how big the traditional Big Society could claim to be.

So, just as the government tells us that they want to expand the Big Society and focus on social well-being as a measure of progress, they bin the survey. It is a paradox that was pointed out to Mr Pickles in a letter today from the head of the UK Statistics Authority, Sir Michael Scholar.

Pleading with communities secretary to "look again" at the survey, Sir Michael (an ex-Treasury mandarin) says he "fully recognises the severe pressures on Departments' budgets" but thinks that "insufficient account has been taken of the effect of discontinuing the Citizenship Survey".

"Your Department's summary report of the consultation it carried out said that the 'vast majority' of current users of the statistics expressed concerns about the Survey's discontinuation, noting that these concerns were particularly strongly articulated by other government Departments, voluntary organisations and academics; and noting the use of the Survey's data in providing evidence on the Big Society, extremism, cohesion and integration, fairness in the criminal justice system, discrimination, the impact of immigration, volunteering, well-being, and many other issues."

It is a letter which pushes every conceivable button that might make an impact with the architects of the coalition's reforms: "fairness", "volunteering", "immigration" and "well-being". With regard to the latter, Sir Michael reminds Mr Pickles that the National Statistician had noted the survey's particular "relevance to the major work programme to measure national well-being announced on 25 November 2010; and to helping the public to assess what the Big Society means."

These are subjects close the prime minister's heart - the public consultation on well-being he launched personally last year has only got a few more days to run. You can add your views on the Office for National Statistics website.

Mr Pickles department does not believe that national data is often required:

"We are keen to move away from costly top-down monitoring and measurement of local policies. Local providers are best placed to decide which data are needed to inform local priorities and monitoring."

The survey costs just over £4m a year to run, money Mr Pickles thinks could be better spent on local practical programmes and policy initiatives, particularly "those which directly promote integration and participation in communities".

It is an argument we may hear increasingly: let's not spend money on central bean counters when we can use it at local level (or not spend the cash at all).

The concern of the statisticians is that unless the country has access to consistent data, how are we going to know if the cuts, and localism and the Big Society are making matters better or worse? Without national figures, they might ask, how can Britain hold Mr Pickles to account?

Is Nick Clegg a hypocrite?

Mark Easton | 11:45 UK time, Wednesday, 6 April 2011

"It is easier to dispose of an opponent's character by exposing his hypocrisy than to show that his political convictions are wrong." I can imagine that Nick Clegg might take some comfort this morning from the words of American political theorist Judith Shklar writing in 1984.

Deputy Prime Minister Nick Clegg with school pupils


The deputy prime minister is duffed up in many of the papers today for trying to prevent the middle classes from using their connections to get their children valuable internships - after he benefited from just such an arrangement.

The charge is that he is a hypocrite - trying to deny to others what he enjoyed himself. But does the accusation really hold water? Are we saying that no politician can ever pursue reforms to a system because he or she is a consequence of that system?

Many Labour politicians were and are products of grammar schools. Harold Wilson, Dennis Healey, Barbara Castle and Gordon Brown benefited from such an education. Is it then hypocritical for them to argue for an end to grammar schools?

I will guess that those who wish to see more such establishments will say "yes" and those who would have fewer will say "no". In other words, the accusation of hypocrisy is used as a way of avoiding the argument rather than engaging with it.

David Cameron has never denied that he was hauled before the headmaster at Eton having been caught smoking cannabis in 1982. I don't know whether the would-be PM derived any pleasure from his encounter with illegal drugs, but it would surely be perverse if that incident prevented him from campaigning against pot-smoking today.

Similarly, until (as he tells it) 1.45pm on the day in March 1980 that he married Cherie Booth, Tony Blair smoked cigarettes. Should such a past have excluded him from any political activity designed to reduce cigarette smoking among others?

The origin of the word hypocrisy is Greek - hypokrisis - and thought to mean "playing the part". In other words, it is about acting one way in public and another behind the scenes. There is a requirement in the true hypocrite, it seems to me, for the two states to exist simultaneously.

An accusation of hypocrisy against Al Gore promoting his film about global warming, An Inconvenient Truth, while criss-crossing the planet in jet-liners may be fair or unfair. But it is, at least, an accurate use of the word. John Major's "Back to Basics" campaign was interpreted as a call for a return to old-fashioned values. Again, fair or unfair, the allegation of hypocrisy related to the questionable moral behaviour of ministers, including the PM, at the time.

What hypocrisy cannot be, surely, is a charge against anyone whose past contradicts their views in the present. If that were so, no-one would ever be able to change their mind or challenge the circumstances of their upbringing.

William Wilberforce, the great reformer, spent his student years gambling and drinking. A religious and spiritual conversion in his twenties saw him become a formidable campaigner against such "immorality". Was he a hypocrite?

Deputy Prime Minister Nick Clegg talks to school pupils


In his book Political Hypocrisy: The Mask of Power, the academic David Runciman explores the history of the vice "from Hobbes to Orwell and beyond".

It is a relatively gloomy view of human nature and the motivation of politicians, but he makes the point that: "Because people don't like hypocrisy, and because hypocrisy is everywhere, it is all too tempting for democratic politicians to seek to expose the inevitable double standards of their rivals in pursuit of power and votes."

Negative advertising, he suggests, is the most obvious contemporary example of this: "If you wish to do the maximum possible damage to your political opponent in thirty seconds of airtime, you should try to paint him or her as a hypocrite: you must highlight the gap between the honeyed words and the underlying reality, between the mask and the person behind the mask."

Nick Clegg, however, does not disguise the fact that he benefited from an expensive private education and all the advantages of well-connected parents. He would argue, with some justification, that he is not trying to hide or deny his past.

Indeed, it would be tempting to suggest that the accusations of hypocrisy over his internship come from some of those who would rather not see that particular route of middle-class privilege closed: a case of playing the man, not the ball.

Big nudge, no cash

Mark Easton | 13:30 UK time, Tuesday, 5 April 2011

Not so much a policy, as a giant nudge. That, perhaps, sums up the ambition of the government's social mobility strategy [2.82MB PDF] published today.

Ministers' power to make a difference is diminishing: they are no longer in the business of trying to improve matters with imposed targets or new regulation, pulling levers in Whitehall. Now it is all about encouraging and urging people to change the way they behave. Oh, and by the way, there is no money.

The principles laid out in the document ("we take a long-term view...we will take a progressive approach...we will adopt a ruthlessly evidence-based approach") also include the admission that "Government does not have all the answers." Well no, they don't. And the next paragraph explains why they might currently have rather fewer answers than before.

"We cannot get away from the intense fiscal pressures we face as a country. Failing to reduce the deficit would saddle future generations with enduring public debt and slower growth, threatening social mobility. That creates challenges. We must do more with less. Above all, we must do more to promote a fairer society."

The strategy neatly sets out the challenge. It is much harder for poorer children to make it in Britain than other comparable countries.

Graph showing the relationship between incomes of parents and their children

Indeed, the report says British women are right at the "bottom of the range" in terms of social mobility.

Graph showing rates of occupational mobility

There is recognition of the need for a real focus on what the report calls the "Foundation Years" - from conception to primary school. The strategy accepts that poorer children turning up for their first day of state education have already fallen behind their peers.

Graph showing children from higher income backgrounds do significantly better on a range of early years outcomes

But when one looks at the proposals for those early years, it is clear this is not a government that wants to force change itself, but rather wants to encourage others. (The word "encourage" incidentally appears more than 20 times in the strategy document.)

So in responding to the recommendations from Graham Allen MP that more be done to help mothers from poorer backgrounds the government says:

"We agree that a broad-based alliance of interested groups, charities, employers and foundations would be best placed to take this forward..."

A ministerial determination to encourage localism means that, while the principle of early intervention is supported by a grant of more than £2bn a year to authorities in England, the money is not ring-fenced.

Local authorities facing cuts to their overall budgets can use the cash "to respond to local needs". The result is that in some areas, Sure Start centres are closing - even though today's report says the government is "supporting...the national network".

The much-vaunted scheme to get organisations to open up internships and work experience to those whose parents are not in a position to "have a word with someone else at the golf club or the tennis club" is all about "urging employers" to do the right thing, not passing legislation or imposing regulation.

Existing government commitments to recruit 4,200 new health visitors in England, expand the apprenticeships programme, introduce the pupil premium, offer the opportunity for longer paternity leave are listed by the government as "policy highlights" of the strategy.

But critics argue that such measures do not amount to the kind of long-term, progressive investment that will be needed to make a real difference. And in the context of cuts and the introduction of higher tuition fees in English universities, opponents of the coalition suggest the strategy is dead in the water.

In the end, it is a strategy - not a policy document or a set of spending commitments. With its indicators and rhetoric, it is designed to shape the thinking of Whitehall departments, local government and wider society. It is a nudge. But is a powerful nudge enough?

Should the NHS drop the 'N'?

Mark Easton | 16:52 UK time, Friday, 1 April 2011

There will be some who regard the fact that NHS patients in England are now the only ones in the UK who might have to pay for prescriptions as evidence of unfairness. 90% of items are issued free even south of the border, but those who are eligible contribute £450m a year to the pot - equivalent, the Department of Health says, to the salaries of 18,000 nurses.

It is a question of priorities, ministers argue. Variation is an inevitable consequence of devolution and localism. These days, the national in National Health Service is about an over-arching philosophy not, as the government might put it, one-size-fits-all policy.

Success, they contend, should be about value in terms of outcomes, and analysis of the differences between England and Scotland on this score is revealing.

While per patient spending in England is roughly £200 less a year than Scotland, on almost any measure, the English NHS performs as well or better: on waiting times, productivity, patient satisfaction and mortality rate (Nuffield Trust NHS efficiency report [429KB PDF]).

Graph showing NHS expenditure

Even when one takes into account deprivation and geography, experts insist the NHS north of the border appears less effective for more money.

This difference has even been given a name: "the Scottish effect". Scotland's taxpayers might wonder whether that is fair.

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