Hand-out Britain? Has a dependency culture made us sick?

Battle of Ideas debate, 29 Oct 2011 Notes by Harley Richardson

Disclaimer
These are my sketchy personal notes of debates at the Battle of Ideas 2011, which I attended in a personal capacity. I thought they might be of interest to folks who weren't able to attend. They're not comprehensive I'm a fast typer but some of the speakers were faster talkers - and any quotes I give are from memory and may not be 100% accurate. I tried to capture the main points I thought each speaker was making, but if you're one of those speakers and you feel I've misrepresented you, please let me know. I've flagged up the names of questioners from the audience where I know them.

Blurb
From http://www.battleofideas.org.uk/index.php/2011/session_detail/5712/ The current drive to cut public spending has focused attention on a dependency culture. The summers riots were seen by some as the consequence of a dysfunctional welfare system destroying informal community bonds by institutionalising individual dependence on state hand-outs, thereby fostering a widespread and antisocial sense of individual entitlement. Even some supporters of the welfare state concede there is something wrong when generation after generation in some areas do not expect to work, and that the problem is not as simple as a lack of jobs or opportunities. In particular, many feel there is something dodgy about the high number of people claiming incapacity benefit. But is the problem about a minority of malingerers on the sick, or is there a broader cultural malaise, whereby people are encouraged to see themselves as ill? Labour MP John Cruddas has said we are not suffering from a crisis of welfare dependence but one of mass chronic ill health caused by worklessness and poverty. Nowadays those deemed too ill to work seem as likely to be suffering from mental health conditions as the industrial ailments and diseases of old: over a third of successful incapacity claimants have been diagnosed with mental or behavioural disorders. But do these disorders owe more to the welfare system itself than to the economic situation? It is not just benefit claimants who are accused of being on the sick. Last year, the government replaced sick notes with fit notes asking doctors to suggest types of work the patient may be fit for - in an attempt to claw back the estimated 100 billion per year lost due to employee illness. But can politicians and pundits plausibly complain about a sick-note culture when the constant refrain from these same commentators is that contemporary society makes us ill? From the beginning of the economic crisis, experts lined up to tell us impending hardship threatened our mental health, while Camerons happiness agenda is underpinned by the notion that modern life makes us depressed. Is it true, as some allege, that the rise of poor health is genuine, a product of precarious employment and an inequitable society? If sickness is psychological, isnt it still real? Or are we simply talking people into being ill? Can the welfare system be reformed in such a way as to encourage resilience and help people regain their independence while still guaranteeing a safety net for those who need it? Is it time to rethink the welfare state more generally?

Speakers
Andrew Haldenby, Director, think tank Reform Duleep Allirajah, welfare policy leader, major charity (speaking in personal capacity); 19 yrs in voluntary sector; sports columnist, Spiked Rosemary Thomas, The Work Foundation; argues wellbeing should be central to questions of work Steve Reed, leader, Lambeth Council; in favour of rethinking top-down model of welfare [for some reason most of his points escaped me, so he's under-represented in the notes below] Chair: Martin Earnshaw, chair Institute of Ideas Social Policy Forum

Intro (Martin Earnshaw)

Welfare blamed for creation of 'feckless underclass' - or more politically incorrect equivalents Is work making us more ill? Is it a dependency culture? Are the problems exaggerated?

Andrew Haldenby
The right (particularly Iain Duncan Smith) seized on riots as sign of sick society. But Britain not broken. Become healthier each year, wealthier, still got 2.5% growth despite recession. First findings of capacity reviews actually people are more capable than they thought. Riots were more to do with bad policing, initially. Fixed when that turned into good policing. 'Happyness economics' should really be called 'misery economics'. They always try to prove that growth makes us less happier. Best argument against it is economic one true that happiness not related to economic growth, but also no linkage between happyness and depression, or unemployment and happyness. Something else is going on. Can't remove politics from this. Who created the Happyness Index? Sarkozy. Wants to distance himself from traditional growth. We'll get happier if we get more people into work so we need to make it easier to employ people. Stop spending on middle classes, do something about NHS which isn't good at dealing with mental health problems.

Duleep Allirajah
'Stress is the modern epidemic of the Black Death' this is moral relativism gone mad. Stress now the most common cause of long term sickness. Discussion started in the 1990s. Incapacity benefits trebled in earlier 90s, flatlined since 1995. Been 3 or 4 Welfare Reforms since then. The focus on happyness is about breathing life into directionless social policy. Same inflow of people onto benefit each year (approx 200,000 / yr), but they're not coming off so total figures getting bigger. Can't compare stress levels no definition or baseline. But are today's lives more stressful than during the 30s? Probably not. This is pathologising a social problem. Only way for people to cope with work problems is to go off sick previously sorted out via unions.

Rosemary Thomas
Always concentrating on the minority who screw the system. OECD figures: half of all UK workers experienced no sick days off last year, 75% of people have gone to work feeling unwell. A lot of us want to or have to work. Only 6% of the population called in sick when nothing wrong with them half of them to look after someone who was genuinely sick. Presenteeism being at work but ineffective or infectious. Costs more than sicknesses. Or people going into work because absenteeism now used to determine redundancies.

What is dependency culture? People on long-term sick? Haven't got enough bosses saying 'go home' when people are getting ill at work. A lot of people returning to jobs they don't want to do causing mental health problems.

Steve Reed
Government's view: Rich need tax breaks to make them work harder, poor need stick to make them work harder. In Brixton, kids growing up in families that have never worked. Lots of mental health issues. Services often disempower the people they're supposed to help. Should we be surprised people try to play the system? We lose far more through offshore tax evasion than through benefit fraud.

Discussion
Martin Earnshaw: Do we have a tendancy to see people as frail in relation to mental illness? Rosemary Thomas: Yes, do medicalise things more than they used to. DSMs (Diagnostic and Statistical Manuals) - big manuals that categorise mental illness. Put people in a category rather than tell them it's just a normal human experience. Employment Support Allowance designed for gradual reintroduction to work. Martin Earnshaw: Do all jobs make people happy? Why can we only defend work in terms of its medical benefits. Andrew Haldenby: Of course some jobs unpleasant. But achievement of small tasks brings satisfaction. Martin Earnshaw: Isn't there some reality to the stress problem? Duleep Allirajah: Not suggesting they're fictious problems. But the mechanisms through which we understand problems and seek to rectify them have changed. Used to be thought of as workplace conditions. No collective mechanisms to resolve them through unions. Steve Reed: Every time the Tories get in you get questions about malingering poor. The Spirit Level argues that inequality > ill health. Britain has a lot of inequality.

Audience member: Evidence suspect. If you ask people whether they want to work, of course they say yes. Karl Marx said: without coersion, people leave work in droves. Most jobs are low paid, low skilled, unpleasant. But jobs need doing. We ought to take human nature seriously. This is a western problem. Largely coincides with decline in number of skilled jobs.

Audience member (Neil Davenport): In the past the working class did take on unskilled jobs. Claiming welfare was thought to be shameful. Previous speaker's view very fatalistic. People would have done low skill jobs for a while, and then tried to do something to improve their lot. He grew up in Manchester during a rough economic time. People set up magazines, businesses, etc. Audience member: Only 1% of claims found to be fraudulent. John Humphreys show made no attempt to look at how hard it is to get a job. ESA back to work tests are ridiculous and inappropriate, the things they ask you to demonstrate. Audience member (Para Mullen): Happyness debate is a non-debate. Culture at work perpetuated by HR departments etc helps people to feel stressed. Number of questionnaires sent to people asking how they feel about work framed to elicit stressful feelings. What was just trivial office politics > now encouraged to feel stressed about them. Culture of feeling vulnerable at work surrounds us and should be challenged. Andrew Haldenby: A certain amount of stress is good for us and should be celebrated. Audience member: Caring as a job is undervalued. Rosemary Thomas: Very difficult to come up with a test for work readiness. They probably have targets to fail/pass a certain number of people a week. The government is aware of the shortcomings of the tests. Yes we're getting healthier but getting more long-term conditions eg diabetes. Duleep Allirajah: Organised working class became dependent on Labour and state. Now people don't feel capable of solving big problems in society. Solving small problems won't make you feel better. What will solve it is people changing the way they confront problems. No policy can bring this about. Steve Reed: Sunderland Home Care, set up as a mutual. Different model of ownership and management. Lower sick rates and staff turnover. Audience member: Manchester schools, teachers sacked and taken back on as contractors with worse conditions. Don't feel they can do anything about it. Turns work into a social dependancy. Extending the absence of dignity afforded to care workers to all areas of work. Audience member: Jobs not intrinsically shit, it's the wages. The majority of people in poverty are in jobs. But we need a minimum wage that's a living wage. Women should be paid to look after their children. Audience member (Michael, a HR Consultant): Very cynical about this. Most HR people would say that more of stress-related sickness is dubious eg someone who resigned claiming to be too ill, but keeping down another job. Job centres should do more to insist that people take jobs that are available. East Europeans are coming in and taking them, understandably. Audience member (Sally Millard): Do you think reliance on the state is problematic? Dependency destroys your independence as an individual. Better just to have short term emergency reliance on state. Encouraged to see ourselves as in need of help.

Audience member (Kathryn Ecclestone): There's a huge amount of psychological therapeutic dependancy, via support and counselling re low self-esteem, mentors, advocates. Andrew Haldenby: Cuts to spending did not come out of air, came because we've been overspending for 10 years. Duleep Allirajah: People insufficiently reliant on own agency and agency of colleagues. Yes, benefits tests are more difficult but people still aceing them. If we cut benefits, problems will reappear somewhere else. Rosemary Thomas: Yes, better not to be dependent. Need a safety net. Do something about the benefits trap. People work for Tescos and love it sociable. Work is what you make it.