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The Public Health Crisis Created by UK Social Policy Reforms

Authors:

Abstract

As the world is preoccupied by the pandemic, and the British public are beginning to comprehend the full impact of Brexit, the predictable public mental health crisis created by the demolition of the UK social safety net has been disregarded by successive administrations. Few people realized that preventable harm was the inevitable creation of social policy reforms, gradually adopted by every administration since Thatcher, en route to her political ambition which was the demolition of the welfare state to be replaced by private health insurance. In order to demolish the welfare state it was first necessary to remove the past psychological security provided by the welfare state. This has been achieved, with disability denial created by significant social policy reforms since 2008. To justify the adoption of harsh and unnecessary austerity measures, which were introduced without ethical approval, the Coalition administration elected in 2010 vehemently challenged the integrity of the chronically ill and disabled community and routinely accused disability benefit claimants of fraud; whilst failing to produce evidence to support their claims. Their often hostile rhetoric encouraged a 213 percent increase in prosecuted disability hate crimes, and successive administrations disregarded the thousands of deaths directly linked to the Work Capability Assessment, which was adopted using a discredited and dangerous biopsychosocial model of assessment to restrict access to long-term disability benefit. Influenced by corporate America since 1992, the UK social policy reforms guaranteed that many of those in greatest need were destined to die when, covertly, killed by the State.
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The Public Health Crisis Created
by UK Social Policy Reforms
Jusce, Power and Resistance
Mo Stewart
DOI: 10.1332/GQDH4178


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Cita+on:  !"
#$"
%
DOI:10.1332/GQDH4178

The Public Health Crisis Created By UK Social Policy Reforms
Mo Stewart
Abstract:
&"'((
')"#$
"("*
      "  ("  " "  

" + ,"
 "( " "  " 
"(," -.""
"/
 0"((" "" "
" ,  1(   
2 (03"
  (     "    4 /"
&(("
(5",+6"&077#$
"("("
"

Key words!"1"1

Introduc+on:
(078503   " /9"  
907:757 &;"<"*"03;
    (          = >"   9 
4"4/?=
("
 "  , (@  = 0A 
=      # 9< <( 
07-05-7;50B ,
6&#$"
@#$=0A 
C" " " ,/ 9   #$ (     
+007-/9,07:75-3 
( (  ) "  #$  
(D?D? @(5"(
((("=
/07-
0


- 9;B"(,@((=
E0 
="(5(("""
(&6#$""
 .07757:  0- 1  &  
 "' 077:5:  E(B1E( "5F" B 1
4/"&-C"
& C& " , "  '  :50 F 00 1  
"",
9( "/5/((05
08 
6&#$"077G
. /   #9 +   ((   
(0- '"077B#9H59G>/
#$I(("2
077B"+"4 &+"',+' 
@"("&07-A=4"0778 
+""#9+&((
>(:  " (=  &" G>/
  .      5 " '9 
#$1"E49E49 
F9F9 (5",&"5
>/0778 "&"("
)="?"
 F9     ( (5" ,   "
"(5("&0A10- 
The crea+on of preventable harm:
'",@=,(@,,
  D   0         F9   
+"',+' +"',(555",4"
0778 @&4=0778+'
",,(((@(=
@(= 4"0778  @&4= &"5>/ 0778 '9@ 5
  0-107  ('9 
"#9+&>(:1<: 
4     @& 4 = " ,    ((
"837+'
 1   .     < :     "


'=",
"F 08 1(((   "
,  "   +     " ,   
(
'E49/JI9&"
         (    (
F4 &"8  (45&"8 
E#9/9"E"</#"
K0A"&/B (
 & #$ "(6 
45&"8     '95   
+'"0 1+'L
  ", 77 1    ,     ,
  5 "  0A850A: 1  (    
@"=C0A310719( 
& #9   5 (      
(      #9 /  9"  E"
</#";(5
  MC    4  9  /; AN
07 
/((="("' >
",I"(&
   E( B 1       45&" 8
"""4"
"#9+(#(
" " "  (    >( :   - 
&&G,"("
 ## &&G- &( 6#$ 
"077&"5>/0778145&"8101 
&"E49J-C&",+'
4 /"& 4/&   "  ' > :50
((45&"'945&"810  
(   "  C& ,      
.,4/&"("E&<O
45&"8(@("5% 
"(=<OAA L""
"9(0A (
("45&"0 ,'9
4/&("6(L")!
3
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
? ) )((  45&" '9
 "  "  4       45
&"'9("4
" 4  &"=1 
,1 ( (  ,
4/&(
("C&   "  ="
"""
(  (  "(
""
"    
(      5(   
"   ) +         45
&"'9#$(=@ =5"
<()"50A 
?   4/&  - "  >  (  6 45
&"'9<OA10A ("
C&,   (   4/&  
45&"80 '9@5=0A10-1
07 1  ( "4/&  (((  (
("(
  "  C& ,  
   4/&  2 (   @,  = "  6 
'081''/D081E4908 (@"7
 "( 2 (  ,  = ( 4/& ' 08  /L"  E49
        @,  = ( 4/&   
*"0B
Table 1: DWP mortality sta+s+cs, ESA claimants: December 2011-February 2014,
published August 2015
WCA outcome at most recent ESA
assessment
December 2011 – February 2014
Number of claimants leaving ESA
with a recorded date of death
* 3-
45"( :
& :8B
( 383
# 73
TOTAL 50,580
0!E49"C&!E005*0B
B


/   )" "(  +' (   
    ;C&
"0BD?"(8C&,
  ;     9( 0:  L" /= ( ;
"(6E492"
"( " E499(108   E49  
"4/&(
  9( 07 1  "   @" 5=      "
 ,  ) 4/&49/0  
@")"=0- 
The adop+on of the poli+cs of fear:
/("0(,
 " G 0  5 / F( J 9    
")("
>>)""
("(5((
  "   .,       ;  
 1    (       "  ( E" 0B 
C"+*' 08 , )
#$077857A(./.,
""'
#$"
"("
"1(
."0A 
*#$/((0(
 "    F
001 0B1 E" P F( 0B1 ? 0B1 $   01 9 01 '   0A1
0-1/0-1E"0-1E"071' .(
">E2//(
") ? / @
= ""(""
+" 07- /9 /07-   @= 
("  / ( /;(,
"(("("
(,.(&
"49/0+E9)
"","
"F00 E=)",
8


"">;00 03
"(408 ((
<"0 E=()#$
 +E 0     "  "( " "     5
((@,(=(9(08 
&;" BB
  C( 4( 
(    BB 
0E( (
"<"0 
E "  (,  (((
F00 ("
"+"E("()
",E49=,((+
 , .8  (  778       =
F0B ?,
"   " F001 '  031 '  0A  
"

+(0!E"C)G"%&00 c")
(,
E49(;F00 !
4(" ("(@(=@(=
""+"
2(
"@=@=@5"=F00 
A


?    (    "    F 0B
,("E49(",!
 ."    (       ((
  9   "(     " 
 "      "   ,"
(I5((;)%
E49(((
,   (      ,     
  ((  "  "    " 
,F0B 
(64/&("
07   "     ' 081 ? 0B    
("("""
"(9( (("
 " " E49       
 "        (    
"E"F(0B1?0B1'  0A1 E" 
07 E ( 4/&2  ( 
"    ("E49@(=  ;
 C&,(9(0: *
"(,(,""/
?0B  "  /  4 <  "  "
+DE!
(+,(+(+ 
(+"+""(()"
.?0B 
4.4/&
)6D?
,8C&,;
9(0: E49"
4/&?   "
4/&(
","( L'  
0A !
((",(4/"&
"5
5(J"4/&
""
  F        
:


"
"(.
  J "    "  C(  ( 
(",(4/&"L
((",
""(",'0A 

Conclusion:
EC"E"CE 07"9(L"
4/&CE 07   (    &(#$(,
"(((""
E49,"",@,=(
 @ = < P* 0   "  
 " @ G /        " ,   
J(".,"6
4/&    "  #$   (   
6"&""
,       "      " E49  
(""
((#$(
Acknowledgements:
+"(*>FH(2

Declara+on of interests:
D
References:
&&G- !
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" 37A:885A8
EJ+!000AQ5377778 3:5G
'''<C/08 !((#$",
!"#$%"08
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=!  "        R & (
("&' () *:B33753B8EJ+!0003AQ.5
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''/D:&(
'G !E("!""
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E0 !*07-%'2"
D&(E0
E"&F(*0B !"
"   &' 237458961.
EJ+!;!QQ(Q00:Q0:50B5-B:5:
E"0B !/(!F="
):;<
E+0 !<((&"
;!QQ(Q(QQ(55(50*
7
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
E4908 !E49"!C"&+"',
E&F(08
E"9>G$DG&'<07 !4(!
"#$
"( 8B30053AEJ+!00000Q08A
E"90- !9+!,"
"" =83 !0B508:
CE07 !+L""
C"E"378&
C>0A !/4/!/5/?
&#">
F$00 !(((R("
>% (" 2.8466879.
EJ+!;!QQ(Q00-Q7A-:877008AB
F$0B !*!)((5
," HB-: :-5:7-
F&00 !*55@6=9"
,AG"
FG08 !4(","+E
?B&(
?/0B !*,(9RC&*45<&"F
):;<
>(G?: !><(">!#Q9G<
',EC<+&
4; =.//920/0460605@063.
;!QQQ80380QB3A:0*
>;&00 !',!:8S(
&A:G"
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
$$'9E0 !&"!)
)?20.4363865/
G((E/CC0- !4T?EJ(!
E9=C)C"&4<&"F
+>#"C)>
F0A !D%("
,08&
DC"<'E<0 !4R
&",+?)*"0.0.1B./0.C
9<0 !@&(R=E
 "2./466/9..
9(G !CF!2E49(",
>% 4"3G"
9(G !E49(=
>% 4"0AG"
9(G07 !/)?5!E49,4/&
>% 4"7"
9(G0: !(((=C&,(L"
>% 4"0BE
9(G08 !D((E49=4/&(
>% 4"0-E
9(G08 !*@,(=(
>% 4"BG"
<O&A ! F9!&DE4!(&
(+"',
E"&#">
<GP*E<0 !H'"!&"'"
)" ./..23.B.C#6/86.8
<"0 !J!""
00
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
2&:'DE0-J
<G: !D>
"'3A!B58B
;5&'///?EG/"F$0B !
('
*"BB0835:0
4D&(J&0A !'((!4
&"="'9 ")" 690..30
EJ+!000::QA00-30AAB70
0A !)4)#;<
>DF9(
 0- ! /" 9)"!/6
 ) ' )'  0-B0-5
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07 !9!(
%?*0-BB53
EJ+!000-QG9?5:5075:
 !@4!((=
):;<
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... Such agendas have recently been discussed in ME/CFS academic literature, and further situated in a context of neoliberal retrenchment of health and welfare sectors (welfare reform politics) in the UK and beyond (Hunt, 2022(Hunt, , 2023b. This literature is supported in the wider disability sphere by the work of disability activists and scholars (Clifford, 2020;Shakespeare et al., 2017;Stewart, 2022). Indeed, the narrative "you get out what you put in" is permeated with neoliberal and ableist assumptions, championing individual effort and agency in attaining health and happiness and life "success" (see Adams et al., 2019;Hunt, 2022). ...
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Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of five people with ME/CFS in the UK, vis-à-vis healthcare-related epistemic injustice. One superordinate theme is presented, “Being de-centred in patient-centred care,” alongside two sub-themes: “Struggling for epistemic-existential validation” and “Negotiating socio-epistemic hierarchies, politics and ‘power’.” Findings suggest that healthcare-related epistemic injustice may differentially impact according to the patient’s social positionality (here, notably gender), and that a potential pathway of existential harm operates through threats to identity and personhood. Findings also indicate that cultural and political factors may further epistemic injustice in healthcare. Finally, epistemic injustice impacting as a chronic stressor cannot be ruled out and is worthy of further research. The experience of healthcare-related epistemic injustice can carry far-reaching yet varied consequences for patients. Future research should consider drawing upon more socio-demographically diverse samples and an intersectional approach is recommended. Further exploration of structural drivers of epistemic injustice may highlight a need for politically and socio-culturally cognisant clinical approaches.
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The UK government's recent announcement that the highly controversial Work Capability Assessment (WCA) will likely be abolished leaves questions of what precisely will emerge in its place. This commentary revisits a construct central to the attempted justification of the WCA, that of ‘common health problems’, which may well continue to leave a legacy in delineating purported ‘deserving’ and ‘undeserving’ impairment, ill-health and related disability. After outlining the politically strategic application of this construct in social policy, concerns are raised for long Covid. In particular, the risk of long Covid following the trajectory of another post-infection diagnosis, myalgic encephalomyelitis / chronic fatigue syndrome, is discussed.
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Between 2010–2015, the Coalition’s pursuit of a radical austerity programme saw Britain’s Jobcentre Plus experience some of the most punitive reforms and budget cuts in its history. Focusing on the outcomes of these reforms, a growing body of research has found that claiming processes became a more ‘institutionally violent’ and injurious experience for out-of-work benefit claimants. The present article draws upon ideas, developed by Bauman (1989), which focus on the processes that facilitate ‘institutional violence’. We use this framework to analyse ten interviews with front-line workers and managers in public/contractor employment services. In doing so, we expose an array of policy tools and hidden managerial methods used during the Coalition administration which encouraged front-line staff to deliver services in ways that led to a range of harmful outcomes for benefit claimants.
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Historically, the UK welfare system was designed to protect those in greatest need, which provided the necessary financial and psychological security for the unemployed and especially for the chronically ill and disabled community who are unfit to work. This paper identifies how social policy reforms based on fiscal priorities have had the opposite effect, creating a crisis for disability benefit claimants. Conducted over a period of ten years, the Preventable Harm Project demonstrates the negative impact of the adoption of American social and labour market policies, and the often fatal human consequences of the removal of medical opinion from disability benefit assessments. I argue that the adoption of the Work Capability Assessment for the restriction of disability benefit(s) has created preventable harm for those in greatest need, and this article identifies the negative influences impacting on UK social policy reforms to the detriment of the chronically ill and disabled community.
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This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.
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