Social Model of Disability Welfare Reform

Welfare reform in the United Kingdom and what it could mean for us in New Zealand7 min read

3/10/12 5 min read


Welfare reform in the United Kingdom and what it could mean for us in New Zealand7 min read

Reading Time: 5 minutes

In light of the Minister’s comments last week, the Policy and Advocacy Team takes a detailed look at welfare reform in the United Kingdom. The team finds that welfare reform there is based on a faulty model of disability, has inflicted considerable hardship on people and has damaged the relationship between the disability community and government.

Appropriate paid employment can make a real difference to people’s lives. In research we carried out in 2003, the people involved identified ‘the ability to obtain meaningful employment’ as being very important to them (Contact Sam if you want a copy of the research).  The government can help people access appropriate paid employment by providing support and systematically removing the barriers society creates. To be effective, support needs to be based on the Convention on the Rights of Persons with Disabilities and the Social Model of Disability.

Last week, the Social Development Minister, Paula Bennett, delivered a speech on the direction of welfare reform in New Zealand. In this address to medical professionals, the Minister talked about the proposed assessment process for people on the new Supported Living Payment, stating:

“It also echoes the UK’s assessment processes and the “Pathways to Work” initiative for vocational rehabilitation designed by Professor Sir Mansel Aylward.”

The Minister mentioned she had been talking to Sir Aylward about welfare reform and indicated that the changes will be based on his thinking.

The Minister was talking about the work capability assessment done in the United Kingdom. These assessments are partially based on the work of Sir Aylward and carried out by a multinational private company, Atos. The assessments have been very controversial within the disability community with protestors saying the tests are ‘damaging and distressing’ and have led to suicides. Senior Jobcentre executives (Jobcentre is similar to Work and Income here) have warned staff that the mishandling of claims could lead to attempted suicides.

Spartacus, a disabled-person-led research organisation, produced the Responsible Reform Report on the reforms in the United Kingdom. The report found that 74% of people who participated in the government consultation on welfare reform were against the reforms; 19% had mixed views and only 7% supported it fully. There have also been heated parliamentary debates about Atos and the assessment process (the debate starts in the link at 11am).

A large number of people have appealed their assessment. 41% of those found fit for work appealed the decision and out of that 41%, 38% had their appeal upheld. For people using the support of professional advocacy groups, the appeal success rate is closer to 70%. There has been a large backlog of appeals as tribunals are unable to cope with demand. People are on a lower rate of benefit during the appeal process. Appeals also cost the Government £42.2 million pounds in 2010/11. Many people believe the high rate of appeals indicates major problems with the assessment system.

It has been difficult to hold anyone accountable for the assessments. Atos stresses that it just carries out assessments and that Jobcentre Plus staff make the decisions. Professor Malcolm Harrington in his first Independent Review, however, found that Jobcentre Plus staff do not in practice make decisions, but instead they typically ‘rubber stamp’ the advice provided through the Atos assessment.

Given all this, we have grave concerns about basing welfare changes in New Zealand on such a flawed approach.

The Atos assessment process and the work of Sir Aylward is driven by a model of disability known as the bio-psychosocial model. The bio-psychosocial model was  developed by psychiatrists in the 1970s. The model says that biological, psychological and social factors must be all taken into account to manage a person’s health and provide treatment.

Sir Aylward emphasises that psychosocial factors, such as an individual’s lifestyle and social circumstances, are the dominant barriers to a successful return to work. Sir Aylward sees a major role for health professionals in intervening to help an individual overcome their obstacles to work. Sir Aylward states that health professionals need to use cognitive and educational interventions to change a person’s beliefs about their injury and teach them self-management and independence. Sir Aylward is the Director of the Centre for Psychosocial & Disability Research, which is funded largely by Unum, a large multinational disability insurance company.

Disability organisations, particularly disabled persons’ organisations, have been deeply critical of the bio-psychosocial model. Most disability organisations, including us, use the Social Model of Disability. The New Zealand Disability Strategy and the Convention on the Rights of Persons with Disabilities also use the Social Model.

The Social Model recognises that people have impairments, but focuses on the role society plays in creating disability. In the Social Model, disability is discrimination imposed upon people with impairments. Disability is not what you have, but what you experience in society.

The Social Model would state that the barriers to employment are primarily created by society, such as the;

• attitudes of employers and fellow workers;
• availability of suitable jobs in the local economy;
• ability to make adjustments to the work place;
• availability of flexible hours;
• availability of formal and informal support networks;
• a person’s access to education and work experience;
• lack of accessible transport options and;
• an inaccessible built environment.

The Minister’s speech did not really address ways to remove these barriers or genuine ways to create paid employment opportunities for disabled people.

The Social Model was developed primarily by disabled activists and academics. It was a reaction to the medical model of disability. Under the medical model, disabled people felt dominated by medical professionals who made all the important decisions. The Social Model played a key role in the move away from medical model institutions to community living. The Social Model emphasises that disabled people are the experts about their own lives.

By comparison, the bio-psychosocial model is primarily advocated for by health professions. Sir Aylward is a public health physician and Professor Malcolm Harrington, who was appointed to independently review the assessment process in the United Kingdom, is an occupational health physician. The Social Development Minister in her speech mentioned a number of experts, Sir Aylward, Dr Debra Dunstan (a Clinical Psychologist), and Dame Carol (a physician, who is also linked to the welfare reform process in the United Kingdom). The only disabled persons mentioned in her speech were Sophie Pascoe, who she held up as an example of what is possible; and an unidentified 19 year-old with Asperger’s syndrome who in the view of his Mum needed a ‘kick up the bum by Work and Income’.

The Responsible Reform Report states that successful welfare reform requires the Government to listen to the people it will affect and consider a wide range of evidence with an open mind. The proposed move to a bio-psychosocial model and Atos-style assessments, indicates that the Government is not listening to disabled people and their allies. Instead the process appears to be driven by medical experts promoting the bio-psychosocial model.

What we really need is for the Government to listen to the voices of disabled people and their allies, provide the support they need and address the barriers they identify. Unfortunately, this does not appear to be happening. On the same day the Minister’s speech was posted; the Mainstream Employment Programme announced that new placements would be stopped for this year because of too much demand. If the Government is serious about getting people appropriate employment, it needs to invest in the proper supports to address the barriers people face.

The welfare reform process in the United Kingdom has created a very negative climate for disabled people and their families. The tabloids are full of stories of alleged benefit cheats, with British newspaper, the Sun, saying it is ‘declaring war on feckless benefits claimants’. The Sun also claimed to have the support of the Government for its campaign. Reporting of disability hate crime has substantially increased.

The Responsible Reform Report says that due to welfare reform in the United Kingdom there is now a terrible “Trust Deficit” between Government and disabled people. We do not want to see New Zealand go down the same path as the United Kingdom. The New Zealand Government has the chance to do something much better and actually address the real barriers to paid employment. To bring about real change however, the Government needs to listen to the people most affected, not just overseas medical experts.

What are you thoughts?

Peter Wilson
Policy and Advocacy Team

Research and drafting
Sam Murray
Policy and Advocacy Team