Sunday, 10 November 2013

The Gathering of Evidence



I’ve struggled for things to discuss recently. Not least of all because I have had a dodgy stomach for the best part of a weak and it’s rather knocked me for six. No doubt some bug that’s doing the rounds. I don’t cope with illnesses very well, no matter if they aren’t serious. But that’s just me.

Certainly there are things I could discuss, though other blogs are better at investigation than I; you can check some of them out from the links on the right. It seems a week doesn’t go by these days without some DWP legal challenge going awry (for them or us). How Duncan Smith remains in his job I simply do not know.

I have another appointment with my (other) doctor tomorrow; yet another attempt to explain what I need. I don’t know how many times I can go back and forth with people that seem almost institutionally unwilling to grasp the reality of the situation. Not only that but they also seem to believe that government policy, directly or indirectly, cannot be counted as a reason to experience problems. As a result one is left perched precariously in terms of support. The only benefit is that I am not in as bad a position as some. God knows how I’d manage if I needed to use a foodbank – nor even how I would get to one.

I am forced to change back to my previous doctor for two reasons: he is available at least some of the time locally, and because the current doctor is even more ignorant. The saddest part of all is that she assures me that I will get support, yet when pressed she doesn’t understand this won’t be possible. If I fail the tribunal she won’t be able to help. By not directly helping that outcome is made more likely (at least according to the CAB).

The great irony is at the heart of their ignorance: they refuse to see that ESA isn’t solely intended as a passport to a life of plasma screen fed indulgence and indolence. Yet because I’m the one asking for support my attempts to explain fall on deaf ears. Consequently they won’t underwrite, as evidence for the tribunal, the symptoms that the claim needs evidenced. However they are happy to offer assurances that I will get support while suggesting that work will set me free. This, if nothing else, betrays the nature of their ignorance: a complete lack of understanding of the reality of the labour market and the effect of government policy. It is as if they are saying “we can’t do anything about either of those things so we do not count them as hurdles or problems to overcome”. Yet problems they are.

Both doctors will and have written sick/fit notes, but balk at providing further evidence. They can’t verify this, but then who can verify the effect of mental health on someone? Who lives in my mind but me? Do I need to start cutting myself? Hearing voices? Stalk the streets with a knife? These horrible symptoms are too often the result of people whose problems have been underplayed and ignored for too long. Sticking their professional heads in the sand will not change things.

And yet the doctor I had been seeing recently (now permanently moved and not available locally) was happy to post off a load of peripheral notes and case history to the CAB. I had made my appointment to see her right after my meeting with the CAB advisor, yet she chose not to wait until I could explain what was required and why (or at least try). When I tried to clarify what the CAB wanted subsequently of course I was regarded as being ungrateful and that doing anything more, to rectify, would constitute the sort of extracurricular work doctors now feel intimidated by – even though no more than a page or two is all that is required.

It is this mixture of ignorance and indifference that is the problem. What people in my position need is a holistic approach. The systems involved should be in synergy, they should not be in opposition. Unfortunately this will remain the case as long as GP’s think the benefits system is neither their problem nor their remit, and the DWP insist on processes that do not reflect the reality of individual problems.

For example, the CAB, in writing back to me their concerns that the doctor hadn’t provided specific evidence (and I concede they may be a little too specific), mentioned the doctor had said ‘he is capable of work’. This is a problem because of how ESA works. It shouldn’t be a binary interpretation of health: yes/no in respect of ability to work. It is meant to be about facilitating support through recognising the conditions and problems present. That is what the CAB is asking of my GP: to acknowledge the particular problems. They aren’t even asking for a specific medical diagnosis. They just want a list of the problems; if that list scores 15 points (an arbitrary scoring arrangement beyond all of us involved that most us in the real world and dealing with this system recognise as such) then I am deemed to warrant ESA. But that doesn’t necessarily mean I couldn’t earn a living somehow. The question that should be asked and that should follow is: how?

Unfortunately we have a system that looks for an admission of ‘he can work’ because no matter how you qualify that statement, in terms of symptoms or conditions attached, you exclude yourself from state – and thus financial – support on grounds of health. What is left is a flooded labour market further swollen by people forced to participate that will at best struggle in competition. Until doctors realise this nothing will change and no amount of British trademark stoicism will help.

2 comments:

  1. Very true. One point I particularly recognise is that of being made to feel my mental health issues aren't really a 'problem'. That if I had something tangible to present - a broken arm, a slit wrist - that would be taken seriously but as long as I'm 'nebuous' it can be pooh-pooh'ed by a condescending professional. It's so frustrating how byzantine the DWP processes are. Complication deliberately created to confuse us all so that we give up or, if we do stay and fight, end up tongue tied trying to explain it to people. When will people realise that real help just isn't out there?

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    1. People don't want to realise that. People are dismissive these days. They say things like "other people manage", but don't explain how, or "just get a job" without understanding anything. All this does is risk further alienating people. The beam of support is so narrowly focussed, if it exists at all, that people are forced to accept narrow terms regarldess of whether they can cope, or risk being deemed uncooperative. We desperately need a medical service to be integrated into all this and to understand the reality of what is happening and how things really work.

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