“How’s it going?”

That was how I started my last entry, before going off on a complete tangent.

The purpose was to reason through what I expect from my ‘review’ with the GP tomorrow. That got sidetracked so I’m going to try again here because I think it taps into the nature of the relationship between such people and those of us in my position. It seems, regrettably, that there is a disparity between the two positions: the expert and the patient-on-benefits.

The above question is how I believe this appointment will begin. It defines that relationship by putting the responsibility on my, the patient’s, shoulder. I don’t really think that’s fair because looking for support as someone with problems functioning in the society he finds himself; the form of which he had no influence over, it is unreasonable to expect the patient to be the source of his own solutions.

Society likes to put forward notions of self sufficiency. In an age of austerity and hardship and with the pressures of modern living this is more appealing than normal. Personal responsibility is a noble trope, but like all such notions it is not a blanket that can be thrown over someone by way an assumptions or, increasingly, a judgement. It is not enough to just tell someone to ‘get over it’ or ‘pull their socks up and get on with it’ and so forth. In fact I believe these are more often than not stated by people trying, perhaps subconsciously, to cover their own insecurities. I’m no psychologist, nor do I particularly care for pop psychology analyses of people, but it strikes me that this is what people do when they see these insecurities in others – no one likes to face their own weaknesses, myself included, but we live in a world that increasingly emasculates us; a society of rising tensions pressures and pace.

Asking me how it’s going is a judgement: it’s the GP performing an assessment of my circumstances. The problem here is that this will include the GP’s own prejudices about welfare and benefits as well as his almost willing lack of understanding of the system and the motives of those running it. If I were to sit and say “it’s all that bloody Duncan Smith’s fault” I would be seen as not taking responsibility and probably being a bit melodramatic. If I were to point out the total failure of the Work Programme – and justify my experience as a very familiar one – I would be seen as making excuses. This is the problem. What exactly can I do?

I’m not sure what ‘it’ the GP will refer to. I presume that he means ‘have you got a job yet’. No, my problems haven’t just cleared up like the common cold or a common rash. These are issues that will stay with me for the rest of my life because it’s how I am. These are as much a part of me as my skeleton.

So in the face of the complete lack of ability to deal with these problems it’s easy and probably quite appealing for doctors to blame the patient. This is partly why it’s so appealing to blame others and scorn them for their failings. Unfortunately people do not see the damage that does, nor how much of a vicious circle it breeds.

Ultimately things need to change and patients, those on benefits least of all, are the worst placed to effect that change. We can campaign for it, and many do, but when no one listens who gets the blame? We have a social security system that is influenced by private interests and politicians that listen to money and not need. The Work Programme was, and still is, touted as the saviour of the welfare state that will get even the sick back to work. It has failed dismally, but it won’t be the providers and the politicians that will get the blame. Instead we have a narrow minded DWP that takes a perverse view of helping people back to work: it ignores what people are good and insists they apply for any old rubbish no matter how unsuitable. We have a society that thinks any job is better than no job when people could be doing something worthwhile and fulfilling

‘Beggars can’t be choosers’ they say. Well why are they begging in the first place?