Sunday, 20 March 2011

I'm a Tory and proud of it. But still, these Sickness and Disability Cuts are Wrong!

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The news for the last year has been dominated by the argument about public spending cuts: how soon, how deep, and what to cut? Between the recession and the previous Labour government, Britain has been left with a £155 billion public annual deficit: 11% of GDP, 22% of government spending, £425 million a day, £5,000 a second. Whatever way you phrase it that is a butt-load of money. The arguments about cuts dominated the general election last year and continues to motivate newspapers, press releases, broadcasts, rallies and riots. There is a general consensus that some cuts are necessary but no agreement about how much or what should be cut. The Labour party were planning £50 billion of cuts pre-election and the Coalition have promised £81 billion. Either way this is also a lot of money and won't happen without valuable services being unfortunately restricted or cancelled entirely.

I'm a conservative: by choice, by temperament, by experience, and by Party. When it comes to debt and the deficit I am a hard-liner. I think we should get our debt and deficit down as fast as possible given the health of the economy and the limits of practicality and morality. I believe this is the most sure and responsible way to ensure our future economic prosperity, by taking the hard decisions now. One of the core reasons I voted Conservative was because they promised to bring the deficit down faster and harder than Labour did, and were the first party to have the courage to stand up and say that serious spending cuts would be needed. Not the easiest message to take to the people in any climate. I'm also proud the Conservative Party took the lead in the election in promising to increase our spending on International Aid to the UN target of 0.7% of GDP, despite the immensely challenging economic climate, something Labour never managed in a decade, as well as ring fencing the NHS, protecting the schools budget and reconnecting the state pension to earnings. All while facing up to the fact that these choices mean harder choices must be made elsewhere. Generally I entirely agree with these priorities and the choices the government has made.

There is one glaring exception to this though. One area where support for some of the most vulnerable people in our society is being severely slashed, contrary to these principles I've mentioned, and that is the support available to long-term sick and disabled people. Starting with the previous Labour government and now the Coalition services and welfare that provide essential support for the long-term sick and disabled are being cut by a total of £5 billion a year. Just for some comparison that is equivalent to the money raised by the government's Banking levy and the removal of child benefit from higher rate tax payers combined. These are extensive cuts across the range of support given to sick and disabled people including Employment Support Allowance, Disability Living Allowance, the Independent Living Fund, Access to Work, as well as Housing, Council Tax and Health and Social Care  (Don't worry if you don't know what those are, I'm going to explain).  And their stupidity is being compounded by a choice of language and lack of communication that is just scaring people for no good reason. People are getting the impression that the government is not listening and does not care. Now, I'm an optimist, I genuinely think that politicians, even most of the ones I strongly disagree with, are really trying to do the best for the country. I think they do care, but they are currently not giving that impression to too many of the more vulnerable people in our society.

There has been opposition to all sorts of cuts.  We've had outraged campaigns against selling forests, increasing tuition fees, removing child benefit from the rich, cutting housing benefit, public sector pensions, closing libraries, raising VAT, cutting EMA, Higher Education, the British Film Council, the Future Jobs Fund, defence, the police, councils, and almost everything else. I pretty much support all of these policies (give or take a few details). I even support some cuts the government have given up on including ending free milk for under 5's, something called Bookstart and re-designing NHS Direct to save money.

This does not mean that it is acceptable to just hack away at random though.  Cuts must be restrained by two minimum principles. Firstly, and obviously, what is good for the economy; and secondly a basic level of service and support for those most vulnerable in our society. This is a matter of sheer morality, but also a matter of political honesty. Before the election British politicians, almost as one, united to try to partially conceal the scale of the challenge of cuts and tax rises that would be necessary to bring the deficit under control, whether using the Coalition's plan or Labour's weaker one. Implicit and explicit promises were made that basic standards of welfare and support wouldn't need to be compromised. Nor is there any need for them to be. Even under the Coalition's program the cuts amount to reducing total public spending by 2% a year. It is rather a matter of choosing, admittedly difficult, priorities.

It is very easy to be NIMBY about cuts. To claim to support cuts in theory but oppose cuts in practice whenever they are to a service or money that I benefit from or care about. There has been a huge amount of this since the election, an orgy of special pleading from those representing almost every imaginable group affected by public spending, on occasions brilliantly coupled with complete loss of perspective. The Labour party is currently making an art-form out of combining these features: Supporting some cuts and tax rises in theory while opposing all specific examples in practice, with occasional, uncontrollable outbursts of total, balls to the wall hyperbole.

This is categorically not one of those issues though. Out of all the cuts and policies I mentioned above this massive, badly planned assault on support for disabled and long-term sick people is by far the most serious. Far more than any of those things these are cuts to essential services, supporting basic financial security and opportunities in our society for some of its most vulnerable and disadvantaged members. These are essential, basic elements for a civilised society more so than any of those other things. I think if you oppose cuts to any of those things, if you consider them a bridge too far, then you must oppose cuts to disability and long-term sickness provision even more, as a priority above them.

Suffering a severe, long-term illness or disability is one of the most difficult things to live with of any of the disadvantages in people can face. Almost by definition it robs people of so many advantages the rest of us take for granted including too much of the ability to take part in society. It is often painful, almost always fundamentally exhausting and draining and always stressful for the rest of a sick or disabled person's family.  It makes life constantly more of a struggle than for well people. It also leaves a person open to a constant flow of minor indignities and general ignorance from a society where many people are still totally clueless about how to relate to disabled and extremely sick people in a human manner. Not to mention more objective stats like the fact that disabled people are the most likely of any group in society to be living in poverty (twice as likely) and to be unemployed (50% are).  I could, of course, go on; the difficulties faced by disabled and long-term sick people are as various as the possible mental and physical conditions people can suffer with, but I'm sure you understand the general idea.But that is enough vagueness.  What is it that I am actually talking about?



Two main things.  There are two main pieces of welfare that support those who suffer from serious long-term illness and disability in the UK.  The first is the Disability Living Allowance (DLA).  This is a universal benefit, meaning its open to anyone indefinitely regardless of personal income or other economic circumstances.  It is designed to help people with the extra costs of care or mobility that comes with being disabled or seriously ill, put by one study at 25% higher than the living costs faced by a non-disabled person. And is only available to the most disabled and ill.  Being disabled or sick is an expensive business.  Whether it's expensive home modifications, mobility equipment, prescriptions, taxis because public transport or driving is impossible, tuition support, personal care or god alone knows what else.  DLA is not an out-of-work benefit, it helps many people who are sick or disabled stay in work as well as others who cannot work.

The 2nd main piece of welfare for disabled and ill people is the Employment Support Allowance (ESA), which replaced Incapacity Benefit in 2008, which itself replaced the previous Sickness Benefit.  DLA is a universal benefit designed to help with the extra costs associated with being disabled and is paid regardless of income or work position.  ESA, on the other hand, is similar in many ways to the dole, Job seekers allowance (JSA).  It is meant to provide the money needed for living, to those who don't have a job, and has a contributory form that is universal, but rationed by NI contributions, and an income based form that is means tested.  Whereas JSA gives an income to those who don't have a job but are looking for one, Sickness and then Incapacity Benefit were designed to provide a minimal income for those who are incapable of working due to physical or mental disability or long-term sickness.  It is paid at rates somewhat higher than JSA (about £90 a week), recognising the fact that it is not meant to be strictly temporary, and that it is not trying to incentivise people to get a job and that disabled and long-term sick people suffer higher costs (see above).

Sickness and Incapacity benefit were criticised for effectively 'parking people on benefits'.  The criticism ran that once someone had been designated to ill to work they were effectively left on welfare from then on, and not supported or encouraged in any effort to get back into work.  There were also accusations from both left and right, though never seemingly actually backed up by evidence, that first Margaret Thatcher's government and then Tony Blair's had massaged politically sensitive unemployment figures by subtly moving people onto Sickness benefit, and thus off the unemployment figures. And thus of course also leaving them there until they retired.

In response to these criticisms the Labour Party introduced ESA in 2008 for new claimants as unable to seek work for medical reasons, and also with the intent of, at some point in the future, reassessing all the people already on IB and Sickness Benefit, in order to weed out those people possibly placed their for convenience of the figures, rather than absolute need.  The new benefit, ESA was deliberately modelled after JSA.  It was designed to radically change the focus of support for the sick/disabled from one that supposed they would remain inactive (as far as paid work goes), to one whereby the presumption was most people would be supported and encouraged to gain work.  This can be seen from the change of name, from Sickness/Incapacity Benefit to Employment Support Allowance, a far more dynamic, employment focused name.  Unlike the old benefit ESA is divided into two parts along the lines of this presumption. ESA claimants are either placed in the work-activity group or the support group. The support group are people considered so ill/disabled and entirely unable to work that they are just supported as before without any expectation that they will meet any further conditions. A lot of people on ESA are placed in the work-activity group though.  This is for people who are assessed as too long-term ill or disabled to fulfill the work-seeking requirements for JSA, but still capable of some 'work-related activity'. These people are then placed on a specialist program, with some similarities to that faced by JSA claimants, meetings with advisers to discuss strategies for trying to seek work, undergoing training etc, but with a higher degree of support and specialist help, specifically designed to support those who are long-term ill or disabled into work. Because of the change in assumption this is the largest group of people on ESA.  The assessments are deliberately skewed so that anyone capable of any 'work-related activity', which may range from great to small, should go onto the work-activity group, rather than being placed into the support group.

In theory ESA is a good idea.  There is a gap in provision between those who are sufficiently well and able-bodied to seek work with only the help given by jobcentres, and people who are so disabled/ill that they are totally incapable of taking and holding down a job.  Done well, with suitable structure and support, ESA could fill the gap and have a valuable role in supporting those people, who could benefit from more intensive help, into work thus supporting their income, independence, and in the long term saving the public money by getting people off welfare and into paying taxes.

That is the theory but the theory relies on a number of fundamental assumptions.  Firstly, that people who apply for ESA are being steered into the group that would most benefit them, whether rejected and placed on JSA, or the work-activity or support group.  Secondly, that the support in place is actually any good, and sufficiently personalised and thorough to actually help people.  Thirdly, that there are actually jobs for long-term ill/disabled people to go into and employers willing to take a risk in employing them.  Unfortunately, in practice, none of these three conditions are actually happening, together producing a significantly botched operation.

Firstly, there is widespread criticism of the manner in which the new beefed-up work capability assessments are taking place, so far for new entrants but soon also for people already on IB or Sickness Benefit.  The work-capability have been outsourced to company called ATOS.  David Cameron at one point talked about assessments being carried out by a specialist squad of mental health professionals, nurses, physiotherapists, doctors and others to holistically determine what people were capable of and have them assigned appropriately.  This just did not happen.  The assessments are a computer tick-box affair, conducted by a single person, who may indeed be one of those groups of professionals, but certainly not all of them.  For example people with mental health disabilities have been assessed by physiotherapists.  Not that the specialism of the person in question really matters because it is a computer tick-box exercise determined by the ability to do a series of basic motor and mental tasks.  The evidence of doctors or consultants who may have known and treated an ESA applicant are not accepted as evidence, and there is seemingly little to no accommodation for the fact that many long-term sick or disabled people have conditions that vary considerably over time, meaning that their ability to perform tasks on one day over a period of a few hours may in no way reflect their health and capability over the long term or their ability to hold down a job.

Don't take my word for it though.  The Scottish branch of the Citizen's advice bureau labelled the assessments "deeply flawed" and creating "unnecessary misery and hardship", with examples of people labelled as 'fit for work' including the terminally ill, and those suffering from advanced parkinsons, heart failure and severe mental illnesses.  They also noted that some people were being found too well for ESA but too sick to fulfill the requirements for JSA and so were just falling into a gap with no welfare support at all.  Professor Paul Gregg, a welfare reform expert and one of the men who designed ESA, said that the tests were a "total mess", "badly malfunctioning" and that, quite simply, "the system did not work".  What is more the government's own review of the process, the Harrington review, recommended no fewer than 20 changes to "every stage" of the process, many of them representing deep and cultural change to the whole process, and labelled it “mechanistic, impersonal and lack[ing] empathy”.  Further evidence of the level of problem with the tests and decisions is the rate of appeals.  Appeals for ESA decisions have sky-rocketed compared to the previous system.  Around 40% of those found 'fit to work' appeal and around half of these appeals are upheld, overturning the original decision.  The thing is though, these official reports, although telling, do not reveal the true extent of the problem.  The impact of the need to go through the assessments, the stress involved, the fear of losing all financial support and security for people already struggling with the huge stress and difficulty of serious illness and often poverty, and the sheer exertion of going through the testing procedure for people struggling with very severe illness, fatigue and pain are all deeply damaging.  The final element of this whole issue that has not exactly inspired confidence for those who have to go through it, is the fact that the government had already announced how much money that were going to save by people being moved from ESA to JSA, before the assessments had begun: £1 billion a year.  This gives people the impression that the numbers of people assessed into the categories could be being driven not solely by need or individual circumstance but by a pre-defined target for savings, rather than people's health and well-being.

Secondly, the support available to people placed in the work-activity group has been criticised at some length.  If you talk to almost anyone who has been on the dole, they will have horror stories about the support available at jobcentres for people seeking work.  It does not seem that these issues have gone away for the support available for those on ESA.  Except for healthy, able job-seekers it does not matter so much, as they can and should be able to do a lot on their own.  For those on ESA in various levels of sickness and disability they, by definition, require a much higher level of personalised, tailored and effective training and support, which it does not seem they are getting.  This is understandable, real, personalised support is expensive, but without it there seems to be little point to ESA it seems likely that it will achieve considerably less than it is hoped, while putting many disabled and sick people involved through serious stress, difficulty and physical exertion that absorbs a considerable amount of their very limited supplies of personal energy for little gain.

Thirdly, to be quite honest, there just are not the jobs out there.  In a period of near full employment ESA could have an important role helping well-qualified and experienced people back into work and thus opening up a substantial new group of skilled and experienced labour.  In current circumstances though, with unemployment at 2.5 million and 5 unemployed to every vacancy, there is just too much competition for many disabled people to stand much of a chance. There are so many well-qualified people applying for almost every job that no employers have any serious incentive to take someone who is a risk, even if they are skilled and experienced, since this risk may mean extra cost, and at a time when so many companies themselves are struggling this kind of social generosity is far from their minds.

So unfortunately on all available counts there are serious flaws.  One of the remarkable things about this process is the numbers that have come out for the success rates of those applying for ESA.  Of new claimants, 64% have been found 'fit for work', 26% have been placed in the 'work activity' section of ESA and 10% are placed in the Support group. These figures are only believable if one thinks that 2/3rds of people who apply for ESA are entirely well, which contrasts with the evidence that even some people suffering from serious or even terminal illnesses have been rejected (see above).  These figures are also vastly different to those that have come from the first pilot re-assessments of people already on IB.  The results of these have been 30% placed in the support group, 40% in the work-activity group and 30% have been found 'fit for work' and rejected from ESA.  Oh, and for both these sets of figures, about 1/3 of those found 'fit for work' appeal with 40% (ish) of those appeals being successful.  The numbers for those rejected are considerably lower, as would be expected since these people have already been through a previous assessment process.  The divergence in the other figures has no obvious explanation though.

Of the £5 billion annual savings the government is hoping to gain from cuts to disability support £1 billion comes from removing people from IB or ESA and putting them on Jobseekers Allowance. Another £1.5 billion also comes from ESA, and was announced in the October Comprehensive Spending Review. ESA has both contributory and Income based versions. One is open to people of any income, as long as they have made sufficient National Insurance payments. The other one is only available to those with no savings, income or partner working.  Both have, until now, been unlimited in time. You are on it for as long as you need to be.  It was announced in the June budget that from next year contributory ESA for the work-activity group would be limited to one year. This mirrors the 6 month limit to contributory JSA, after which it is only possible to get the Income version if you pass the means-test. There is obviously some logic in this, if people have assets or other income then it seems somewhat reasonable that they should consume those before being supported by general society.  There are real problems with this though.  Time limiting contributory JSA is justified in a circumstance where it is expected that JSA is only a temporary measure anyway. For many of the long-term sick and disabled ESA they will need the support ESA gives permanently. There is some parallel that this change has only been made for those in the work-activity group, as it is hoped that this will help them into some work. Whether the work-activity group will succeed cannot be known in advance though and it seems likely that the exit rate will still be well below that for the dole. It is wrong to base policy in advance on this when we don't yet know if it will work.  

The other issue is that, as I said, even now households with a disabled or long-term sick member are the most likely to be living in poverty of almost any group. Not to mention the considerable range of other stress and personal difficulty that sickness/disability bring that is not institutionally comparable to being merely unemployed.  There are other issues as well.  Incomes ESA is not open to those who have a partner who works or have savings. This does not take account of the fact that families where one member is disabled/sick and another works suffer severe strain due to the need for care and support for the disabled/sick family member and the considerable additional costs that often come with being long-term sick/disabled. This all combines to put a massive strain, both emotional and financial, on such families that is not there in the equivalent situation with a family where one person in unemployed but their partner is not.  As I said, these families are already twice as likely to be living in poverty as any other group.  The low level of income somone can have and still render their partner ineligible to receive ESA, combined with the additional costs of being disabled, means that vast numbers of these families containing the estimated 300,000 people this will effect will be pushed down into poverty by this change, if they are not there already.

There is also the issue of the wisdom of de-capitalising those who are already poor, through this country's very strict asset limits on means tests, though this applies more widely than just ESA. Savings provide a cushion giving people confidence and meaning they are both less likely to need state support and also once they end up needing support they are more likely to be able get back to financial stability. Demanding people consume almost all savings before accessing welfare means that they are more vulnerable and likely to need help in the future because they are less able to cushion further future financial shocks without state support.  It also arguably doesn't save that much money in the long-term, as it merely means those on welfare consume their savings and then require even more state support than otherwise. This is emphasised for something like ESA where people are likely to be on it for a long time, and there is already so much stress and difficulty and vulnerability to deal with anyway. There is also a massive bias in favour of having wealth in the form of owning a house. The equity on a house does not contribute to the means test. So you can own a £1 million house, and have no cash savings, and receive full welfare, or you can have £17,000 in savings, but only rent, and not be able to receive any welfare. Of course there should be some requirement to use one's savings or assets before receiving welfare, but the limits for this are currently set too low and too harshly, as well as being entirely arbitrarily biased in favour of house ownership.

Moving on from the disaster that is current and recent policy surrounding ESA, £2 billion of the cuts that are being made are occurring to DLA. Here the issue is considerably more simple.  The Coalition revealed in the June Budget they are planning to cut £2 billion a year from DLA by re-designing the entire benefit as Personal Independence Payments (PiP).  They are planning to massively tighten up the entry requirements and thus cut the costs by 20%. This is a bizarre decision. It has been dressed up in some language about making the payments more targeted and individualised, so they act to empower to choose how to support themselves better. This is bizarre because that is precisely what DLA already did, and they haven't at all explained how they are going to improve it. What is more DLA is already quite possibly the best designed benefit there is, without the legitimate problems that did lead to the introduction of ESA.  DLA is already only open to the most sick/disabled, who are able to demonstrate specific additional costs caused by their disability they need help with. It is universal, meaning it doesn't affect work incentives, and actually supports many people to stay in work and has the lowest fraud rate of any benefit, at 0.5%. The fact that the first thing that was announced was the amount of money to be saved, rather than any information about what principles eligibility were to be tightened on, means that the whole thing looks overwhelmingly like it has no basis at all apart from just cutting costs, rather than being an actual plan for reform like ESA (however botched), and without real thought about the impact it will have on people.  The only up side is that the changes aren't meant to start until 2013, so there is some time to campaign against this yet.

The other cut to DLA has been more targeted than the above transformation, but no less bizarre. With DLA you can money towards additional costs for supporting mobility or personal care.  The government has proposed removing the element involving mobility costs from those disabled people in care homes. These people are often the most disabled, hence they're in care homes, and the money for mobility support may be the only thing that provides them with some mobility and independence to travel outside their care homes.  This cut will save £160 million a year. It seems entirely indefensible as it stands.  There is some confusion in the CSR document itself.  At one point it mentions cutting mobility support for those people in care homes where that supported is being provided by the home.  On this reading the measure is only avoiding double payment. It, however, does not mention this at any of the other points the cut is mentioned, nor has it been mentioned since then in any reports of the issue, nor has the government at any point explained what it actually means by this.

The last two cuts that have been reported are to two further programs to help the long-term sick/disabled.  The first is the shutting of the Independent Living Fund. This is a £360 million fund that provides extra money to some of the most disabled people and their families to help them stay and live and be cared for in their own homes rather than having to go into care homes.  This fund has been shut from this year and is to close with little explanation.  The final one is something called the access to work scheme  This scheme provided grants to employers who were considering hiring a disabled person to help cover the costs of any alterations to the workplace or equipment they may need to buy specially so the disabled person could do their job. This has not been cut by an explicit figure but what has happened is the fund has considerably restricted the range of items they will provide grants for, thus leaving those costs on the employer and making them less likely to take on the cost of hiring a disabled person in the first place  That gives the complete list of cuts to specific support for the sick and disabled.  It amounts to about £5 billion a year, not including the lower spending on the Access to Work fund that there hasn't been an figure given for. It also does not include the general welfare cuts in Housing benefit, Council tax benefit, and restrictions to Healthcare and Social Care, due to general cuts, which will all of course also affect disabled people, especially those large numbers already in poverty.

I entirely understand and appreciate the need to cut spending in this country considering the £155 billion deficit we have. I'm the last person who would argue against that. But like I said that does not justify any old cut. Families with long-term sick or disabled members already face some of the worst poverty and social exclusion in our society, without even mentioning the obvious pain and suffering that so often comes with these conditions, and the huge stress it places on individual and families.  A lot of cuts are unfortunate and down-right difficult, but they do not involve the risk of fundamental damage to our most basic social duty, provision for those who just cannot provide for themselves.  Alan Bennett recently equated closing some libraries with "child abuse".  He is an idiot.  Philip Pullman labelled a plan to remove the 25% of the funding provided by the government from a charity that sends free books to children an "wanton destruction".  He is a moron.  Both of these cuts and many others are a damn shame but they don't risk real damage to the lives, chances and financial security of some of the most vulnerable people in our society.  These cuts to disability support do though and that is why they need to be opposed.

No matter how right-wing you are support for the sick and disabled is among the most worthy of causes a government can pursue. They come under the heading of the deserving poor if anyone does.  This support is also a basic religious principle in Christianity and other religions.  The Bible talks at great length about God's wrath and anger against those who do not care for those who cannot support themselves, most commonly mentioning 'oprhans and widows', but meaning any who are vulnerable and disadvantaged in our society.

The cut to DLA is some 20%, which is also about what the whole package of cuts represents to general disability support through the welfare system.  This is an unjustifiably high percentage.  The whole £81 billion program of cuts amount to 11.5% of government spending.  Any budget that is reduced by less than 11.5% is being relatively protected, any by more than this cut relatively hard.  If disability support was being cut by less than this, or even 11.5%, then it would be vaguely justifiable, as part of a contribution right across government to cut spending.  But it is being cut by a lot more than this. Of all the areas of government spending support for the disabled and long-term sick should be first in the line to be protected and ring fenced.  The fact the government has ring fenced health, schools, International Aid, EU contributions and state pensions and, to a lesser extent, defence, proves it can be reasonably done.  20% cuts mean that the government is targeting disability and sickness support for cuts rather than protecting it.  This is totally unjustifiable.  On top of this there is also all the issues with ESA that are not directly connected with the money, but still resemble more of a train-wreck than a solid program for reform. Even if these difficult changes to cut costs were being done in order to plow that money back into better support elsewhere, whether in more individualised support or to help carers or some other improvement, then it could also be justified to an extent.  But the figures plucked out of the air as targets before any analysis of need, among other things, makes this seem to be purely a money saving drive in an area where there is urgent need.

If cuts do have to be made there are numerous things that could be done to increase people's confidence in the process and reduce the possible negative impact on people. No rationale has been given for replacing DLA, which is one of the better designed benefits. The government must give a clear explanation for any changes they make to reassure people. They should also reduce the amount to be cut from DLA to at most 10%, which would be in line with general cuts, without specifically targeting DLA. The cut to mobility support for those in care homes must be reversed except where the government can clarify and guarantee that those costs are already being supported elsewhere by the government. There must be some change to the restriction of contribution ESA, whether extending the time to 2 years (instead of 1), or after 1 year putting people onto a lower level of support instead of eliminating it entirely, or reforming the rules around the means test for Income ESA. Ideally other cuts would be also reconsidered, especially as things like the ILF and Access to Work are meant to enable people to live independently and hold down a job, both things the government claims it wants to put at the centre of its policy towards supporting sick and disabled people. To its credit Labour put down an amendment to the Welfare and Disability Bill that contained many of these proposals. The ideas I outlined would still result in cuts of around £2.5-3 billion. Surely more than enough of a reduction to be borne by these supports by possibly the most disadvantaged and vulnerable section of our society.  

The final question then is what can people do?  Many things.  The first is get yourself aware of what is possibly happening. The greatest danger is just that so few people know about these cuts, because sadly the sick and disabled do not have the loud supporters, the friends in the media or noisy ability to defend themselves shown by more high-profile but less vital issues. Though it is inspiring to see the grassroots movement that has emerged (largely online) in a few months to campaign against these measures. 'The Broken of Britain' is a great collaborative group that attempts to raise the profile of this issue and bring disabled, sick and well and able-bodied people together to campaign against these cuts. 'Diary of a Benefits Scrounger' is a great blog written by a wonderful lady called Sue Marsh, who herself suffers from serious Crohns disease, and explains these issues much more eloquently (and briefly) than I could hope to. Both of these have a lot of information on what people can do to help. There are also a load of other resources online.

There are always things people can do, whether writing to your MP, to make sure politicians know the strength of feeling about this, signing petitions, informing others, writing to newspapers and generally raising awareness.  There is also some time, since many of these changes do not come in until 2013 or later.  There has even actually already been some success. Under great pressure the government has already decided to review the decision to remove mobility allowance DLA from those in care homes, and in the last day has announced a public review into ESA.  This is hence a crucial time to increase the pressure on them to reverse these cuts and secure proper support for long-term sick and disabled people in our society permanently.

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