macmillanMacMillan Cancer Care recently reported that in 2015 there will be 2.5 million people living with cancer in the UK, due to improvements in survival rates. MacMillan warned that this would place “huge pressure on the NHS”. What wasn’t mentioned was the pressure it could also place on the social security system.

Many of these 2.5 million people will be unable to work for varying lengths of time whilst they receive treatment. Some will have to give up work altogether. As MacMillan reports, “growing evidence shows that many cancer patients do not return to full health after gruelling treatments and many suffer from serious side effects of the disease.”

This, surely, is just one more reason why our current system of assessing eligibility for sickness or disability support is unfit for purpose. For cancer patients, as for most patients, their own doctors know if they are well enough to work. To send them to see a private contractor’s Healthcare Professional (who may perhaps be a physiotherapist) and have a medically unqualified DWP Decision Maker decide whether they should get support is not only inappropriate, it is adding more stress at a very difficult time.

As medicine progresses and more and more people survive illnesses that once would have killed them, we are necessarily going to have a larger number of people who are too ill to work, if not indefinitely, then at least for some periods in their life.

Yet instead of trusting them and their doctors, and providing support when it is requested, we now have an extremely expensive bureaucratic system which ‘processes’ their claims, and which can really only be justified if we assume that a significant proportion of claimants, and their own doctors, are wrong about their condition. It is a highly lucrative business for the companies involved, but has achieved little except to create distress and misery.

A friend of mine, a very positive person, worked despite illness, until her doctor told her to stop. She was placed on Incapacity Benefit, and lived a difficult but relatively stress-free life for several years. Her condition deteriorated gradually, but she retained a very positive outlook.

Then, she was caught up in the new system. A Work Capability Assessment reduced her to tears, and she was told to go to the Jobcentre to take part in Work Related Activity, to prepare for a return to work. This, as her organs began to fail.

She gave up on Social Security and relied on a tiny pension from her regrettably short career, and family. Her dialysis nurses recently persuaded her to apply for Personal Independence Payment, and the result was an unpleasant phone call from another private DWP contractor which left her tearful yet again. She asked me, “Why did they give me a transplant if they didn’t want to support me when it failed, as they knew it would at some stage?”

This is the crucial question. Why devote money and energy to keeping people alive if we are not prepared to give them enough support to enable them to eat? Why trust NHS doctors to keep people alive, but not trust them to decide if their patients are well enough to work? Why treat sick people who apply for support as potential fraudsters, when we know that fraud in the system is very small, and we have laws to deal with it? And why employ an army of healthcare professionals to process claims, when they could be working in the NHS helping to treat people?

It is difficult to see how the Work Capability Assessment is anything other than a very expensive mistake. People were not ‘written off’ on Incapacity Benefit, if they got well they were free to apply for a job, as many did, and as my friend would have loved to.

It was politically useful to portray Incapacity Benefit recipients as one amorphous mass of people who had all given up thoughts of ever working again, when the truth was that people moved on and off the benefit all the time, if they were lucky enough to get well.

Aneurin Bevan said: “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community.”

This is usually quoted in reference to the NHS, but it should equally apply to social security.

It is time to abolish the Work Capability Assessment and go back to trusting people and their doctors. And perhaps some of the money saved could go to improved support for sick and disabled people who are seeking employment.