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The question of disabled people's productive contributions has been the ‘spectre at the feast’ in policy terms from early capitalist industrialisation in Britain (Barnes et al, 1999). The imperative to move formerly ‘unproductive’ disabled people, and those deemed ‘faux’ disabled people, away from welfare towards work represents a key challenge – intellectually, politically and economically. There are few more urgent themes identified in anti-welfare discourses developed since 1997 (DWP, 2003, 2008, 2011). The redoubling of efforts of Britain's coalition government to stop the ‘wasted lives’ of disabled people distanced from paid work and the perceived threat of overspending on the future economic health of the British economy suggest that this question is unlikely to become less pervasive in the coming years (HM Government and DWP, 2010). The current government position is that too many disabled people have been written off by disincentives to enter paid work and benefits that reinforce this ‘perverse’ incentive to remain out of work for often long or life-long periods (DWP, 2011).
In the interest of balance, these ideas can be seen to sit alongside anti-discrimination legislation (ADL) precepts that employers must be open to the employment of those previously excluded from the contemporary workplace (Government Equalities Office, 2010). Overall, however, the limited impact of an ADL approach and the continued growth in out-of-work benefits from 1.25 million people on Incapacity Benefit in Great Britain in 1980 to 2.5 million in 2006 (Anyadike-Danes and McVicar, 2008) arguably led to a hardening of rhetoric post the accession of the coalition government in 2010 (Lister and Bennett, 2010; Garthwaite, 2011; Grover and Piggott, 2013; Grover and Soldatic, 2013). Current debates and solutions to the disability employment problem are by their nature short term and attempts to reduce headline figures for disability and out-of-work benefits seem driven by rather febrile concerns to correct what are longstanding challenges overnight. The focus of this chapter is on the longer-run structural exclusion of disabled and ‘non-standard’ individuals. It is a strong contention of the chapter that a failure to reappraise these historical developments and a contemporary comprehension of diverse forms of productive activity will ensure policy failure and the continued stigmatisation of many disabled people (Prideaux et al, 2009).
This chapter aims to draw out the lens in exploring longer-run developments in the construction of valued and valorised contributions to advanced economies.
Beresford provides a warning against any blithe acceptance of new terms in social care and support. He warns against the term ‘personalisation’ being seen as a new, inherently progressive and irreversible development and language. These assertions are helpful and sobering. So often, newly minted terms in adult social care arise and are aggrandised by use and exchange to take on proportions and promise that cannot be delivered, or that even distort reality. ‘Empowerment’, ‘citizen control’, ‘user-led services’, ‘emancipatory practice’, all in their time offered new visions or even relations of social support while strangely emanating from a traditional practice and policy context. What makes personalisation different is the apparent borrowing of the language of the Disabled People's Movement and perceived convergence of Department of Health (DH)-driven policy and the more collectively based ideas that sprang from a radical rejection of a paternalist heritage. This convergence could be the result of a genuine listening and response of the DH and an attempt to deliver on the process of capturing the voices of the Disabled People's Movement. Alternatively, personalisation and self-direction can more generally be seen as a cynical use of the term, as a sort of Trojan horse, for obscuring cuts and externalising risk to sick and disabled people in the longer term. For example, by simply changing the language slightly from ‘personalisation’ to ‘personalised solutions’, we can undertake a policy sleight of hand that increasingly expects self-determination and self-provisioning to prevail in an era of chronic austerity. This has already happened to some extent in the linguistic shift from ‘self-direction’ to ‘self-management’ and in the shift to personalised ‘condition management’ in the wider policy domain.
The truth is somewhere between these points, I would argue. I fully agree with Beresford's concern that personalisation does not enter the lexicon of policy and practice without health warnings. There have undoubtedly been genuine attempts to listen to organisations of disabled people and personalisation is clearly a counter to paternalist Fordist principles that services will be delivered according to professional needs and not those of service users. However, the term and its use risk becoming post-Fordist in the sense that limited funding and the spending of meagre budgets on essentials, rather than transforming social care, may simply be the equivalent of changing the outer appearance of disabled people's lives.
This article explores recent developments in the modernisation of adult social care through the lens of changes to English day services. Drawing on wider policy debates, it argues that Disabled Peoples' Movement and governmental ideas on self-directed support, although superficially similar, are growing increasingly apart. It is argued that in the absence of adequate funding and exposure to organisations of disabled people, day service recipients risk moving from a position of enforced collectivism to an enforced individualism characteristic of neo-liberal constructions of economic life.
Pro-'workfare' governments justify their policies by claiming 'workfare' helps enhance self-esteem and promote the dignity of the unemployed. On the other hand, welfare activists argue that 'workfare' suppresses the dignity of unemployed persons. This book examines the concept of human dignity in this context and attempts to clarify its meaning.
Few areas of social policy have received more attention than disability and employment policy during the lifetime of the New Labour governments (DSS, 1998; DWP, 2001, 2002a; PMSU, 2004, 2005). The urgency and weight of issues are illustrated in the myriad policy and programme changes that have taken place since 1997 (Burchardt, in Millar, 2003, pp 145-66). However, an essential paradox remains: how is it that, despite much policy effort in the UK to enhance the employment activity of disabled people, these efforts have not been reflected in significantly enhanced employment outcomes (Burchardt, 2000; ONS, 2002; Labour Force Survey, 2003; Stanley and Regan, 2003)?
A number of possible explanations can be posited for the continued difficulty in increasing disabled people's employment. First, policy solutions are essentially sound, but not fully or widely implemented. A related position might be that the coverage of a given policy, benefit or programme is uneven and a lottery of provision has prevailed. Alternatively, one could view the policy framework at a macro-level as essentially sound, but observe factors that severely militated against the effective application of a policy, for example labour market conditions (Beatty et al, 2000; Faggio and Nickell, in Dickens et al, 2003), structural benefit traps (O’Bryan et al, 2000) and perceptions and suspicion of state interventions (Drake, 1999; Roulstone, 2000). Perhaps more fundamentally, the view might be taken that disability and employment policy is premised on an inappropriate model of disability; that policy details and employment programmes may have failed or been severely weakened due to a misunderstanding of the ‘disability problem’ (Oliver, 1990; Barnes, 1991; Abberley, 1992; Saraga, 1998; Oliver and Barnes, 1998; Roulstone, in Barnes and Mercer, 2004, pp 18-34). Indeed, the historical predominance of a medical model in UK disability policy more widely is hard to dispute. All of these explanations may of course hold clues as the disability and employment paradox.
Attempted discursive solutions to this paradox have been framed in diverse ways that include: social inclusion (Cabinet Office, 2004; PMSU, 2004, 2005); formal legal equality (DRC, 2001); civil rights (Barnes, 1991; Gooding, 1994); the business case (Zadek and Scott-Parker, 2001) and human rights discourses (Daw, 2000).
… attempts to ‘protect’ disabled people within a much reduced welfare state have not been effective and have in any case had the unwelcome consequence of increasing the scrutiny and control exercised by professionals…. This stands in contrast to the alternative policy agenda articulated by disabled people themselves that stresses autonomy, integration, an end to discrimination, and rights to equal chances in employment, to an adequate level of income, and to services which enhance personal choice and facilitate independent living. (Glendinning, 1991, p 3)
Despite considerable progress, disabled people are still experiencing disadvantage and discrimination, barriers - in attitudes, the design of buildings and policies for example - still have to be overcome by disabled people … too many services are organised to suit providers rather than being personalised around the needs of disabled people. (Prime Minister Tony Blair, Foreword to PMSU, 2005)
The weight of historical disadvantage experienced by disabled job seekers and workers is now well documented (Barnes, 1991; Burchardt, 2000; DWP, 2001; ONS, 2002a, 2002b; Burchardt, in Millar, 2003, pp 145-66; DRC, 2004a; PMSU, 2004). The principal policy response has been an increased governmental emphasis on ‘welfare through work’ and ‘work-based welfare’ (Giddens, 1998).
The focus on paid work as the primary source of social well-being has been further emphasised by New Labour policies (DSS, 1998a; HM Treasury, 2001). The continued rise in sickness and disability benefits from 1997 has been a key driver of policy reform, while the changing rationale for reducing claimant numbers is that of the human cost of long-term absence from the labour market (DWP, 2002, 2004a; PMSU, 2005). Paid work has become the leitmotiv of New Labour welfare policy and for many, social inclusion the natural corollary of engagement with paid work.
The genesis of disability welfare reform can be traced, however, to much earlier reforms of the Conservative governments of the 1980s and 1990s. This is somewhat paradoxical at first sight. The neoliberal governments of the 1980s did sanction the increase in invalidity benefit (now Incapacity Benefit) by re-designating some unemployment benefit claimants. However, the decade 1980-1990 also witnessed a growing emphasis on rationalising the benefits system for disabled people.
This chapter suggests that to overcome the problem of disabled people’s ongoing disadvantage in mainstream employment and, therefore, society, a radical alternative strategy is required that poses a direct challenge to orthodox thinking on work, and associated policies that centre almost exclusively on disabled workers. Building on longstanding analyses from within the disability studies literature, it is argued that an holistic approach is needed that includes:
• the reconfiguration of the meaning of work for disabled people;
• the de-stigmatisation of associate welfare provision;
• that the theoretical and practical foundations for such an approach have already been laid (Barnes, 2000, 2003; Abberley, 2002: Oliver and Barnes, 1998).
This chapter begins with an overview of theoretical considerations with reference to the concept of ‘independent living’ for disabled people and the social model of disability. Attention will then centre on the organisation of labour, the reconfiguring of work for disabled people, and its implications for work and welfare in the 21st century.
As the contributions to this book indicate, disabled people are disproportionately disadvantaged in the labour market. This is because in western society since at least the eighteenth century, work has been organised around a particular set of values and principles; namely, the pursuit and maximisation of profit and competition between individual workers, both of which effectively disadvantage, or disable people with any form of perceived functional limitation/impairment, whether physical, sensory or intellectual. The more overt the impairment, the more severe the disadvantage or ‘disability’ (Finkelstein, 1980; Oliver, 1990; Barnes, 1991; Hyde, 1995; Stiker, 1998; Gleeson, 1999). Hence, in his recent review of work, disability and European social theory Abberley (2002, p 136) has argued that to address the problem of disabled people's exclusion from mainstream society:
We need to develop theoretical perspectives that express the standpoint of disabled people, whose interests are not necessarily served by the standpoint of other social groups, dominant or themselves oppressed, of which disabled people are also members.
The thrust of Abberley's argument is based on three main points:
• that the eradication of environmental and cultural barriers associated with capitalism, will not generate a society in which all people with impairments are able to ‘work’;
In this brief postscript, we reflect on some of the key policy insights to flow from this book's chapters. These empirical and theoretical insights have provided a detailed appraisal of a range of key disability and employment policies and have established the benefits and limitations of current policies. Given the broader objectives of translating new ideas into changing policy and practice the key policy points are laid out later in this chapter.
Working futures? makes clear both the continuities and changes that marked the shift from neo-Conservative to New Labour governments. A continued commitment to making welfare conditional upon certain types of active labour market behaviour characterises the links between these approaches. There is once again continuity between these political and policy responses to the challenge of employing more disabled people. However, the old distinctions between deserving and undeserving have been shifted to reflect the alterations to the ‘disability category’, which are at the heart of New Labour's dichotomous treatment of work for those who can and support for those who cannot. In practice, while this commits far more than governments of the 1980s and early 1990s, it does oversimplify the relationships between paid work, disability, impairment and perceptions of the value of paid work for disabled people.
While the Conservative governments of 1979-97 made efforts to distinguish between levels of support in terms of daily disability support (Disability Living Allowance mobility and care components), it has been New Labour that has looked more fully at the range of disability employment programmes with the aim of more targeted support.
There is evidence in this book's chapters that some policy and programme improvements have taken place, and these are clearly to be welcomed. Specifically, more flexible benefit linking rules, a less fragmented employment and benefits service and the mainstreaming of disability tax credits. The emphasis in WORKSTEP, the new supported employment programme is philosophically and practically on open as opposed to segregated or subsidised employment, this too has to be welcomed for many disabled people for whom this represents a further step towards social integration.
There are many continued limitations and concerns, however, about current disability and employment policy and programmes.