‘Thatcherite’ policies have caused ‘epidemics’ in obesity, stress, austerity and inequality, according to a new book by public health experts.
The authors of the book, from Durham University, argue that the UK’s neoliberal politics, often associated with the economic policies introduced by Margaret Thatcher in the 1980s, have increased inequalities and literally made people sick.
They suggest that the epidemics could have been prevented, or at least been reduced in scale, through alternative political and economic choices such as fairer and more progressive taxation, strengthened social protection and reduced spending on warheads.
The public health researchers are calling on the new Government to take drastic action to ensure a decent living wage, a fair welfare system and an end to privatisation within the NHS.
The book, ‘How Politics Makes Us Sick’, is due to be published by Palgrave Macmillan on May 20.
The authors, Professors Clare Bambra and Ted Schrecker, show that the rise of precarious jobs and zero-hours contracts has led to an epidemic of insecurity and chronic stress, and austerity measures have widened the gap between rich and poor with destructive consequences for health.
The book points out that the rising economic inequality is resulting in a growing health gap between the most and least deprived ten per cent of local authority districts in England, which is now larger than at any point since before the Great Depression.
Co-author Clare Bambra, professor of public health geography and director of the Centre for Health and Inequalities Research at Durham University, said:
“Our findings show that modern-day ‘Thatcherism’ has made us fat, stressed, insecure and ill. These neoliberal policies are dominating the globe and they are often presented as our only option but they have devastating effects on our health.
Around three-quarters of the way through tonight’s Question Time, I was ready to believe the BBC had pulled a fast one on us and we weren’t going to see Iain Duncan Smith get the well-deserved comeuppance that he has managed to avoid for so long in Parliament and media interviews.
There was plausible deniability for the BBC – the Isis crisis that has blown up in Iraq is extremely topical and feeds into nationwide feeling about the possibility of Britain going to war again in the Middle East. The debate on extremism in Birmingham schools is similarly of public interest – to a great degree because it caused an argument between Tory cabinet ministers. Those are big issues at the moment and the BBC…
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Shocking new figures show that the North is the anti-depressant capital of Britain.
The region takes up six of the top 10 places in England for use of the drugs, with poverty and deprivation being blamed for the widespread problems with people’s mental health.
NHS data shows doctors here prescribe more anti-depressants per head than anywhere else in the country, with more than one million prescriptions handed out in the last three months of last year.
In the former industrial heartland of East Durham there are 45 prescriptions for every 100 patients – the second highest rate in the country.
And six of the 10 most-prescribing areas are in the North East, including Sunderland, Gateshead, South Tees, Newcastle West, and North Durham.
Mental health charities said depression and anxiety were strongly tied to deprivation, with some laying the blame at the government’s door. Easington MP Grahame Morris, a member of the Commons Health Select Committee, said: “We’re fighting a rearguard action to protect our community.
“I see in my surgeries every week people displaying symptoms of anxiety, stress and depression as a consequence of the government’s policies.
“I had a gentleman come to see me on Friday who was 60-years-old, had worked from being 15, and he’d had to give it up due to a crumbling spine.
“He’d been put in a fit for work category when he couldn’t walk for 20 paces, and his benefits were suspended for eight months while the appeal is heard.
“There’s a definite link between the Government’s policies of austerity and welfare reform and the impact it’s having on people’s mental health.”
Doctors in Sunderland made 41.2 prescriptions for every 100 people in the area, while Gateshead gave out 40.7.
Other badly affected areas included Salford, St Helens, Barnsley and Blackpool – all former industrial areas. Richard Colwill, from the mental health charity SANE, said the figures should be treated “with caution” because they might be inflated by repeat patients for drugs which are used for a range of other conditions.
But he argued they “should be no surprise” because of the strong links between depression and “unemployment, debt and homelessness”.
He said: “SANE’s own experience suggests that it is not only the high demand for treatment that is concerning, but also the dwindling supply.
“The Government’s relentless agenda to cut expensive community and inpatient services often leaves healthcare professionals with little to offer other than medication.”
Paul Farmer, chief executive of mental health charity Mind, said: “We know that reforms to the welfare system are taking their toll on the mental health of many people. Depression can affect anyone, regardless of background, but there are certain factors that can increase the risk of someone developing depression.
“Unemployment, financial difficulties, a problematic housing situation and physical health problems can all put stress on people, which in turn can lead to mental health problems.”
A spokeswoman for clinical commissioning groups in the North East said: “It’s well-known that poverty and mental health are linked, just as poor housing and mental health are linked.
“As the North East has some of the highest areas of deprivation in the country, it’s not surprising that there are higher numbers of people who need support for mental health issues.
“It’s important that people realise that while sometimes medication is required, there are alternatives for those with mild to moderate depression or anxiety.
“Talking therapies work very well and can act more quickly than perhaps antidepressants or other medical treatments.”
A Department for Work and Pensions spokesperson said: “Our welfare reforms will improve the lives of some of the poorest families in our communities, with the Universal Credit making three million households better off.
“We have also expanded the ESA Support Group so greater numbers of people with a mental health condition now qualify for the benefit.
“We are transforming the lives of the poorest in society and bringing common sense back to the welfare system – so that we can continue to support people when they need it most right across Britain.”
> But then, they always say that… whatever the question was.
Source – Newcastle Evening chronicle 20 April 2014
A Commons inquiry has backed warnings from Newcastle City Council that cuts to housing benefit are causing hardship for families with children and disabled people – while failing to free up housing stock.
MPs are warning that cuts in benefits paid to social housing tenants who are considered to have a spare bedroom has caused “severe financial hardship and distress to vulnerable groups”.
The policy, known by critics as the “bedroom tax”, was designed to free up larger properties for families who need them most by encouraging council or housing association tenants with spare rooms to downsize.
But the Commons Work and Pensions Committee – which has Labour, Conservative and Lib Dem members – highlighted warnings from Newcastle City Council that there simply aren’t enough smaller properties for people to move into.
The Committee published its findings after hearing evidence from a range of witnesses including Coun Joyce McCarty, Newcastle Council’s deputy leader.
The Government has published figures showing that the cost of paying housing benefit in the North East had fallen by £25m as a result of the reforms.
Housing benefit rules introduced last year allow tenants to have one bedroom for a single adult or couple, for any two children under 15 of the same gender and for any two children under nine of either gender.
Housing benefit is cut by 14% of the property’s assessed rent if they have one room deemed to be a spare bedroom and 25% if they have two.
In the North East, 50,000 households had their benefit cut, or 440 households for every 10,000 in the region – a higher proportion than any other part of the country.
MPs highlighted evidence from Newcastle, which told the inquiry that 3,233 of its tenants were on the waiting list for a one-bedroom property but only around 800 one-bedroom properties were becoming available each year, including bedsits.
Referring to the policy as the social sector size criteria (SSSC), the MPs said: “Newcastle City Council questioned whether the SSSC policy was likely to succeed in encouraging better use of social housing stock. It pointed out that in Newcastle overcrowding was not a significant issue”
“Coun McCarty made the point that the SSSC had actually led to very few overcrowded families being rehoused.”
They warned: “We understand the Government’s wish to use social housing stock more efficiently and to reduce overcrowding. However, the SSSC so far seems to be a blunt instrument for achieving this. In many areas there is insufficient smaller social housing stock to which affected tenants can move, meaning that they remain in housing deemed to be too large and pay the SSSC.”
But ministers said housing benefit reforms and the welfare cap – which means no household can receive more than £26,000 in benefits – were needed to manage soaring welfare spending, which grew by 50% in Britain in just 10 years and saw the housing benefit bill exceed £1bn in the North East alone.
Secretary of State for Work and Pensions Iain Duncan Smith said: “It was absolutely necessary that we fixed the broken system which just a year ago allowed the taxpayer to cover the £1m daily cost of spare rooms in social housing.
“We have taken action to help the hundreds of thousands of people living in cramped, overcrowded accommodation and to control the spiralling housing benefit bill, as part of the Government’s long-term economic plan.”
> “And all the stress, debt, homelessness and suicide resulting from this policy is actually good for them, they thrive on it. I’ve got figures to prove it”, he might have added…
Source – Newcastle Journal, 02 April 2014
Socially, the dual strategies of exalting consumerism and increasing control have been central to the neoliberal project. Consumerism and control can be viewed as opposite sides of the same coin. People are encouraged to aspire to ever greater levels of conspicuous consumption, modelled after the lifestyles of a celebrity elite that is plastered all over the media and broadcast into everyone’s living room. Shopping, which was once a means to an end, has been transformed into the UK’s favourite leisure pursuit. At the same time, however, more and more people are excluded from the workforce (sometimes forever) by the movement of industry to areas of cheaper labour, and many others are stuck in low paid work with no prospect of advancement. Large portions of the population are only able to achieve the widely advertised ‘ideal’ lifestyle through illegal means. A highly unequal, consumer-oriented society entices people to break the law, which was illustrated dramatically by the riots in London and other English cities over the summer of 2011
Neoliberalism requires expanded mechanisms of social control to police the lawlessness and social fragmentation that its policies produce. Levels of imprisonment have been rising in many western countries, reaching staggering proportions in the United States in particular.
In 2011, 0.7% of the US population were in prison, with 2.9% in prison, on probation or parole. Among African Americans, almost 7% of adult men were in prison, and one in three African American men can expect to go to prison during their lifetime. ‘In the US’, comments David Harvey, ‘incarceration became a key state strategy to deal with the problems arising among discarded workers and marginalised populations’. Rates of imprisonment in the United Kingdom have also been rising, almost doubling since the early 1990s.
The dual drive to increase consumption and control the casualties of wealth redistribution is bolstered by modern, individualistic notions of mental wellbeing and mental abnormality. Even before the age of ‘neurobabble,’ ideas like ‘mental illness’ located problems with behaviour and emotions within the individual, usually in a defective brain, but sometimes in subconscious mechanisms or defective cognitive structure.
In this way the complex nature of how people relate to each other and to their environment was dislocated from its social context. In recent years, almost all human activity has been claimed to be explained by neuroscience – from economics to the appreciation of literature. These ideas sit well with neoliberal thinking, with its emphasis on the individual and its distaste for ‘society’.
The concept of mental illness is useful partly because it provides a conveniently elastic justification for control and confinement to complement the criminal justice system. Once someone is labelled as sick and needing treatment, almost anything can be justified. As soon as the bizarre, disturbing and occasionally disruptive behaviour we call mental illness is attributed to a brain disease, its origins and meanings no longer have to be understood. It simply has to be corrected, with drugs or Electroconvulsive Therapy (ECT) or whatever else it takes. Normal considerations of the autonomy of the individual can be dispensed with. ‘Health’ trumps freedom in mental health law.
Neoliberal policies breed communities that no longer have the resources or the motivation to accommodate difference. As people are increasingly displaced from family and friends, as social support networks collapse and as work becomes casualised, the social integration that helped some people withstand emotional pressures in the past is often no longer available. Psychiatric facilities are in demand to manage the consequences, and the language of mental illness enables this to be done without revealing the social breakdown at its root.
In England, over 50,000 people were forcibly detained in a psychiatric institution during the year leading up to April 2013, which was 4% higher than the figure for 2010-2011 and represents an increase of 14% since April 2007. This is despite strong financial and political incentives to reduce the use of hospital beds.
The idea that mental disturbance is a disease that is easily amenable to treatment has also enabled the extension of control out of the hospital and into the community. In 2008, a ‘Community Treatment Order’ (CTO) was introduced in England and Wales that allows patients to be treated against their will while they are living outside hospital, even if they have no ‘symptoms’ at all. The orders do not require that people have a history of violence or suicidal tendencies. A CTO can be made simply on the basis that, without treatment, the person presents a risk to their own ‘health’.
When they were introduced, it was estimated that approximately 450 CTOs would be applied per year. In fact, over 6000 were made in a year and a half to April 2010. The use of these orders continues to rise, with a 10% increase during the year between April 2012 and April 2013. Community Treatment Orders almost always stipulate that the individual has to receive drug treatment that they do not want and do not like. Potentially, someone can be forced to receive these mind-altering chemicals for the rest of their life, even if they have full capacity to make decisions about their treatment.
As well as helping the prison system to deal with the fallout of neoliberal policies on individual stability and community cohesion, the more mundane medicalisation of unhappiness has also bolstered the neoliberal project. The promotion of the idea that depression is a common medical condition caused by an imbalance of brain chemicals has helped displace responsibility for suffering and distress away from the social and economic arena onto the individual and their brain. The mass prescription of antidepressants reinforces the idea that it is individuals who need fixing, but psychological solutions, such as CBT (cognitive behavioural therapy), can also perpetuate this way of thinking.
Some of the reasons so many people are currently identified as depressed likely stem from the same factors that have led to the rising prison population – that we are encouraged to want what we cannot easily get.
Sociologist Zygmunt Bauman talks of how consumerism is driven by producing and maintaining feelings of inadequacy and anxiety. People cannot be allowed to feel satisfied. There must always be a lingering discontent to drive people to consume more, coupled with the fear of becoming a ‘failed consumer’. Yet, for many, work has become increasingly pressurised, insecure and unrewarding and as demands for increased productivity and efficiency increase, more people are excluded from the workforce through sickness, disability or choice
Debt, as well as crime, is used to fill the gap between aspiration and income. But with debt comes stress, anxiety and feelings of vulnerability and loss of control. There are so many opportunities to fail, and ‘success’ is ever more improbable.
The proliferation and expansion of mental disorders creates myriad possibilities for failure. As varying moods, inadequate attention and excessive shyness are pathologised, more and more people are encouraged to believe they need to get themselves ‘fixed.’
Just as cosmetic surgery promotes the impossible ideal of eternal youth, so mental health promotion increasingly suggests there is a perfect state of mental health to which we all need to aspire, and which we need to work on ourselves to achieve. People are encouraged to exist in a perpetual state of frustration and disappointment with themselves, looking ever inward so they do not think to challenge the nature of the society they inhabit.
Ideas about the nature of mental health and mental abnormality are intrinsically linked to the social and economic conditions in which they emerge. Neoliberalism and its ‘no such thing as society’ champions have helped to produce a biological monster that subsumes all areas of human activity within a neuroscience paradigm and, by doing so, banishes the philosophical tradition that acknowledges human experience as irreducibly social. We can only begin to challenge this impoverished view of humanity when we understand its political functions and the ends it serves.
The psychological is political!
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
> Another whistleblower spills the beans – as usual, nothing that those of us at the sharp end haven’t had experience of, but nice to see it confirmed from the other side of the desk.
An ex-Jobcentre worker has admitted that advisers are being pushed into deterring people from claiming any form of benefit, in order to “protect the public purse” and trick them into making mistakes so that their benefits can be removed.
Commenting on an article in the Guardian newspaper, the ex-Jobcentre worker, whose identity we have protected, said:
“As a Jobcentre worker who took early retirement last year to get away from the pressures and stress, I can confirm what many contributors are saying.
“Since the change of government in 2010 there was a total shift in emphasis in what we are there for. It is now to “police” the benefit system, ‘protect the public purse’ and deter people from claiming anything. We are NOT there to help or advise people any more.
“We had a mystery shopper process where we would be rung up and visited several times a year and mystery shoppers would ask questions about claiming, ask for leaflets etc. This was fed back to offices & used to improve the service. The new government scrapped it.
“Staff now know that they can say any old rubbish to customers, forget to mention things that can be claimed for and no one is going to challenge them. We were even told by management that “x” was available but that we were not to tell claimants and only discuss if asked by them.
> I’ve certainly been finding this whilst slugging it out over a revised Jobseeker’s Agreement.
“The job is now to discourage as many people as possible and harass them into signing off, not try to get them a job or what they are entitled to.
> And always remember – it is what you’re entitled to by law.
“Claimants are referred to pointless courses in the hope that they won’t go….so then we can stop their money. It does not matter if anything we do is of use to claimants. If staff don’t do this they are threatened with disciplinary action and possible dismissal.
“Staff are left with a ‘them or us’ attitude. Many of my ex colleagues have mortgages and kids and are trapped. As jobcentre workers, they know how hard it is to get a job and no one wants ex Jobcentre staff!”
> Right, and no-one on the dole has a mortgage and kids or feels trapped by circumstances (without the option of early retirement) ?
If Jobcentre workers feel stressed and pressurised, it’s largely of their own making.
If they don’t like they way things are going, why don’t they make a stand against it ? They have a trade union, they could refuse to sanction anyone, they could tell people what they should be telling them anyway.
Work with people, not against them.
They could make a stand. The majority, though, choose to keep on making life just a bit harder for those they’re supposed to be helping.
Source – Welfare News Service, 26 Jan 2014
> A whistleblower’s account of what really goes on…though I doubt it’ll come as a suprise to anyone who’s done time on the WP.
I took on a full-time job as a student in the summer holidays. The interview was fairly standard and the company advertised the role as a customer management assistant that helped people get back into work.
However, as I started my new job, I began to notice that it wasn’t the caring compassionate company that it had advertised itself as. My position involved taking calls from “clients”, these were both Job Centre advisors from over London and the South West as well as Job Centre customers who called us directly.
The calls were to make appointments to put the customers onto their first meeting with their work program advisors. Other calls from direct customers were either for this same reason, as they had been instructed to, or to cancel an upcoming appointment.
What I discovered however, as my time there ticked along, was that our company was paid directly from the government for every individual they successfully “engaged” onto the Work Programme (WP) – a rough estimate of £1000. For every six weeks that person was in employment the company would be paid another £300 to £400; in fact the centre had a completely separate section called In Work Support, solely to make sure that the customers employment was maintained.
At the end of twenty-six weeks in paid employment the company would then be paid another lump sum of at least £1000. This meant that for every individual successfully engaged into employment through the WP the company would be paid approximately £3000 to £4000.
Now, let’s just deal with that for a second.
This is one company of many. With roughly 100 staff over all departments. The question that I pondered constantly was how is it cheaper to fund these centres and its staff with its financial incentives, how is that effective and where could that money be dispersed for the greater good?
A second but more important point is the effect that the pressure of this had on people. I was called on one occasion by a man who had his JSA stopped. This man was homeless and currently living in a shelter, yet he had been contacted on his mobile by his job centre that were insistent that he make an appointment to see an employment consultant, before his money would be reinstated. Money that he picked up from the post office. I spent a relatively long time just speaking to him, getting to know his situation and trying to help him as best I could. A lot of the available appointments that we had on our books clashed with meetings at his job centre. He took what he was being made to do in his stride but I found it a pointless exercise. He was homeless yet this wasn’t a priority. Without a fixed abode he would not be able to start a bank account and without a bank account he would not be able to find legitimate employment.
Another gentleman called me, enquiring about his(ESA) claim. He had been sent a letter stating that he needed to attend this particular appointment or his money would be stopped, however he very calmly and politely told me that he couldn’t get to this specific date and time as he had to undergo dialysis three times a week. Dialysis! Yet he was being forced onto the WP with threats to stop his money [if he failed to do so].
I worked mainly with(JSA) customers, however on other occasions I did also deal with ESA claims. I had people call [me] in tears, telling me they didn’t know what to do or where to turn. These people were being blackmailed into the WP so that our company could receive it’s pound of flesh, it’s profit, it’s blood money.
We received weekly emails from the CEO who visited the centre on two occasions, encouraging us to engage the customers, giving us statistics on our success rate and constantly telling us “engage, engage, engage”, even with promises of bonuses. It was also discussed in these emails the bad press and statistics of those who had been forced on the WP and had committed suicide, it does happen and it is being ignored. Now, I wish I had saved some of those emails.
Eventually, when I saw it for what it really was, I decided I could no longer stay there. A few weeks previous to my leaving, I was taken into the manager’s office as she pointed out all the things I had done wrong; joking with the customers, not engaging them. I knew what I was doing. Soon after I handed in my notice, the job was to save up for my wedding but morally I couldn’t stay there.
I’ve never before seen such a vulgar display of capitalism exploiting the poor, the disabled and the sick.
The money that is poured into these centres I have no doubt could be put to better use. Training centres, volunteering, computer access. Why do these places still exist and yet the government are cutting welfare that will affect EVERYONE?
People are genuinely being pushed into stress, depression and in some cases suicide. This is real, this is happening! The WP needs to be either seriously reassessed or shut down.
I feel it is my civil duty to share my experience and to make you all aware that the work program doesn’t work!
Source – Welfare News Service, 26 January 2014