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Reforming the welfare state for real

Dr Simon Duffy explores the future of the welfare state. He argues that only a welfare state rooted in a commitment to citizenship is economically and politically sustainable.

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Reforming the welfare state for real

  1. 1. Reforming the Welfare State for Real Staff College: Future Directors Programme
  2. 2. • The reality of Austerity • Creativity amidst injustice - heading upstream • Advancing citizenship • Strengthening families • Growing community • Democratic and constitutional change
  3. 3. 1. Austerity
  4. 4. • Austerity is the policy of making the poorest & weakest pay for the mistakes of the rich & powerful. • The welfare state is totally affordable, but it has become politically unsustainable. • Past assumption about how to ‘manage’ the welfare state from the centre are now collapsing.
  5. 5. In total, across England as a whole, the WCA disability reassessment process during this period was associated with an additional 590 suicides (95% CI 220 to 950), 279,000 additional cases of self- reported mental health problems (95% CI 57,000 to 500,000) and the prescribing of an additional 725,000 antidepressant items (95% CI 406 000 to 1 045 000). Barr B, et al. J Epidemiol Community Health 2015;0:1–7. doi:10.1136/jech-2015-206209
  6. 6. The Committee is seriously concerned about the disproportionate adverse impact that austerity measures, introduced since 2010, are having on the enjoyment of economic, social and cultural rights by disadvantaged and marginalised individuals and groups. The Committee is concerned that the State party has not undertaken a comprehensive assessment of the cumulative impact of such measures on the realisation of economic, social and cultural rights, in a way that is recognised by civil society and national independent monitoring mechanisms (art. 2, para. 1). UN Committee on Economic, Social and Cultural Rights: Concluding observations on the sixth periodic report of 
 the United Kingdom of Great Britain and Northern Ireland
 24 June 2016 UN declares UK Government fails to respect human rights
  7. 7. …there is reliable evidence that the threshold of grave or systematic violations of the rights of persons with disabilities has been met in the State party… The core elements of the rights to independent living and being included in the community, an adequate standard of living and social protection and their right to employment have been affected… freedom of choice and control over their daily activities restricted, the extra cost of disability has been set aside and income protection has been curtailed as a result of benefit cuts, while the expected policy goal of achieving decent and stable employment is far from being attained UN Committee on the Rights of Persons with Disabilities: Inquiry concerning the United Kingdom of Great Britain and Northern Ireland carried out by the Committee under article 6 of the Optional Protocol to the Convention
 6th October 2016 UN declares UK Government fails to respect disability rights
  8. 8. 2. Upstream
  9. 9. • The welfare state is necessary for the sustainability of a 21st century democratic society. • But the welfare state has often been designed using 19th century assumptions about power. • We are applying instrumental, rather than ecological thinking to the welfare state.
  10. 10. 3. Citizenship
  11. 11. • Post 1945 the welfare state focused on sustaining people as workers and service users. • Progressive attempts to convert people into consumers have further undermined citizenship. • Only a welfare state that supports citizenship will itself get the support it needs to be sustained.
  12. 12. Citizenship is practical and inclusive
  13. 13. Location N Change England - 6 Sites Phase I Report 60 -18.0% England - 17 Sites Phase II Report 128 -9.0% England - 13 Sites IBSEN Report 203 -6.0% England - Northamptonshire 17 -18.7% England - City of London 10 -30.0% England - Worcestershire 73 -17.0% England - Southwark 85 -29.8% Scotland - Glasgow 12 -44.0% USA - Denver - Disabled Children - -34.0% USA - Florida - Disabled Children - -30.0%
  14. 14. 4. Family
  15. 15. • Families are the bedrock of all societies, and they need supporting as families. • Policy and practice tends to isolate individuals and ignores issues of gender. • A decent welfare state would start by supporting families and show greater sensitivity to gender.
  16. 16. The women with the most complex needs don’t fit in services
  17. 17. Managing a serious health condition 64% Finding a safer place to live 27% Living with childhood abuse 51% Didn’t finish their education 76% Recent experience of domestic violence 85% Fractured family (for those with young families) 66% Children experienced abuse (for those with children) 55% Living with a severe level of mental illness 55% Living with some mental illness 91% History of drug or alcohol misuse 52% Victim of crime 41% Perpetrator of crimes 39% Worried by debt or lack of money 65%
  18. 18. A partnership between women - improving mental health
  19. 19. Service label n Urgent problem n Real need n Victim of domestic violence 55 Debt 50 Better self- esteem 64 Mentally ill 39 Housing 48 To overcome past trauma 54 Criminal 35 Benefits 46 To manage current trauma 51 Poor mother 33 Health 37 To stop being bullied 50 Misuses alcohol 24 Rent 32 Guidance 50 Uses drugs 22 Criminal justice Advocate 24 Relationship skills 45 Violent 19 Dentistry 8 Mothering skills 26 Chronic health condition 16 Others 3 Others 1
  20. 20. 5. Community
  21. 21. • UK welfare state is not only centralised, it is blind to the richness and diversity of its communities. • Communities create capacity through relationships and shared values. • The welfare state needs to respect, support and challenge communities.
  22. 22. Peers with mental health problems leading community change
  23. 23. £0 £500,000 £1,000,000 £1,500,000 £2,000,000 £2,500,000 £3,000,000 MH NursingHome CareMinimum WageCost of PFG The average cost of PFG over the last 2 years has been £79,000. However the value of PFG is much greater. If its support and work had all been paid at the minimum wage it would cost over £0.5 million. If it had been commissioned as home care it would have cost over £1 million. If it had been provided by a mental health nurse it would have cost £2.75 million.
  24. 24. • Postnatal depression reduced by 77% • Unemployment dropped by 71% • Reduced fear of crime • Childhood accident rate dropped by 50% Community led programme of neighbourhood renewal
  25. 25. 6. Reform
  26. 26. • The current ‘reforms’ are actually unsustainable attacks on social justice. • But the welfare state does need reform, a reform rooted in a better understanding of justice. • And a welfare state based on citizenship requires constitutional change, not policy change.
  27. 27. Aristotle explains that a community is not made out of equals, but on the contrary of people who are different and unequal. The community comes into being through equalising, 'isathenai.' [Nich. Ethics 1133 a 14] [Arendt]
  28. 28. Could we not see part of our role as preparing our children for citizenship? “Every educational system has a moral goal that it tries to attain and that informs its curriculum. It wants to produce a certain kind of human being.” 
 [Allan Bloom]
  29. 29. DISCUSSION
  30. 30. @citizen_network
 @simonjduffy e