A Mean form of Testing

Where a patient claimed he could not afford treatment, an investigation would have to be made into his means, with all the personal humiliation and vexation involved. This scarcely provides the relaxed mental condition needed for a quick and full recovery. Of course there is always the right to refuse treatment to a person who cannot afford it. You can always 'pass by on the other side'. That may be sound economics. It could not be worse morals.... The essence of a satisfactory health service is that the rich and the poor are treated alike, that poverty is not a disability, and wealth is not advantaged.

Aneurin Bevan, "In Place of Fear"

The Jersey system of attendance allowance is described as follows:

Attendance allowance (income-tested): Payable to a severely disabled person or a disabled child aged 4 or older who requires extra care and attention. The allowance is paid after 6 months of disability. The allowance is subject to an annual income ceiling of £51,511.

http://www.ssa.gov/policy/docs/progdesc/ssptw/2006-2007/europe/jersey.html


Recently (see article below), Paul Routier, the Minister in charge of Jersey's new income support scheme has come under fire, because attendance allowance for minors is being assessed as part of parental income, and under the new scheme, parents are worse off. It is not helped by the fact that in place of a simple application for one kind of benefit, there is now a form that weighs in something of the order of 20 odd pages to be completed.

I was reminded of Lord Addington, speaking on this kind of thing in England, with means testing. He said:

One has to go through a bureaucratic process and therefore, on the margins, that will probably waste money--through reassessments and so on--and incur greater costs. The bureaucratic system does not help.

Attendance allowance is given to those who, under the old Poor Law in England were termed "impotent poor".

The impotent poor could not look after themselves or go to work. They included the ill, the infirm, the elderly, and children with no-one to properly care for them. It was generally held that they should be looked after.


Because of this, and quite rightly, applicants are is subject to a medical report by an independent doctor appointed by the social security department for this purpose.

When it comes to the point that such applicants would clearly be unable to understand or complete any form, however simple, because of the severity of their handicap, and they are children, their parents have to apply on their behalf. Unlike other matters regarding income support, the lot of these children is unlikely to improve substantially in terms of independence, they may often need supervision for the rest of their lives. If the parents threw up their hands, and asked the State to take over this job, it would be at considerably greater cost. And yet these same parents are burdened with vexatious form filling and scrutiny where a medical report should be sufficient.

There is a wonderful debate in the Irish Parliament, where the speaker completely loses touch with reality. Here is his rational argument for means testing:

The real trouble about all this appears to be the means test. This only seems to arouse a lot of discussion and a lot of discord. I can never really understand this because through all our lives whether we are looking for a loan from the bank to buy a house or getting a car on hire purchase there is always the means test, no matter what class one belongs to.

Of course, you don't have to buy a car, it is your choice whether you want to be means tested and buy one. Having a severely mentally handicapped child is not a matter of choice. It is not something that people go out and actively seek! The complete inability of the speaker to see the difference shows how utterly removed he is from the lives of ordinary people.

Returning to the matter in hand. Not only is the State getting "community care", it is also getting a cheap alternative to institutional care, and it is no surprise that parents are going to be angry when after all the bureaucratic hoops, they are actually ending up in a worse regime than the ancient Poor Law, which despite its many deficiencies, looked upon the "impotent poor" as needing to be looked after by the State, not dumped on parents. Means testing under these circumstances is a mean form of testing, "a principle that eats like an acid", as Bevan put it, of those already facing a struggle that will not go away.

Kathleen Jones summed it up well, when she said:


To the politician, community care is a useful piece of rhetoric; to the sociologist, it is a stick to beat institutional care with; to the civil servant, it is a cheap alternative to institutional care which can be passed to the local authorities for action, or inaction; to the visionary, it is a dream of a new society in which people really do care; to social services departments, it is a nightmare of heightened public expectations and inadequate resources to meet them.

We have a long way to go to find a just society like Bevan's vision, in which the essence of a satisfactory social security support service is that the rich and the poor, but severely handicapped and in need of care, are treated alike, that poverty is not a disability, and wealth is not advantaged.

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http://www.thisisjersey.com/2008/05/23/parents%e2%80%99-anger-at-income-support/

Parents' anger at income support

By Harry McRandle

PARENTS with disabled children at Mont à l'Abbé School vented their anger to a Scrutiny panel yesterday at the prospect of being much worse off under the new income support scheme. They were among various members of the public who told the Economic Affairs Scrutiny sub-panel how means testing of the attendance allowance benefit will make life more difficult for them. Their stories led to some spiky clashes between panel member Deputy Geoff Southern and Social Security Minister Paul Routier, when he later gave evidence on the new system. Deputy Southern accused the minister of depriving the most vulnerable by means testing an allowance paid to 750 Islanders at a cost of about £4 million a year. Senator Routier may be on the verge of a u-turn on attendance allowance for families with disabled children.