the design of neglect: what preventable deaths of benefit claimants tell us about the powerful

Pippa Ward

Critical scrutiny was once again focussed upon the Department for Work and Pensions recently, as details concerning the death of Errol Graham – yet another DWP claimant to have died not long after having his benefits withdrawn – were brought to public attention by the Disability News Service website [1].

Mr Graham, a 57-year-old grandfather with a history of poor health reaching back over a decade, had his Employment and Support Allowance stopped after he did not attend a Work Capability Assessment, and then did not respond to the DWP’s follow-up communications or two safeguarding visits.  His Housing Benefit was also stopped.  His body was discovered some months later when Council officials who had come to evict him for non-payment of rent forced open his door.  He had starved to death.

Reports of the inquest [2] revealed some significant details regarding the way in which the DWP operates.  We learn that there was “no formal requirement for DWP staff to seek more information about Graham’s health or how he was functioning … and [they] had not done so” before undertaking the “standard procedure” of stopping his benefits without having seen him: thus lack of due regard to claimants’ capacities to sustain themselves is embedded in procedure.

Likewise, reports refer to Steven Smith, who also died after having benefits stopped “despite multiple debilitating illnesses and weighing just six stone”; the inquest “found officials had missed ‘crucial safeguarding opportunities’ although policy had been followed”.  This case, then, again demonstrates that DWP policy allows ‘safeguarding’ to be carried out in ways which can be, well, fatally unsafe.  Holes in the safety net have not, then, developed by accident; they are inbuilt by design.

This should give cause for pause.  We, together, fund the welfare service – and, more invaluably, contribute to the maintenance of society through our influence as partners, children, parents, siblings, grandparents, friends, workmates, team mates, moment by moment, in – thankfully – ways in which no one can never cumulatively quantify, and thus can never be in a position to evaluate.  So, when need arises, what do we get in return?  Possibly nothing at all?  Is it really the case that, when we don’t show for critical appointments and haven’t paid rent for ages, agencies to which we are required to affiliate don’t even have to resolve the mystery, ensure we’re not sinking?  What of the right to life?

Come on DWP, step it up: at least make like you value your work, find reward in supporting people – that’s how we’re supposed to behave these days, isn’t it?  (“Hi, I’m Clive, and I’m passionate about work capability …”).  To make it easy, we could start with just a bit of service; respect, even?  That should surely be within the purview of our powers-that-be: recent decades have seen an increasing prevalence of what author David Smail [3] described as business culture, with efforts made to depict us as ‘customers’ in as many realms as possible.  (When taking a train, for example, we are no longer ‘passengers’).  I find this puerile: but, since it is hard to avoid, let’s deploy such nomenclature for our purposes – we may as well reap any consolations we can find whilst we’re being widely instrumentalised.  Why shouldn’t benefit claimants be responded to as ‘customers’ too?  A memorable sketch from the Modern Toss ‘Work’ series [4] depicts the jobseeker phoning his Job Centre adviser from a reclining position on his sofa, bullishly demanding to know what their “agent” was doing for them: taken to a joyous nth degree, this is more akin to what the DWP-claimant dynamic should be like.  

That said, given that it is largely when we are in more vulnerable circumstances that the state is closest to us, we need to move beyond standing simply in the role of customer in our dealings with the state.  In the arena of child protection, we’ve had, in response to the preventable death of 8-year-old Victoria Climbie, the policy initiative of Every Child Matters; perhaps it’s now time for Every Adult Matters.  One envisages a framework of activity, and underpinning attitude, threading through society and its institutions, formulated and resourced to a degree sufficient to ensure that everything possible is done to promote the welfare of citizens, particularly those who experience significant difficulty.  Perhaps such an initiative might encourage reactions to the preventable deaths of vulnerable adults in becoming just as outraged as they are when children die as a result of neglect: after all, to state the blindlingly obvious, it’s not as if we no longer need protection once we reach adulthood.  (Is there any justifiable reason why the preventable death of a child is scrutinised by an independent public inquiry, whilst that of an adult rendered vulnerable through health difficulties does not?  Is this age discrimination?).  I do realise as I write this that the notion of the government actively valuing the unwell and marginalised sounds unrealistic, even silly.  However, this sense of value, and its absence, is at the essence of these recurrent tragedies – Mr Graham and Mr Smith are two of a string of people to have died after having benefits withdrawn [5]; and it’s this which we must demand is held in focus if the aim is to avoid similar tragedies occurring.

If is a key word here, and it’s a big if.  It seems from the DWP’s actions in these cases that the question of whether or not avoidance of such tragedies is a primary aim is a necessary starting point in investigating them; this question looms out from behind Labour MP Debbie Abrams’ reference, when raising the issue of Mr Graham’s death, to “departmental procedures which are meant to protect vulnerable people”.  But if protecting people was a prominent aim of the DWP, then you’d expect this to be hard-wired through their policy and procedure; as outlined above, it clearly isn’t.  One would, further, expect their response to such appalling events to be frank, fair, and out in the open; however, they have seemed discouragingly evasive.  

The DWP’s public statement following the inquest declared that “this is a tragic, complex case and our sympathies are with Mr Graham’s family.”  I perceive the use of the word ‘complex’ here as defensive – a cipher for “this was a difficult situation to understand, one which anyone could easily have misread”.   However, I demur on their description of the case as “complex”: on the basis of the basic facts, it appears relatively simple.  This is a man who had a long history of poor health, in regards to which he had relatively recently been re-assessed as unfit for work, and even more recently been hospitalised.  He had “cut himself off from family and friends” and hasn’t responded to attempts at contact.  Is such a person more likely, on balance, to be well, or unwell?  

It thus may appear that extension of sympathy is being deployed by these authorities as a vehicle for the parading of excuses, the shirking of responsibility.  Bear in mind, too, that the panel the DWP are convening to investigate the many deaths that have occurred after people have had benefits stopped is to be comprised purely of DWP civil servants (this after the department had originally said it was to incorporate at least a degree of independence [6]).  

However it operates, here are some questions which that panel might address.  Firstly, what qualifies DWP staff undertaking safeguarding visits to make sufficient assessments of the effects of, for example, Errol Graham’s social anxiety – which, like other ‘mental health’ issues [7], can be difficult to locate and adequately comprehend within a comparatively short interaction?  (I suspect that anyone without a stack of salient experience as a health professional would be woefully under-qualified for this).  And how would these officials be able to guarantee a fair reading of Mr Graham’s well-being on any one visit (or in this case, pair of visits), given that – again, like other ‘mental health’ problems – his condition may well have been subject to fluctuation?

Further, should it be the DWP that undertakes such visits at all?  Anyone answering the door to state officials who possess the power to discipline them is probably not in a position to communicate freely; those experienced in dealing with the DWP are very aware of the fear that any interaction with them may induce.  Here’s an idea: such visits should instead be undertaken by an independent, not-for-profit and neutrally-motivated body; perhaps some sort of Ombudsman, strongly empowered to inspect and rule upon the DWP and their interventions.

And why was Mr Graham’s Housing Benefit also stopped, leading to the plan for him to be evicted?  Contrary to popular belief, the withdrawal of DWP benefits should not cause HB to be terminated; eligibility is determined by one’s financial capacity or otherwise to pay rent, not necessarily by being in receipt of other benefits [8].  (A legal adviser informed me that many hard-pressed Councils know this is the case, but choose to play on the public being ill-informed about the matter so as to save themselves money).

No matter what details of cases the panel address, however, procedural tweaks in themselves will not bring the change that is required: it is the entire ethos of the DWP, and its regime, that need to be swept away.  The panel might, for instance, consider why it is that, whilst utility companies are forbidden to cut indebted householders off from their fuel supply, it is nonetheless deemed reasonable for claimants to effectively be denied the means by which to procure sufficient food.  They might also muse as to what purposes are served by the fact that decisions affecting claimants are largely taken by people who are some distance away, and who never meet them; and similarly, that when on Universal Credit, it is virtually impossible to engage with the DWP regarding one’s claim face-to-face.  One hesitates to suppose that the panel will take a radical approach; however, perhaps we can do something to help them towards this.

This might begin with our being unabashed and direct not just about our anger at such events, but also the fundamental lack of heart we find, perversely, at their heart.  An aspect of discussion of such cases which I find particularly infuriating is the persistence of many in honouring the conceit that they must be the result of some aberration, of unfortunate system failures.  Rather, what needs to be widely and vociferously said and heard is that the system is designed to be punitive, and is so to an extent that casualties are inevitable.  Or, to put it another way: the government really don’t seem to care if ‘ordinary’ people die as a result of their policies.  

They know, for example, what could well happen to those denied cancer treatment as a result of being made subject to the Hostile Environment immigration policy [9].  They know what consequences could result from their flagrantly slovenly responses to fire safety concerns in the aftermath of the deadly Grenfell inferno [10].   And, to return to the realm of welfare, they know that their policies can have fatal effects, because coroners have told them so [11].  If the government felt anything more than indifference about their less celebrated citizens being fatally harmed, they wouldn’t have ignored those coroners.  

We might reasonably conclude that, as comedian Francesca Martinez memorably said at a 2015 demonstration in support of refugees, whilst “people keep talking about the system being broken”, in fact “it isn’t broken at all – it’s working perfectly well, doing exactly what it’s designed to do”.

Indeed, we should not be at all surprised when those inhabiting more precarious circumstances are left to die.  As author and academic Danny Dorling noted not so long ago in discussing the huge increase in street homelessness since the Conservatives returned to government in 2010 [12], such outcomes are in keeping with what the party of government essentially believe: that whether we ‘succeed’ or not in life is, in the final analysis, a result of our own efforts, rather than opportunities that do or don’t result from what we inherit through birth and upbringing, or other forms of fortune.  They believe, at root, in the creed that we get what we deserve.  This, one senses, is their idea of ‘social justice’; one might discern an impression of their revering this justice as righteous, even beautiful, in their holding as fast as possible to the commandment that the state must not intervene to subvert it.  As Dorling put it: “they want a society in which if you don’t do well, the penalty is that you end up on the streets – it’s an incentive to try hard …  It’s a big, big mistake to think that the government actually cares that much about people who are poor”.  Our reactions need to clearly and consistently connect the deleterious outcomes of policy to the administration’s core philosophy.

One might further speculate that there is perhaps a segment among the right who are quietly regretful, indignant even, regarding the demise of capital punishment in the UK; and, while the climate is not quite ripe to permit a campaign for the return of the rope, they take steps to ensure that their gods continue to receive sacrifices.  Perhaps these sacrifices could have the claimed, but mythical, deterrent effect [13], and thus duly incentivise the rest of us to try harder.  Perhaps power, for some, lacks allure if it doesn’t incorporate the holding of the supreme power, that over life and death.  Or perhaps these speculations are wildly fanciful; I don’t know.

And perhaps they hope that, as with street homelessness, deaths of welfare claimants will become normalised.  Maybe this strategem has worked: maybe we have come to accept such events as inevitable.  Yes, these are “complex” cases; what can one do?  And so perhaps many of us each carry a tiny portion of responsibility in what is happening.  People are dying unnecessarily whilst in circumstances wherein they should be being helped: where is the angry mass response?  Whither the volume?  Hundreds of thousands can be mobilised to march, for instance, about the future of a trading bloc, but austerity policies being implicated in an estimated 120,000 premature deaths isn’t enough to rouse us so audibly and visibly.  Thatcher’s infamous line that there is no such thing as society, whilst often derided, actually has an aspect of truth to it: society arguably doesn’t exist of itself – we have to continually make it through our active recognition of each other; the sociopaths who rule us will sure as hell destroy any framework that supports it unless we keep demanding otherwise.  However, we should care that they don’t care, if only for selfish reasons: when our homes flood [14], when the ambulance or fire engine arrives too late for us, it will be all too evident that the inhumanity of the powerful isn’t only a problem for welfare claimants enduring a crisis.  It could be you.

Further important questions percolate from these recognitions and speculations.  Does power necessarily lead people to be so callous towards others?  Are the people who devise and hold to such damaging policies, and who impose them upon the staff and clients of the DWP, fit for their own work; or are they sick – and if so, in what sense?  Do they suffer from some compulsion, some addiction?  I recognise that we are all capable of clinging to dogma, of pursuing ways of doing and being even when these evidently cause harm: but – unto another’s death?  That takes a twisted kind of spine.  How could such sickness be healed? 

This notion of the state’s cold disregard towards the lives and deaths of many of its citizens needs to be brought fully into public consciousness, openly and vocally asserted at every salient turn.  We should be pointing to this as a central factor in relation to government action and inaction on welfare, and so much else; there is some liberatory energy available to us through acknowledging this.  In a previous existence, I had cause to seek legal assistance on behalf of someone needing to secure practical support so as to attend the funeral of a close family member.  The authority that were responsible for providing said support weren’t being at all co-operative, hence the call for legal help.  I recall my feelings of relief when the legal adviser responded to my description of the case not with the typical bureaucratic ummings, aaahings, and jargonised meanderings, but with an accurate summation of the responsible authority’s position: “they don’t care”. 

This sounds obvious, even bland, and perhaps this is why we don’t spell it out often or loudly enough: however, things don’t have to be sophisticated to need saying.  Although those at the Mental Health Resistance Network and Disabled People Against Cuts have been telling it like it is [15], there is generally still too much servile verbiage at large about “mistakes made” and “opportunities missed” when administrative indifference leads to significant harm and loss of life.  Stating that the DWP is “failing in its safeguarding responsibilities” isn’t enough: we miss the point when this is the language with which we consider these events.  If the approach of the state towards those less cushioned from circumstance is ever to improve, we need to be loud and clear in collective awareness of the position we are starting from.  So hang the banners, get the t-shirts printed, tell friends and relatives – let us at long last proclaim what can surely be perceived: those who rule us aren’t really bothered if we die at their hands.  







7  I use inverted commas around the term mental health to convey my sense of scepticism regarding the term, on account of its potential to reinforce the problematic notions of disembodiment and the mind/body split; but this is a subject to explored more fully on another occasion.