When Government Policy Abuses the Vulnerable….

Over the past 5 years or so, I have frequently had patients with significant mental health problems being deemed fit by the Atos Healthcare administered system of medical examinations for people on sickness benefit. I recently had a patient come to me with heightened distress over this. She felt she was doing well, was seeing a psychologist who was helping her fight her considerable psychological difficulties. Then she received a letter deeming her fit for work, and then an invitation to see a ‘Personal Adviser’ at a Jobcentre Plus office about 2 miles away (she has trouble travelling out of the neighbourhood).

I told my patient (let’s call her H.; this is not her name) about the work of Franz Kafka, about vulnerable people getting caught up in a bureaucratic nightmare. I printed out a few paragraphs from Wikipedia on ‘kafkaesque’. She was comforted by this, knowing that someone had described this situation, that she was not entirely on her own in this.

I told her I would provide her with a letter to take to her interview with the ‘Personal Adviser’ the following week. I asked her permission to write this up on this blog. She consented, provided she remained anonymous. I asked her to write a few words about it felt to be on the receiving end of these letters and injunctions.

Here is my letter to the ‘Personal Adviser’:

Sharon(not her name), Jobcentre Plus

Dear Sharon,

I understand that H. is due to meet with you this week.

I think it is important that you be aware that H. suffers from quite significant mental illness in the form of bipolar affective disorder (she was hospitalised two years ago for some time) which at times has psychotic features. She also has chronic depression and anxiety, and panic attacks. She has a sleep disorder, with regular nightmares of abuse she suffered as a child. She is under the care of local psychiatric services, on an ‘Enhanced Care Programme’. She sees her keyworker monthly. She takes antipsychotic medication, mood stabilisers, and antidepressants. She has just finished a course of psychology treatment which she has found very helpful. She also has chronic fatigue syndrome. She struggles to hold things together on a daily basis.

H. has a 22-year-old son with autism. She is his carer. He has high dependency needs.

The DWP seems incapable of assessing people with mental illness intelligently. As a result, a number of patients of mine with significant mental illness are forced to jump through quite inappropriate hoops in order to hang on to their benefits. This system is in itself abusive and worsens their mental health.

I am aware that you are merely doing your job and you have nothing to do with the development of this policy. Please let your superiors know that this lady is struggling to survive and that if you attempt to force her into one of your pigeonholes you risk making her worse.

If you wish to discuss this any further, I can be reached on  Tel……

Yours faithfully,


Last night I saw H. again in surgery. She said the Personal Adviser said it was nothing to do with her; she did not make the decisions; she advised H. to appeal; and gave her some documentation and an ‘invitation’ to see someone at A4e, the next hurdle in the thoughtless endurance trek she has to undertake.

She had brought something she had written at my request, about how it felt to be on the receiving end of all this. She said she had difficulty writing it down, so she wrote a poem, she hoped that was ok. She gave me permission to publish her poem, provided she remained anonymous.

Here is the poem:

I need the Lord my saviour,
but you make me feel a failure.
I need love and tenderness,
but all you give me is stress.
I am made to feel like a criminal,
but your knowledge of me is minimal.
I am innocent and free,
but you make me feel guilty.
I try to be good with all my might,
but you think me a parasite.
I need salvation,
but you give me aggravation.
How would you feel, if you were me,
made to feel worthless and lazy.

2 Responses to When Government Policy Abuses the Vulnerable….

  1. I like “H” will no doubt have to go thru a similar treacherous journey and to say I’m terrified at the prospect is a understatement. I have suffered with mental health issues for over thirty years. Depression/bipolar? anxiety and panic disorder and like “H” had an abusive childhood which included sexual abuse. However I have been able to work since leaving school in 1975 but have had times off sick during this time, mostly during the 90’s to present and have been unemployed for short periods. For the last 5 years things have been becoming harder and harder in my present employment and the last two winters I have spent being off sick. This is like 3 months at a time and it makes me feel totally guilty which doesn’t help the anxiety. I had been experiencing very sore muscles and wasn’t sleeping properly. However I was asked by my supervisor to help him move a metal cabinet which was heavier than I thought and being metal (and he gave me the bottom end to lift form the floor) it cut into my hands I didn’t feel the strain on my back. But the next day I could hardly move. I got back to my work after two weeks off but my back wasn’t right. And the pains I had been feeling in various parts of my body and to varying degrees of pain from numb to excruciating became worse! I re injured my back again at work last June and have been off since. My Dr has done various tests and found my hormone levels were in my boots so now on hormone replacement therapy have seen a rheumatologist but haven’t got a arthritic problem which in myself I knew as my joints are ok this seems to just be muscular. My Dr says it might be Fibromyalgia which I had never heard of. She is treating this with amityptaline which is supposed to help with the pain which it doesn’t and tramadol which has the same affect! The most worrying thing is the lack of sleep. Which raises my stress levels and this raises my anxiety therefore making my depression worse. And she has raised my meds for anxiety. So feel spaced out most of the time! I have had a medical with ATOS for industrial injuries benefit which my back injury has been found to be. Now my work has terminated my contract and I’m now on ESA which God only knows what this is!! It’s so confusing and in the state I’m in I’m lucky if I know which day of the week it is! So I await the resulting ATOS medical for this thing I have, which in itself I don’t understand, with trepidation! If anyone out there has any advice I really would be very grateful. Thanks Les

  2. David Moynagh says:

    This tory led government is openly sadistic in the manner in which it punishes and vilifies the sick, disabled and unemployed. Their cruelty is remincent of nazi Germany’s tyrannical abuse of specific groups. The only solution is to use your vote at the election ballotbox and keep them out. Up here in Scotland, the people despise the tories for their welfare cuts and consider them to be more scurulous and verminous than a plague of scavenging parasitic rats

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