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Experts attack government plans to cuts benefits for addicts who refuse treatment

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e3694 (Published 24 May 2012) Cite this as: BMJ 2012;344:e3694
  1. Zosia Kmietowicz
  1. 1London

Job centre staff in England, Wales, and Scotland are to be given the task of spotting unemployed people who are addicted to alcohol or drugs and referring them for specialist treatment services, the work and pensions secretary hinted on 23 May. Those who refuse rehabilitation will have their benefits cut, government sources suggested.

However, specialist addiction professionals and charities have lambasted the proposal saying that job centre staff do not have the skills to deal with addicts and that there are insufficient high quality services to offer the level of help some people need.

Ian Gilmore, special adviser on alcohol for the Royal College of Physicians, said: “Current treatment facilities for addicts in this country, particularly those with alcohol dependence, are woefully inadequate and we strongly support initiatives to improve this. However, patients must be treated with respect and given genuine choice in their treatment options, and these must be fully respected in any scheme.”

Martin Barnes, chief executive of drug charity DrugScope, called on the government to clarify its plans saying that there was no mention of benefit sanctions in the drug strategy it launched in December 2010.1

“There is no evidence that using the stick of benefit sanctions will help people to positively engage with treatment and support their recovery. Indeed, the risk is that people will disengage from support services, potentially worsening their dependency and the impacts on their families and communities,” he said.

“Linking benefit to a requirement to undergo treatment would set a dangerous precedent for people with physical or mental health problems and would be against the principles for healthcare set out in the NHS constitution.”

The work and pensions secretary, Iain Duncan Smith, was speaking at a meeting organised by Alcoholics Anonymous at the House of Commons to publicise the organisation’s work. He explained that he wanted the new single welfare system to change the support that is currently on offer to addicts from passive to active intervention. Known as universal credit, the system is due to be introduced in October 2013.

Duncan Smith said, “The outdated benefits system fails to get people off drugs and put their lives on track. We have started changing how addicts are supported, but we must go further to actively take on the devastation that drugs and alcohol can cause.

“Under universal credit we want to do more to encourage and support claimants into rehabilitation for addiction and starting them on the road to recovery and eventually work. Getting people into work and encouraging independence is our ultimate goal. Universal Credit will put people on a journey towards a sustainable recovery so they are better placed to look for work in future.”

Full details of the plans have not yet been announced as Duncan Smith wanted to use the event to highlight the work that Alcoholics Anonymous does in helping people recover from alcoholism. But under the universal credit reforms claimants enter into an agreement that they will look for work in exchange for support from the government while they do so. It is believed that staff in Jobcentre Plus offices will be able to report claimants whom they suspect of being addicts as in breach of the agreement if they do not seek help for their alcohol or drug problems.

A government source is reported in the Guardian2 as saying: “The universal credit will allow staff in Jobcentre Plus offices to say: this person has been unemployed for some time. The staff know if people are addicted to alcohol. They know the people they are dealing with.

“But we want this to be positive and to be about signposting people to superb organisations that can help them. This is about changing their lives. It is very important to support addicts into the workplace.”

But if claimants refuse “there will be sanctions,” the source said, citing cuts to the jobseeker’s allowance as an example.

Analysis from the department shows that almost 40 000 people claim incapacity benefits with alcoholism as their primary diagnosis. Of these, 13 300 have been claiming the benefits for 10 years or more.

Eric Appleby, chief executive of the charity Alcohol Concern, said, “It’s true that a number of people are not living their lives to their full potential because they have a drink problem. It’s right that the government recognises that these people need help to overcome their addiction. Incentives are only part of the story; the real answer is to make sure that high quality treatment services are fully funded and available all over the country. At the moment only one in sixteen people with an alcohol problem are receiving specialist alcohol treatment. In order to make this work, job centre staff will need to be properly trained in order to recognise when someone has an alcohol problem and to be able to offer the right advice.”

Notes

Cite this as: BMJ 2012;344:e3694

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