Thursday, June 02, 2011

Sickness and invalid benefits - try something different

In regard to welfare reform my focus has always been on the DPB for the reasons that 1/ children are being disadvantaged, sometimes very badly 2/ this benefit is at the heart of inter-generational dependence and 3/ it has the greatest potential for reform and improved lives in the process.

While I am very familiar with the history, statistics, reasons for being on and other aspects of sickness and invalid benefits I have spent far less time talking about them. But a lot of time thinking about them. Their reform is absolutely essential but much more fraught, in terms of hardship and politics. Sometimes I wonder if they aren't being handled by the wrong bureaucracy. That is, shouldn't they be part of the health system? If they were, perhaps more focus would go on getting people better, more rigorous diagnosis and attention to trends.

As it stands well people are lumped together with unwell people and are all seen under the same roof by the same people. People with no expertise in matters physical or psychological. If the money for sickness and invalid benefits was coming out of DHB funding you can bet that the focus on why more and more people are going on them would sharpen up pretty fast.

Which leads me to a further thought. Money is very tight in Health. It is also capped, whereas MSD funding is not. Does Health tacitly sign people over to the responsibility and cost of MSD because there isn't money available for whatever it would take to get them functioning?

This must be right to a degree. That is why various governments have tried programmes like Pathways to Health, bumping beneficiaries up public waiting lists in the Counties Manakau system I recall.

Some individuals may have been helped by these initiatives but overall the trend upwards continues. The percentage of working age New Zealanders reliant on one of these benefits continues to climb.

Suggestion: The existing funding pool for sickness and invalid benefits could be transferred over to the relevant DHB and thereafter managed but capped. Money saved by reducing the caseload (the current levels are artificial) and used elsewhere in the health system or invested in resources to further assist beneficiaries back to good health. Mental health exponents will tell you how badly under-funded their area is. This would give them a chance to up their funding and treat people to the best of their capacity which is surely what health professionals want to do.


MacDoctor said...

Does Health tacitly sign people over to the responsibility and cost of MSD because there isn't money available for whatever it would take to get them functioning?

Definitely. Health is allocated on a "needs" basis, but the level of need required to accesshealth is determined by funding, not be society's wishes. There are many who could be easily rehabilitated and returned to work if they could access the health system. Unfortunately, they do not meet the stringent criteria of the points system to qualify and must wait while their condition deteriorates. In the meantime they can no longer work and become sickness beneficiaries.

The problem is most obvious with unskilled manual labour. Most of these jobs are very physical and require a good physical condition. Unfortunately the gap between "can work" and "qualifies for treatment" in these folk can be very wide indeed.

Bizarrely, no real attempt seems to be made to upskill these people into work that matches their physical condition. ACC will attempt this, with variable success, but WINZ's attempt can only be described as "desultory" - or, possibly, "risible". These poor folk are usually manual labourers because they lack motivation to upskill themselves normally. It therefore makes little sense that re-training opportunities are both poorly advertised and entirely voluntary. It would make sense that ACCs proactive approach should be adopted by WINZ.

Expect blood-curdling screams from the left if this is ever attempted.

Mort said...

what an interesting idea.
perhaps a regional medical director could review all the cases of sickness beneficiaries and then be allowed to purchase health fixes for those patients/beneficiaries condition along with an appropriate recovery period if something like surgery is involved, and then time limit the sickness benefit thereafter. Some illnesses like emphysema won't be able to be fixed, so those beneficiaries won't be able to be rehabilitatd.
You could also tighten up the criteria of qualification, i.e. personal choice sicknesses should be exempt from qualification.
Would you get as much resistance to the idea if it were trialled in a Whanau Ora environment, with the provider holding the purse strings for the beneficiary for their health and welfare?

Anonymous said...

"Expect blood-curdling screams from the left if this is ever attempted. "

NZBORA 1990, s11:
"Everyone has the right to refuse to undergo any medical treatment."

So why are you blaming WINZ for not dealing with SB/IB numbers????

Parliament legislates, not govt Depts.

Anonymous said...

Or - once again, you can just stop the benefits.

Then, there will be no benefit dependency.

There. See. Not that hard was it?

Benefits create dependency. Reforming benefits just "reforms" benefit dependency. Stopping benefits stops dependency.

S. Beast said...

Hey Lindsay,
Yes I agree with your observation. I'd also add that the focus on (often non exsistant jobs) is getting tired. Expanding the highly successful Enterprise Grant and Enterprise Allowance scheme futher and particularly encouraging those on the SB/IB to gain overseas income would be tremendously helpful to many.

Although SB and IB still qualify for the scheme they really need to make it more accessable for those people only able to work part time.

Just a thought.

Anonymous said...

Dont agree at all as someone who has worked twenty years and was injured at work i expect a safety net to be available as i have paid taxes. You try working while taking 15 pain killers a day and at the same time having great pain in your hands while typing this comment. i have have had two lots of surgery for a neck injury, i have a small metal disc that causes horrific pain down my right side its like having a heart attack. The issues regards people being sick are complex and dont need red neck comments .