The biggest pre-election legislative splash of the end of the summer parliamentary term was the Green Paper “No One Written off: Reforming Welfare to Reward Responsibility”. This set of proposals is currently open for consultation (until October 22nd 2008) - everyone involved in drug treatment or working with drug users should take a look at them. Coming out of The Department for Work and Pensions, the Green Paper's stated intention is to reduce poverty and increase opportunity.

What it Says

People using illegal drugs and claiming benefit wil be affected in two ways. First of all wide ranging changes to the benefit system –

• An Employment & Support Allowance (ESA) to replace Incapacity Benefits (IB, DLA etc) by 2013
• An extension of the concepts of individualisation and personalisation of employment support (including individual budgets) for people experiencing barriers to work through health or social care need (but not people who have/are experiencing problems with drug use.)
• Requiring people who have claimed Jobseeker's Allowance (JSA) for two years to undertake mandatory community work in return for benefits
• Contracting out many of the Job Centre Plus functions to the private, voluntary or third sectors.

Under the proposals, problematic drug users - defined initially as people experiencing problems with crack and heroin but with the potential to include users of other drugs and people with alcohol dependency in the future - will also be affected by a range of measures designed specifically to support the reintegrative ambitions of the Drug Strategy (Drugs: Protecting Families and Communities, 2008). These measures include:

1 New ways of identifying problem drug users who are not in treatment but who are claiming benefit
Leaving open the question as to whether everyone who signs on should have to declare whether or not they use drugs (though identifying that the contracting out of drug testing and increased number of fraud investigations would have “resource implications”), DWP have identified three routes to identify drug users. Firstly Job Centre Plus will be informed of the results of all claimants positive drug tests in Test on Arrest. Secondly information about everyone subject to a Drug Rehabilitation Requirement (DRR) will be passed to Job Centre Plus. Thirdly, DWP estimate that up to 50,000 people a year leaving prison and starting a benefit claim could be problem drug users and say

“We will explore options for sharing information between the Prison Service and Jobcentre Plus to enable us to fast-track support for identified problem drug users”

A requirement that those who are identified as drug users will attend an assessment with a drug treatment service and the replacement of JSA or ESA with a Treatment Allowance for problematic drug users in receipt of benefits – These two measures taken together enabled the Daily Mail to announce:

“Jobless drug addicts who lie to obtain benefits will be forced to repay the money and could face jail, under a new crackdown on welfare cheats to be unveiled tomorrow. And unemployed people who take drugs will be banned from receiving dole money and switched to a new Treatment Allowance - a category introduced solely for drug-takers in a bid to shame them into giving up their addiction.”

Although at the launch event for the Green Paper at Westminster Hall in July, Rt Hon Stephen Timms MP, Minister of State for Employment and Welfare Reform stated there was no intention to apply conditionality based on treatment compliance to drug users on benefits (ie to cut off their cash if they didn’t turn up for treatment), the provisions outlined in the green paper would enable Government to do exactly that –

“In return for this access to drug treatment and specialist employment support, there will be an obligation on individuals to take it up. Failure to do so without good cause would result in a referral back to Jobcentre Plus and a potential benefit sanction.”

This means that treatment providers could be required to report to the Job Centre any drug user referred by Job Centre Plus who drops out of treatment.

2 The opportunity for problematic drug users to work with Job Centre Plus to draw up a Rehabilitation Plan to identify the support needed to get back into work
It remains unclear how this will work alongside the treatment plan. Given the separate pathways through the benefit system proposed for people experiencing problems with drug use, it seems that while drug users in receipt of benefit may be able to take advantage of some additional support they will not be able to take advantage of the greater choice and personalisation of that support available to other people with long term chronic conditions and disabilities. Nor does it appear that they be eligible for Pathways to Work – a programme currently piloted in 18 areas, but planned to be extended under the new legislation, that gives people who have got back to work but who will be earning less than £15,000 a year additional support plus a £40 a week Return to Work allowance for a year.

3 Employer Support
Work with a small number of employers to extend Work Trials, guaranteed interviews and mentoring support to people who have or who are experiencing problems with drug use. The extent of this is not clear, however it does not appear to be something expected to be extended widely in advance of or alongside the plans for the Treatment Allowance. No plans have been announced to look at wider campaigns – such as those underway for people with mental health problems – to tackle the stigma attached to having problems with drug use – as demonstrated in the Daily Mail headline above.

4 The appointment of “Drug Coordinators” in Job Centre Plus
Its currently unclear exactly how these posts will work. The big question how the posts are oriented within the larger system of support. An outward facing service focussing on supporting employers to take on more people who have been or who are in drug treatment, working with DATs to ensure more flexibility in terms of treatment provision and better co-ordination of services to ensure opportunities for gaining or maintaining employment are maximised (eg: greater use of facilities out of hours for people on 8 hour DRRs to enable them to complete their sentence without threatening their employment) could be helpful. On the other hand, an inward focus – essentially replicating the role of the DIP co-ordinator, scrutinizing case management to ensure targets are met etc - may be less useful. It will be interesting to see how these roles will differ from the Progress2work Job Centre Plus Drug Co-ordinators. First set up in the P2W 2002 pathfinder sites, these individuals were tasked with developing local employment focused plans between Jobcentre Plus and key agencies, especially Drug Action Teams, Probation and treatment providers.

Links to the Strategy

Given the focus in current thinking on getting people in treatment signed up to a notional contract that emphasises employment and treatment as the key to recovery and community wide benefits from the drug strategy, the initiatives proposed in the green paper can seem like a logical framework.

As the Green Paper itself says:

“Quite simply, we want everyone who can work to work – and that means more help with gaining skills alongside a requirement to take up these opportunities. It means medical support alongside an expectation that when treatment is successfully completed people will return to work. It means treatment for drug misusers coupled with clear consequences for those who fail to take it up.”

This is obviously a laudable ambition, and one that responds to the objectives of the drug strategy. However given that unemployment is rising – estimated to be over 2 million in the next 12 months - and difficulties for families with limited incomes are increasing, this might not be the best time to introduce greater conditionality on benefits.

However the Green Paper is not very clear about whether drug users who are already in treatment and claiming benefit will be transfered to ESA or to the Treatment Allowance. Nor is it obvious at a first - or even second read - what new services will be available for these individuals. Despite the Drug Strategy's emphasis on Kin carers and families, there seems to be little if any new support available to help these groups access the support they need to get back into work.

The thinking behind the Green paper seems to be to set up Job Centre Plus to act as a sort of "mini DIP" - where the great untreated can be co-erced and cajoled into treatment. The evidence that this is what's needed is far from conclusive. Firstly to reach their figure of 100,000 people on benefit using drugs but not in treatment, DWP used some rather insubstantial research - Population estimates of problematic drug users in England who access DWP benefits: A feasibility study. This estimated that around a quarter of a million people who claim the main benefits Disability Living Allowance (DLA), Incapacity Benefit (IB), Income Support (IS, and Jobseeker’s Allowance (JSA) are problem drug users and that about 100,000 of them are not in treatment. The researchers themselves are very cautious - maybe more so than DWP - about this piece of work and are clear that more research should be undertaken. The key caveats are about whether the prevalence figures on which the research is based are reliable and whether people who are out of treatment claim benefits at the same rate as people who are in treatment as this was crucial to their calculations.

On the first its probably worth having a discussion with one of those DAT co-ordinators who prevalence estimates have shifted by up to 50% up or down over the past year. On the other point - that of benefit claiming behaviour - we simply don't know. The Alliance gave me an informal estimate that around 90% of the people they talk to on their treatment helpline are in employment. They also said that one of the big problems people face is that treatment disrupts work - that inflexible services can make it hard to keep a job and that the stigma attached to seeking treatment can dissuade people who are working to go into services. Maybe a lot of people who are working avoid treatment services because of this? Its also possible that people who are in treatment are at the end of a long journey of problematic use that has lead among other things, to losing their job or worsening health conditions. This would mean that people in treatment would be more likely to be claiming benefits either because of unemployment or disability or chronic ill health. Either way, there are good reasons why benefit seeking behaviour among the two populations - in and out of treatment drug users could be very different - and these estimates could be misleading

Drug Use and Work

As drug use is still a widely misunderstood problem, increasing expectations for drug users to move into employment without providing additional support to employers and proactive communications campaigns to reduce the stigma attached to drug use and drug treatment may be a waste of resources. At times of high unemployment, the essential “lack of market value” of an ex- or current- drug user is likely to significantly impede their ability to get work. Imagine the small business, faced with an employment hungry field of candidates for a job saying

“No, I don’t want you people with experience or you, you darned enthusiastic school leaver. What I’d really like for this vacancy is someone who’s in drug treatment and hasn’t worked for 5 years”

There might be some ways to tackle poverty and lack of employment among people affected by drug use that are more effective than the blunt stick of benefit conditions. Trying to imagine what assurances we can offer as a society to that employer to make that perceived risk more worth taking for example. Or investing in the personal capital (skills etc) of people affected by drug use to help them deliver what the employer wants.

Of course we all know that there is no reason someone who is on script can’t work. One of the positives of substitute prescribing programmes is that they do enable people to regain stability – get into work, sort their finances and lives out. It gives people space and time – and provides an opportunity to see what life can be like without the daily grind of grafting and scoring.

Good services recognise the need for service users to access medical services before and after worktimes. For most in-treatment stable drug users there should be no reason why an employer would know about their drug use – the only exceptions being those safety critical occupations where any drug that might impair performance should be disclosed to an employer or supervisor.

Drug Use as Disability?

Some critics of the proposals have suggested that as drug use is a “chronic relapsing condition” people who experience problems with drug use should be protected and supported by the same legislation as other people with chronic health conditions and disabilities. This takes us into the dangerous territory of drug use as disability and the debates about the extension of the Disability Discrimination Act (DDA) to cover people in drug treatment. Some people, those who have chronic health conditions related to their drug use - the numbers of whom are increasing given our aging population – are disabled. However it is questionable whether it is useful or productive to consider people with what is essentially a treatable, tractable condition as disabled.

Will it Work?

Some commentators have questioned whether, having brought so many people into treatment over the past few years – with imprisonment available since 2005 as a sanction for those who won’t attend an assessment – that those supposed few outside the treatment system will be encouraged to get into treatment through benefit sanctions. Or even if they were, that the establishment of what could be a fairly costly and resource intensive programme of activities would pay off in terms of community and individual benefits and savings - or in lowered levels of poverty and disadvantage.

Much of this legislation is based on American Workfare schemes that started out in the 1980’s as a response to concerns about rising levels of poverty and welfare dependence. Critics in the States have argued that despite the apparent reductions in number of claimants, Workfare has little or no impact on levels of poverty and economic opportunity. Workfare, it is argued, forces people into low wage employment that does little to build their market value to employers and requires little if any increase in skills and therefore social capital. In Wisconsin the most gung ho of the Workfare schemes in operation withdraws all entitlement to benefit for anyone with a lifetime claim of more than two years. Yet Wisconsin’s tough approach demonstrates no greater success than areas which retain minimum income guarantees.

Discussion with workers and service users across the drugs field has identified a real welcome for any support to help people in treatment access work opportunities. However some have identified concerns that people having their benefits cut may turn to crime – not to fund their drug habit, but to survive. Others have expressed concern that a relapse already destabilises people and threatens whatever stability has been won through treatment – reducing benefits so applying sanctions may only intensify problems.

Some drugs charities have argued that the increased use of private providers to deliver Job Centre Plus services will give us a targets focussed system that is not really concerned with what happens to individuals. The rather muted response of some others may indicate their eagerness to bid for contracts to provide those services to drug users in the benefits system.

The NTA have responded to the new legislation as an opportunity to maximise the benefits of treatment. Paul Hayes was quoted as saying

“Service users are always telling us they want to get back into work. This is a real opportunity to remove barriers to work and maximise the routes into employment for those in treatment. Drug treatment services and JobCentre Plus will need to work together to persuade employers to give drug users in treatment a decent chance.”

I think its undeniable that we need better access to employment support and training for people who have been affected by problems with substance use. I know from my work in the last recession in Liverpool the positive impact employment can have on problematic drug use for individuals and communities. I also think poverty and drug use are complex problems and are rooted in many things - and that the work ethic - the only aspect of peoples worklessness that conditional Workfare type schemes have been shown to impact on - is the least of the problems these individuals and communities face. So I'm not, on the whole, convinced that these proposals represent a coherent or practical way of tackling the poverty that contributes to drug harms or of supporting people back into employment.

The very best employment or training initiatives I've seen (the old Community Programme - of which I'm a 1980's graduate myself, the Intermediate Labour Market Schemes developed in Glasgow and some radical and aspirational (not to say rare) day programmes like Lifeline's Outlook Services) were not successful because they threatened people with destitution and shame as some of our media might like. They worked because they gave people access to challenging training or the dignity of work with a range of employers - often focussed on improving conditions in the communities in which people live - alongside individualised support. They were about lifting not reinforcing stigma and avoided attaching labels. Progress2Work made some real achievements in its early days in creating strong partnerships to improve the employment chances of people with drug problems - but a quick trawl through the archives suggests that as the emphasis shifted more and more to meeting the treatment and crime targets, local partnerships, providers and government took their eye off the ball in developing this work. The best Progress2Work plans and partnerships focussed on getting people back into mainstream society, earning real wages - and letting employers see the benefits of working with people who are motivated and supported. A review of the evaluation of this important initiative might just help us get the current proposals on the right track.


How You Can Comment

The key questions asked about the proposals in terms of drug users are:

Question 6: Do you agree with the proposed approach for identifying problem drug use? How should it be implemented? Do you think that everyone claiming a working-age benefit should be required to make a declaration of whether or not they use certain specified drugs?

Question 7: What elements should an integrated system of drug treatment and employment support include? Do you agree that a rehabilitation plan would help recovering drug users to manage their condition and move towards employment?

There are another 26 questions about the proposals. You can get a copy of the Green Paper and the consultation questions here.
or by contacting DWP by email

DWP are running events across the country to consult with people throughout late September and October. These include

6 October – Cardiff.
9 October – Edinburgh.
24 October – Newcastle.

The Department for Work and Pensions (DWP) will consider the responses to the consultation after the closing date of 22nd October 2008. The proposals will then be worked up to a White Paper which is then published and will go before Parliament - probably in the 2008/9 session. The earliest the changes could begin to affect current claimants is 2010/11

Tags: recession, employment