In my room

Welcome to my home, a council bedsit. Before we commence the pity party I should point out that it’s in a beautiful, quiet tree-lined street in one of London’s more swanky neighbourhoods. Not too bad a place for a middle-aged mental patient to end up. You can take a mooch around my room by scrolling to the photo gallery below.

Parliament’s Work & Pensions Committee is undertaking an inquiry into assessments for two key benefits for disabled people: Personal Independence Payment (PIP) and Employment & Support Allowance (ESA). Though the submission deadline is now passed, you can read submissions made via the web forum as well as longer written submissions.

This was my written submission regarding a PIP assessment. I think it’s definitely worthwhile reading (especially if you’re not familiar with benefit assessments), but this isn’t the most thrilling blog post I have yet produced. You could try the Psychotic & proud page (though that’s a long read) or Creative accounting which goes some way to explaining my obsession with those bastards at the Victoria & Albert Museum (V&A).

My benefit claims are centred around the fact that due to a variety of psychotic symptoms I spend 90% of my time in my room.

My submission to Parliament’s Work & Pensions Committee regarding PIP assessments

I have Schizoaffective Disorder and Obsessive Compulsive Disorder. I have chronic treatment-resistant psychosis that includes visual hallucinations, thought broadcast (the belief that people are listening to my thoughts) and thought insertion (the belief that people are trying to insert thoughts into my head). I have a severe lack of motivation identified as a negative symptom of schizophrenia. I talk aloud – including while in public – often not fully comprehending that I’m doing so. My consultant psychiatrist has told me that I’m one of the most seriously ill people being treated by the community mental health team (CMHT). I frequently lose two-thirds of the week or more to being psychotic.

Please note that it took me a number of weeks to write this submission and I produced it between episodes of severe psychosis. I have to stress this as, like any number of people who are on benefits, I face having benefits removed if it appears I’m not in a persistent vegetative state. Even though I can use a computer I still have very high support needs, in much the same way a former electrician with psychosis could still be eligible for PIP/ESA if they can change a lightbulb.

Executive summary

  • My assessor for PIP from Atos Healthcare was a nurse who appeared to have little or no knowledge of Obsessive Compulsive Disorder (OCD). It beggars belief that someone could be assessing peoples mental health support needs when they are not familiar with the basic details of one of the most common mental illnesses.
  • My assessor’s report included distortions and inaccuracies about my illness. It failed to accurately report what medication I take along with side-effects. These weren’t just a clerical errors, they show a failure to investigate why I need PIP, how my illness impacts on my life, the support I need etc.
  • The process of applying and attending the assessment made me very ill. Despite claiming to undertake a mental state examination the assessor failed to spot that I was deeply psychotic while sitting right in front of her.
  • The whole PIP application process is designed to deny you benefits rather than to try to establish what support you need to live independently and cover the extra cost of disability.
  • Mandatory reconsiderations have been introduced as a further hurdle to receiving PIP rather than a genuine attempt to reexamine your claim. The lengthy appeals process will put people off appealing.

Recommendations

  • Assessments for benefits should be based on expert knowledge by an applicant’s GP and specialists involved in their treatment and care – not reports by private contractors.
  • The mandatory reconsideration stage should be scrapped and the appeals process simplified and shortened.
  • With reform Personal Independence Payment (PIP) could be a means of promoting independence for individuals with disabilities/serious illness and should be recognised as a potentially effective means of reducing health and social care costs – ie. for people with serious mental health conditions reducing hospital admissions, the time needed with specialist staff.
  • An investigation should be launched into Atos Healthcare’s use of the term “mental state examination”. They appear to be fraudulently using a medical term to describe an informal process of gathering information.

Detailed evidence

  1. I was assessed by Atos Healthcare for the change from Disability Living Allowance  (DLA) to Personal Independence Payment (PIP) on 26 January 2017. I am aware that Atos have subsequently changed their name to Independent Assessment Services, but I’m continuing to call them Atos on the basis that absolutely everybody else does.
  2. I was accompanied by taxi to Atos’s assessment centre in Vauxhall by a support worker from the South Kensington & Chelsea Community Mental health Team (CMHT). I needed someone to go with me as I was in a very bad state mentally. I frequently am, it’s my default setting, but the stress of the PIP assessment made me very ill.
  3. Despite being psychotic I registered a number of things. The waiting area had around a dozen extremely nervous-looking people in it. A few had clearly been crying.
  4. The building had extra wide doorways to accommodate people in wheelchairs. You could be thinking that it was good that they were at least making an effort until a woman was wheeled in with what was more of a bed than a wheelchair. She wasn’t wearing an oxygen mask, but her bed on wheels had an oxygen cylinder attached. I think everyone there thought the same thing. This woman clearly had very profound needs, why wasn’t her application approved simply on evidence from her doctors or why wasn’t she given a home visit? It must have cost some part of the NHS or social care system a small fortune to get her there that day.
  5. I was called into an assessment room by a woman who introduced herself as a nurse. She started asking me questions that had been on the application form. I was quickly overwhelmed and wasn’t able to cope with questions being fired at me. At one point I started to read the answers from my application – this was cited in my award letter as evidence that I don’t have any communication problems. The support worker from my CMHT intervened to point out that I needed time and also that I regularly don’t make eye contact. Up to this point, the nurse appeared to believe that I wasn’t making eye contact out of rudeness.
  6. More than ten minutes of the thirty-minute assessment was taken up with discussing that I had been in hospital over Christmas 2016 with a kidney injury. This had no relevance to my PIP application other than the injury may have been caused by the antipsychotic clozapine. Thinking about it later I got the impression that the nurse was happier talking about physical health and she was pleased with herself because she could pronounce “bilateral hydronephrosis”.
  7. We reached a point where we were discussing my personal care and I pointed out that I hadn’t taken a shower in months (it was a bad patch, things are a bit better now). The nurse reacted strongly to this and said, “So how does your OCD affect you then”? She gave me a look as if to suggest I had been caught out lying, claiming to have OCD while making statements to the contrary. The CMHT’s support worker and I exchanged glances, both thinking that this nurse didn’t know very much about OCD. As you may well know, to have OCD you don’t have to be washing your hands a thousand times a day and cleaning lampshades with a wet wipe. My OCD takes the form of a ritual where I have to hold my fingertips together at many points throughout the day in the belief that this will prevent a nuclear war. These type of rituals and compulsive thoughts are fairly standard with OCD. You can discover this through a simple google search. It beggars belief that someone could be assessing a person’s mental needs under PIP when they are not familiar with even the most basic details of one of the most common mental illnesses.
  8. Following the assessment, I obtained a copy of the assessor’s report. There are a long list of inaccuracies. There are some things I can’t see how she misunderstood and I concluded that she just made things up. For instance, I said at that time I was only able to go to a local cafe with the help of a support worker. The report said I went to a local cafe alone and cited this as a reason for me not requiring a higher level of support.
  9. The worse inaccuracies are regarding my medication. The assessor’s report said I had no side-effects. Putting aside that we had just had a ten-minute discussion about how clozapine may have caused the kidney injury and put me in hospital for a week, I put on six stone while on antipsychotic and this almost certainly explains why I developed type 2 diabetes in my forties (since stopping antipsychotics I have lost a lot of weight). Even worse, the report doesn’t mention the chronic exhaustion I experience as a result of taking sodium valproate. It’s the bane of my life. Apart from the psychotic symptoms I experience it’s why it’s why I’m kept isolated in my flat so much of the time. These things are mentioned in my application and my social worker’s report but seem to have been cheerfully ignored.
  10. The listing of my medication on the assessor’s report was completely wrong. It didn’t mention sodium valproate. Regarding antipsychotics, it didn’t mention that they don’t work for me and my consultant psychiatrist has concluded I have treatment-resistant psychosis. It mentioned that I am on an anti-depressant, but not that it may or may not be having an effect and that I’ve been on several which did nothing but produce side-effects. It’s important to stress that these are not just simple clerical errors, it illustrates a cavalier attitude to assessing someone’s health condition and the needs this may create. Would this be tolerated more widely in the NHS? How long would such a hapless nurse last on a hospital ward?
  11. Before I received the assessor’s report I had received my PIP award letter from the Department of Work and Pensions (DWP). It mentioned a “mental state examination”. I initially assumed this referred to a mental state examination detailed in a letter from a psychiatrist within the CMHT and handed to the assessor. When I received the assessor’s report it was clear that Atos claim to be carrying out mental state examinations. I’ve been treated by mental health services since 1991, more regularly since 2002 and intensely since 2007. I’ve had many mental state examinations. During this Atos one none of the usual questions were asked. In terms of examining me, the nurse just occasionally glanced away from her computer screen. Had she undertaken a genuine mental state examination she would have found out that while sitting in front of her I was experiencing visual hallucinations, thought insertion (the belief that people are trying to insert thoughts into your head) and was deeply suicidal. The CMHT support worker was concerned enough to speak to my community psychiatric nurse (CPN) and my CPN was concerned enough to organise an emergency appointment with my consultant. Everyone involved could see I was in a disturbed state (and that includes the receptionist at the mental health centre and the taxi drivers who took me to and from the Atos building). The only person who didn’t notice my disturbed state was the Atos assessor who seemed to think I was fine apart from not making eye contact. Online I have read a great many scornful comments by service users and mental health professionals about Atos’s use of the term mental state examination.
  12. I had an emergency appointment with my consultant the day of my PIP assessment. She noted that I’m one of the more seriously ill people being treated by the CMHT and that in the ten years I had been seeing her, which coincides with the time I had been receiving DLA, my mental health had deteriorated considerably. We had a discussion as to whether I should consider giving up my council flat and moving into supported accommodation. People normally hope to move the other way.
  13. Quite a few weeks passed without me hearing from the DWP following my assessment. Eventually, a welfare rights advisor who is part of the CMHT phoned the DWP on my behalf and found that I had been granted PIP standard rate for daily living needs and nothing for mobility (I had previously been getting DLA middle rate care and lower rate mobility). The welfare advisor explained that it was more difficult to get the mobility element under PIP. He was pretty bullish about my chances of success if I appealed the care decision. I had eleven out of the twelve points needed for enhanced rate.
  14. Maybe I have a strange sense of humour but I occasionally look at my PIP award letter to make myself laugh. It’s comedy gold. At the time I’m writing this I’m going out of my flat about twice a week. One afternoon I ‘ll try to do a week’s shopping at a supermarket and visit an art gallery (art galleries are my hobby). Maybe another afternoon I’ll go to local shops. I was better during the Summer and but seemed to have slipped back again. I’m not even seeing my CPN much at the moment as he is overwhelmed. Back when I had my PIP assessment I was going out very little and needed to get taxis everywhere. Other than trips to the mental health centre I only occasionally strayed more than a mile or so from where I live. I hadn’t left London in more than five years. I want to point out that I have only been abroad once (a day trip to Bologne when I was eighteen) and have never been on an airplane, I’m saying all this because if you read my PIP award letter you’d think I was an international playboy and jet-setter. There was a strenuous and determined effort to deny me the mobility component. There was also the suggestion that because I was going to the mental health centre a lot – several times a week at that point  – I couldn’t really be that ill. It’s a bit like arguing that if someone is going through a particularly grueling regime of chemotherapy they don’t really have cancer.
  15. In discussion with the CMHT, I decided to put in a mandatory reconsideration. My consultant sent a letter stressing the seriousness of my illness. The mandatory consideration rejection letter from the DWP said that the award of PIP didn’t depend on your illness, but your ability to do specific tasks. Why then does my initial award letter state, “I made my decision using information about your health condition or disability including details of any treatment, medication, test results and symptoms”? Why is Atos attempting to record peoples medication? Why the phony mental state examinations? In any case, as my consultant pointed out, these examinations are snapshots and not intended to establish long-term care needs.
  16. The rejection letter again focused on my life as an international playboy but also introduced the idea that I’m a global financier. I had been asked during the Atos assessment whether I had a bank account. I replied that I have two accounts. Back in 2006, I was so broke I was reduced to counting out coins and taking them to the bank (this was back when you had to use plastic money bags before banks had coin counting machines). I was too ill to make it to my own bank branch so went to the nearest bank. They didn’t want to change the money but said I could open an account with them. I was bemoaning this to a friend who helps me out with money and other matters. He said having two bank accounts was a good thing. He reminded me that when I became ill in 2002 my account was shut down and for a number of years I didn’t have an account with any bank. So I opened an account. The fact that I have two accounts was used against me to say I don’t need help managing money and overall I’m not that ill. I do need help and am very ill but am being punished because I have friends who are financially literate.
  17. The rejection letter also focused on the fact that I occasionally walked to the mental health centre, my GP’s etc. It seems ludicrous now but during the Atos assessment, I mentioned trying to walk places as an example of my trying to help myself and not just giving in to my illness. Between around March 2017 and September 2017, I was going out more but have now slipped back to not walking out and about much. Problem is since I now have less money under PIP than DLA I can’t afford taxis.
  18. I decided not to go to appeal. I was simply too ill at the time. I’m not much better now. Had I appealed I would have had to wait somewhere between three months and one year, possibly longer. I manage to get by through not thinking about my ESA claim and pushing it to the back of my mind. I live in terror of being found fit for work-related activity let alone being found fit for work. I’d be sanctioned at the end of the first week. Although I was appealing for PIP I would have inevitably ended-up thinking about my ESA claim. This would trigger stress, a worsening of my psychotic and mood symptoms and an increase in my suicidal thinking. The mandatory consideration process has clearly been devised to deter people from appealing. It’s intended to make people give in.
  19. We frequently hear about postcode lotteries for a variety of services. PIP and ESA are state-funded lucky dips. It appears that you are awarded benefits depending on the individual prejudices of the assessors (who the DWP invariably backup), who make decisions on a whim or whether they enjoyed their lunch that day. I think this explains the truly bizarre decisions that are reached by the DWP in making benefit awards now.
  20. In theory, I should have no anxiety about my benefit claims. I have very high support needs due to severe chronic psychosis and mood symptoms. On paper, it looks like I should be getting the PIP enhanced rate daily living component and at least the standard mobility rate while remaining in the ESA support group. I’m a textbook care-in-the-community client. It has been decades since this idea came to prominence. PIP and ESA should be enabling independent living and should rightly be seen as a vehicle for keeping health and social care costs down ie. keeping me chugging along in the community is a lot less expensive than the cost of potential repeated hospital admissions.
  21. Without PIP – without the funds to pay a number of people who help me live independently – the cost of my care would rise steeply. For all its imperfections, I am incredibly grateful to receive financial help to support me while I’m unable to work and to help me live independently. The problem is as the system is now operating it at times makes my illness worse.

In my room gallery

The council bedsit of a poor old schizo. Note that the iron and ironing board are even more decorative than the art posters, I haven’t used them in years. I know I look bookish, but this a collection of snot-covered paperbacks I bought from charity shops on the Kings Road during the three years I was living in local authority temporary accommodation in Chelsea.

Featured image: A photo of my room, taken with my iPhone, November 2017.

 

 

PIP/ESA assessments inquiry

This post has now been superseded by a more recent post detailing my submission to the Work & Pensions Committee inquiry: see In my room.

I’m leaving this post here so that you can learn about my pretentiousness and neophobia, while enjoying a gallery of poverty porn from the Parisian world of the fin de siècle.

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Parliament’s Work & Pensions Committee is undertaking an inquiry into Personal Independence Payment (PIP) and Employment & Support Allowance (ESA) assessments. Committee Chair, Frank Field MP, has said, “We would like to hear from claimants – and assessors – about whether and where the system works or is failing, and how it might be fixed”.

Of course, I see this as an opportunity for new heights of pretention. I thought I’d make a video to illustrate the fact that I need PIP as I spend 90% of my time in one room due to various symptoms (see Psychotic & proud).

The problem is, despite having my current iMac for eight years, I have never opened iMovie and don’t know where to start. Neophobia, same reason I have never tried sushi. I’m 52!

I have managed to choose some music for the soundtrack. When I overcome my timidity I’ll open iMovie. This will probably be at Christmas, but it’ll give me something to do while complaining that there’s nothing on the telly and I don’t know why I pay the license fee etc. This week I was reduced to watching one of the adult channels. No! I mean BBC4. It’ll be opera on Sky Arts next.

For now, you’ll have to settle for some poverty porn from the Parisian fin de siècle. These printmakers were at it long before Channel 5.

 

Poverty porn from the Parisian world of the fin de siècle:

Street scenes, sex workers, sheet music and more.

 

Featured image:  Soup (La soupe), Théophile Alexandre Steinlen (1859 – 1923), the Van Gogh Museum.

More details of each image can be found using the keyword poverty from the gallery French printmaking 1890-1905.

(Many images from the Van Gogh Museum can be downloaded for non-profit publications, personal websites, blogs, and social media).

Dickens redux

It’s not been the best of weeks. I have been troubled by very bad visual hallucinations, as well as the usual psychotic symptoms (see Psychotic & proud). I only left the flat once, though I managed to do a big supermarket shop and visit the National Portrait Gallery (NPG) to see The Encounter: Drawings from Leonardo to Rembrandt (now sadly finished, but the web page is still worth looking at for films and essays). The exhibition was extremely good.

I know you shouldn’t think about Christmas till December, but while at the NPG I bought my Christmas cards, good value at £6.50 for 20. They have a wide selection. You can cross the road and get charity Christmas cards for half the price at St-Martin-in-the-fields (or even less at Tesco, Sainsbury’s, Lidl, or down the market, obviously), but charities often only get a small percentage of the profits – though maybe the big names like Oxfam with branded cards do better.

I think major galleries do well. If you have a click around, you can see that they put some real effort into it, especially the Tate. If you’re an arts wankery enthusiast like me I recommend buying from galleries and if you’re in London visiting and so saving yourself the postage.

But all this has been a distraction. What preoccupied me most of the week apart from the psychosis was the news reporting of the rollout of Universal Credit.

If you’ve come here via Twitter and share my interests most of the following may be familiar to you, but I have covered some things you may have missed.

If you haven’t seen the news over the past week here is a quick primer: BBC News What is universal credit – and what’s the problem? Also see Wikipedia, (especially criticisms).

If I hear the phrases “Simplify the benefits system” and “Make work pay” one more time I’m going to headbutt the telly. It’s becoming increasingly apparent that you’ll need a Ph.D. in semiotics to receive Universal Credit and many people are going to be thousands of pounds a year worse off.

Already people are being denied dental treatment and prescriptions due to confusion as to who is eligible.

I know from the voluntary work I do for a charity that Her Majesty’s Revenue & Customs (HMRC) forms for new employees don’t include Universal Credit: not even the taxman can cope with it!

Women’s Aid has raised concerns about the benefit being paid into a single bank account for a couple (people were previously paid separately). This is a return to the traditional “single breadwinner” concept, taking us back several decades, with potential for abusive men to withhold money from wives and girlfriends. I’ve not seen references to it but I assume the same could apply to LGBTQ couples/civil partnerships.

Universal Credit has only been rolled out in a small part of the country and already Citizens Advice is overwhelmed and people are crowdfunding to train volunteers to help people apply. The Child Poverty Action Group has calculated that lone parent families – many of them in work – will lose a massive £2.380 a year on average by 2020. Making work pay?

Universal Credit has been described as a nightmare leading to rent arrears and evictions, people being disincentivized to get a job as they fear if they sign off benefits they’ll never get back on again, and likely to cause a level of destitution not seen since the foundation of the welfare state or even since Victoria England.

Some of the Department of Work and Pensions’s (DWP) own staff are in revolt. A whistleblower told the New Statesman:

“As a case manager, turning away those in abject poverty is a part of the job. Those who have worked in Universal Credit since the early days have become hardened, having dealt with thousands of vulnerable people. It’s very difficult to tell claimants, “I’m sorry but we can’t give you any more”, even if we know that children will suffer and go hungry for weeks”.

A DWP spokesperson gave the usual glib response “Our frontline staff offer invaluable support to people facing difficult circumstances”.

Six benefits that have been rolled into one to create Universal Credit (Income Support, Income-based Jobseeker’s Allowance, Income-related Employment Support Allowance, Housing Benefit, Working Tax Credit and Child Tax Credit).

They are now referred to as, “Legacy benefits”. Does someone have a sense of humour?

These benefits were designed for people who were too disabled or ill to work, people unemployed because there was no suitable work and to top-up low wages and cover high housing costs.

(If you’re familiar with the basic history of the welfare state you skip the next three paragraphs).

The origin of the welfare state is rooted in the acknowledgment that work frequently isn’t available and income needs to be provided to avoid a large number of people being destitute: see The Guardian Long Read, Why we need the welfare state more than ever.

The Beverage Report published in 1942 established the modern welfare state, offering welfare “from the cradle to the grave” and identifying the five “Giant Evils” in society: squalor, ignorance, want, idleness, and disease. Underlying all this was a belief that the state had a moral duty to intervene, though Beverage argued the state, “should not stifle incentive, opportunity, responsibility”.

When launched the Beverage Report proved hugely popular with the public – more than 600,000 copies flew off the shelves – and it fitted the mood of the time. The war gave society a sense of common purpose and social solidarity. People across the social classes were brought together in a way that had never happened previously, there was a new found respect for the common man. Since the beginning, much of the welfare state enjoyed support across the political spectrum.

You may be wondering how I know all this – famously, I have only one O level (geography).

Apart from the fact that I can google and wiki to my heart’s content, before I effectively dropped out of school at 14 (see Psychotic & proud), I was taught about the welfare state. We all were back in the 70s. Are kids now?

It was our thing, it was intricately linked to working-class identity. Our grandparents had fought a war for it, along with the NHS. It was our heritage, it was our LEGACY.

My mother likes to talk about the Land Girls in her sheltered housing scheme: they were heroines for a generation of women. After their sacrifice, they now have granddaughters who regularly go without food to afford childcare, who face cuts to benefits that just about enable them to survive, and could well have to turn to foodbanks.

We all know about benefit claimants, they are presented on Channel 5 documentaries as obese, heavily tattooed chain-smokers and heavy drinkers, slumped in front of the telly when not being promiscuous, only venturing out to the bookies or to Greggs for a steak bake, while stopping off on the way home to commitment some antisocial behaviour – and that’s just the women.

They are scroungers and skivers, living off the backs of the strivers and hardworking families.

The assumption behind Universal Credit is that it is addressing personal failings, lack of responsibility, “welfare dependency”. It ignores the fact that some people are unable to work through disability or illness and it ignores the fact that in a lot of Britain there are simply no jobs.

Within ten minutes walk of where I am sitting writing this, there are two employment agencies. If I were well enough to work (I’m not, see the Psychotic & proud ), I could arrive at eight in the morning, and assuming they were happy with my documents, I could be in work by nine. But this is London, with its pressing need for hospitality staff. If I didn’t fancy that there’s always warehouse work, perhaps I could get a forklift truck driver’s license. Sainsbury’s are crying out for people – I could get a discount when I do my weekly shop.

I don’t need to point out the reality to people outside London and the South-east reading this, especially not to people in the old industrial heartlands, many rural communities, much of Wales and Scotland.

People have said that Universal Credit is Theresa May’s Poll Tax, but Universal Credit makes the Poll Tax look like Disney (interesting historical note, Lord Freud, one of the chief architects of Universal Credit, helped steer the stock market flotation of Eurodisney). The Spectator Magazine published a hagiography of Lord Freud by the journalist Peter Oborne. I’ve liked some of Peter Oborne’s journalism. One time I saw him on the tube at High Street Kensington – he didn’t appear to be the village idiot.

Lord Freud is now denying the six-week wait for a Universal Credit payment was his idea. Iain Duncan Smith (IDS) is also denying that it was his idea. IDS, always keen to appeal to the reasonable man in the street, is in favour of a four-week wait for money for people to be able to buy food.

It has cost £15bn plus to date, and Universal Credit, along with other welfare reform, is having a catastrophic effect on other public services, those provided by local authorities and the NHS. It’s well documented that various welfare reforms have cost more to implement than they have saved. We don’t hear a peep from our old friends at the Taxpayers’ Alliance.

Politician, charities, church groups and others have pleaded with the government to halt the rollout of Universal Credit in the run-up to Christmas. Have you not read Dickens they say, fearing a return to Victorian levels of poverty and squalor.

Was there a subliminal influence in my choice of Christmas cards this year?

But we’re expected to return to a golden age where people “took responsibility” and had “self-reliance”, where there was no “welfare dependency”.

I tell you who are going to be the loudest voices calling for the slow-down in of the rollout of Universal Credit? The insurance industry. At the moment the public still appears to believe that Universal Credit is “simplifying the benefits system” and “making work pay”. Eventually, it will get out into the culture that what we had – our legacy – has been taken away and there’s next to nothing for you if you lose your job or fall ill. There will be a stampede to buy income protection insurance. Too much growth can be as bad as too little, companies don’t want to expand too quickly. They will need help from the government and will get subsidises to cope with demand, former ministers and DWP civil servants will become advisors and join boards.

No doubt there will be a wave a mass public revulsion when people wake up to what has been done. The Tories may be swept out of power again as they were in 1997. But will it be too late by then? Apart from the ravages of welfare reform, have public services been fatally undermined since 2010, the austerity years? What will it take for our society to recover?

Featured image: A Christmas Carol, Charles Dickens Christmas cards, taken with my iPhone, October 2017National Portrait Gallery (NPG) shop.

After this blog post was written my neighbour took me for a second trip to the NPG. Images are on my Instagram account.