Cuts - Yes, Minister

Geoff Tudor imagines the discussions that led to plans to cut mobility allowance for people inside residential care homes.

Author: Geoff Tudor

Cast:

Act 1

An office in the Ministry of This and That. Two civil servants seated at desks. Rumpled hair and much paper tossed around bear witness to some difficult assignment.

Minister: You tell me this is a hard nut to crack – but you chaps are chosen for your wits: here’s a good chance to use them! Disabled people don’t have broad shoulders, so for heaven’s sake don’t slip that in!
Bill: That’s covered, Minister. We promise 'unconditional support to disabled people who have the highest support needs'.
Minister: Nice phrase, Bill, but it won’t save us much money!
Charlie: Ah! We’ve thought of that, Minister. We push the whole thing across to the Local Authorities. They already provide four walls and a roof, bed and breakfast and other things. Shove in Mobility as well! Tidies the whole thing up! How’s this for wording. 'Local Authority contracts with care homes should cover services to meet all a resident’s assessed needs, including assessed mobility needs'.
Minister: Wait a mo! Who will do the assessing and how much will that cost?
Bill: Not our problem, Minister. Local Authorities will need to sort that one out.
Minister: But the Local Authorities are bleating already about the pressures on their budgets. Surely this will make them bleat louder than ever! 
Bill: Won’t hear the bleating up here, Minister! Distance lends enchantment and all that! They’ll manage to find the money somehow: push out a few top officers, defer the repainting of County Hall or turn out a few more street lights.
Charlie: Bill forgot to say that we’ve inserted something to establish a level playing field – ending an anomaly. People sent to care homes to recover following an operation are paid for by NHS. They don’t get Mobility Allowance so why should the rest? After all, fair’s fair!
Minister: A level playing field? I like that phrase. Can you slot it in somewhere in the official statement? Oh! I see a bit of a head shake on that one! Perhaps better not! Well, lads, I reckon you’ve done a pretty fair job! Earned your Christmas bonus perhaps!

The outer door opens and a head appears: Sorted out your patch yet, Arthur?

Minister: Yes! Prime Minister!

The curtain falls

Act 2

An office in the Ministry of This and That. Two civil servants seated at desks. Tousled hair and overflowing paper baskets bear witness to a problem that will not go away.

Minister: Six days ago you told me you had this all sorted out: now I can’t see my desk for the piles of furious letters!
Bill: Sorry, Minister! We really thought we had this licked: we’ve given the job our best effort this time.
Charlie: Yes, we’ve tightened the screw just a bit. Original version went: 'Local Authority contracts with care homes should cover services to meet all a resident’s assessed needs, including any assessed mobility needs'. The revised version reads 'will cover': sounds firmer and more definite.
Bill: Yes. And we’ve 'gentled up' the text quite a bit! How does this sound? …'Local Authority contracts with care homes will cover services to meet a resident’s assessed needs. These will cover activities of daily living which may include providing access to doctors, dentists and local services such as local libraries and banks. Local Authorities should also take into account the resident’s emotional and social needs as part of the assessment……'
Minister: Hang on a mo! These are human beings Bill, not Kipling’s plaster saints! Doctors, banks, libraries! Surely they’re allowed a bit of fun in their lives? How about bunging in 'pubs and football matches?' Those might meet their emotional and social needs better than a visit to the bank!
Charlie: I think we envisaged pubs, and football, and such things as coming under 'emotional and social needs'. Useful phrase Bill came up with there: covers a lot of things. 'Portmanteau', I think, is the expression.
Minister: I still don’t quite see how all this is going to work out in practice. A bloke’s emotional and social needs are going to change from week to week. How can you possibly assess them in advance? I still think it would be simpler – and probably cheaper as well – to give the disabled person the cash and allow him to decide what he wants to do!
Charlie: Yes, Minister, but it’s all for the good purpose of treating everybody the same way, whether they’re in the care home for a few weeks rehab or spending much of their life there.
Minister: I don’t know whether 'shared misery' is really the path we want to tread!
Bill: It all goes back to that 'Level Playing Field' Minister. And remember: it’s the Local Authorities that will be sorting this out. We’ll hardly hear their bleats at this distance – music in our ears!
Charlie: We had to sort this out somehow, Minister – and save some money. That was the problem. Solution - pitch it over the fence into somebody else’s garden: that’s good waste disposal practice.
Minister: I think you’ve convinced me! If at first you don’t succeed……Anyway, I’ll give you some marks for trying, lads!

The curtain falls.

Act 3

An office in the Ministry of This and That. Two civil servants seated at desks. There are three paper baskets – all filled to overflowing – and the two men look as though they have had a rough night.

Minister: Four days ago I could hardly see my desk for furious letters, now I can hardly get into my room!
Bill: Sorry Minister! This isn’t quite in our usual line of business – kind of feeling our way…..
Minister: Let’s go over the wording again. I want to check it against a letter that came in this morning.
Charlie: It starts like this, Minister. 'The proposed measure will end payment of the mobility component of the Disability Living Allowance for all state funded residents in care homes after 28 days'. We go on to reassure them that 'they will retain an underlying entitlement to the benefit and payment will be reinstated if they leave the care home….' I think that sounds clear enough, and generous enough.
Minister: Yes, Charlie, but I don’t think it quite meets the circumstances! Listen to this letter that came in this morning. 'I wonder if Ministers understand that for the majority of residents in care homes, when they leave they will leave in a coffin – and will have no further requirement for a Mobility Allowance of an earthly kind. (A pair of wings and a harp maybe?)'. I hope you realise you’ve made us all look a bit foolish by slipping in that bit you were so proud of!
Bill: Remember, Minister, we did 'gentle it up' by mentioning visits to the bank and so on.
Minister: Yes, and listen to this bloke’s reaction to your 'gentling up' as you call it. 'It seems that there has been a decision to 'sugar the pill' somewhat. Local Authorities will assess mobility needs and make funding available for visits to doctor and bank'. Here’s what he thinks of that: 'Whoopee! What an introduction to the Good Life!'
Charlie: I’m beginning to realise we don’t know enough about what goes on in these care homes.
Minister: You can say that again: and this bloke’s got a suggestion there too! 'It might perhaps help if a few people from the Department spent a week’s sabbatical in a care home. Experience is a hard teacher – but teaches like none other!' Who’s going to be the first to volunteer?

A deathly hush follows as the curtain falls.

Act 4

An office in the Ministry of This and That. Two civil servants seated at desks. A paper shredder has been installed and five large plastic sacks are piled in a corner.

Minister: That was quite a pasting we took in the Westminster Hall Debate yesterday, wasn’t it! What the hell are we going to do now? So many sharp thrusts we don’t have a leg to stand on!
Charlie: Yes, and Bill’s idea to add: 'care homes should help residents pursue their individual religious beliefs' hasn’t had much of a welcome either! Bags of letters from Freethinkers and Druids threatening to fight for their rights under the Equality Laws!
Bill: Not to mention the Licensed Victuallers Association saying “what about trips to the pub? Learned lot some of them – even quoted Housman’s “Malt does more than Milton can to justify God’s way to man.”
Minister: Yes, and there were plenty of Members asking how the hell we – or rather the Local Authorities – are going to assess every disabled individual’s mobility requirements. And how does this square with our undertaking to give unconditional support to disabled people who have the highest support needs? I’m beginning to think that the existing system is miles simpler: give them the cash and allow THEM to decide how they want to spend it! Margaret Curran put in a shrewd blow there. 'In my kinder moments, I honestly think the Government have made a mistake and that the plan was dreamt up by some young spark in the Treasury who had a quick look at the tables and thought There’s a quick saving. It looks as if it’s already double-funded. However they were not in the secret garden and did not think through the consequences.’ 'Some young spark?' Wonder who she could have been thinking of? You’re not blushing, Charlie, are you? Yes! You are blushing!

Charlie’s face slowly returns to its natural pallor as … the curtain falls.

Act 5

An office in the Ministry of This and That. Two civil servants seated at desks. There is a large jug of iced water: one of the men has dipped his handkerchief in it and spread it across his brow.

Minister: Dear oh dear! We don’t seem to be making much headway in explaining what we’re trying to do! Here’s one of our own chaps in Tuesday’s debate: 'If the Government is proposing changes, it does not seem unreasonable to expect them to be set out clearly and unambiguously in terms that everyone can fully understand'.
Bill: Yes! And another refers to 'the perversity of these proposals'.
Charlie: Another Member confessed he was unclear whether something was being taken away or simply replaced through another channel.
Minister: The general public doesn’t seem much wiser either. Listen to this: 'The Government’s total confusion on this issue reminds me of that classic occasion when: those behind cried ‘forward, and those before cried back! Maria Miller, Minister for Disabled People, spoke of an opaque, confusing and inefficient system in the past. I don’t see much prospect of clarity in the future!’
Bill: That was a spirited winding-up speech from the Minister about the objective assessment of people’s needs, so that 'we could target the right funding to the right people'. Surely that’s a worthwhile objective?
Minister: Not in the eyes of this bloke here! 'Targeting the right funding at the right people: that all sounds mighty fine. So does 'focus our resources where they are most needed'. But these fine words seem crafted to conceal the fact that all this forms part of a Spending Review designed to reduce Government spending. If this woolly-sounding objective assessment shows that bloke A needs more cash – then it can only come out of the pocket of bloke B! In this brave new Orwellian world for disabled people, all will be equal: but some will be more equal than others! (Unless – of course – the Government decides to spend a bit more instead of a bit less!)
Bill: Maria Miller promised to be 'consulting in full' and that 'people will have a full opportunity to give their thoughts’.
Minister: I rather fear that some of those thoughts may not be very printable!
Charlie: She did say that ‘milestones have been agreed with the Association of Directors of Social Services'.
Minister: Are you sure you got that right? Shouldn’t that be mill-stones?

The curtain falls.

Act 6

An office in the Ministry of This and That. Two civil servants seated at desks. There are a few scattered Christmas cards – but the atmosphere is hardly Christmassy!

Minister: Well, we got the Consultation Paper on Disabled Living Allowance reform out before Christmas as we hoped. Any feed-back yet?
Bill: Plenty of complaints about the short time allowed for response – taking account of Christmas and New Year. It’s just not the time for dealing with this sort of thing!
Donald: I’m afraid we’re collecting far more buffets than bouquets, Minister! One person calls the document 'deeply flawed' and 'not fit for purpose'.
Minister: I hardly expected 'sustained applause', but isn’t there any polite hand-clapping?
Bill: There’s rather a sneaky attack on our concern that people leaving care homes should not have to reapply for their mobility allowance. This bloke says this only shows the sheer insensitivity and ignorance of the people drawing up the document. 'When the disabled person leaves the care home it will probably either be in an ambulance on the way to die in hospital, or inside a coffin on the way to burial or cremation. Not needing to reapply for Mobility Allowance is more like a bad joke than a serious concession’.
Donald: Yes. Minister, I’m sorry to say that people don’t seem to view the package as some form of 'Christmas come early'. Instead they’re asking awkward questions about the cost of the proposed changes. They say it’s going to be like the Old Poor Law – when half the money went on admin and legal costs.
Minister: People aren’t drawing attention to the lack of consultation with the Treasury’s own disablement experts, are they?
Bill: I’m afraid they are, Minister. Here’s one comment: 'The Equality and Human Rights Commission is due to explore the Government’s handling of this matter – in particular the Treasury’s failure to consult its own specialist Office for Disablement Issues. It appears that this Office was only informed of the proposed changes on the morning of the Spending Review’.
Minister: Does anybody have a good word to say?
Donald: This person here commends the DWP for 'an innate sense of humour' in requiring responses by St. Valentine’s Day. He quotes from two Victorian valentines: 'My Dearest Miss, I send thee a kiss. And R. stands for rod, Which can give a smart crack, And ought to be used For a day on your back'.
Minister: Somehow I don’t think there will be showers of rose petals! I think I could do with another cup of coffee – a strong one please!

They stretch back in their chairs as the curtain falls.

Act 7

An office in the Ministry of This and That. Two civil servants seated at desks. They have been attending an office party. One still wears a paper hat: it perches uncomfortably on his lugubrious face.

Minister: Cheer up, Bill! Things are bound to get better! They couldn’t possibly get even worse!
Bill: Don’t know where we can find a gleam of sunshine, Minister? I spent part of yesterday evening reading up the House of Lords Debate on Social Care Funding – we’re supposed to keep an eye on what’s said up there.
Minister: Yes: had a look myself. Shouldn’t say this of course, but there are folk up there who know far more about disability problems than us folk down here. They know what they’re talking about – less blather, more sense. Baroness Thornton made a fair point, I reckon, saying that the onus is on the government to build up a consensus on the way forward. I don’t somehow think we’re doing this.
Donald: None of the speakers could find much to commend. The Bishop of Ripon said point-blank it was wrong to be seeking cuts among the most disadvantaged. 'Cuts should be borne by those most able to bear them'.
Bill: And Baroness Sherlock made the criticism – so did many of the others – that the government was trying to do too much, too fast. I looked up her background: She’s a person who knows what she’s talking about. So does Lord Low with his links with RNIB. He warned the government to be prepared for storms ahead.’
Minister: Yes, it was disturbing to find so many speakers concentrating on the lack of 'fairness'. Lord Adebowdale was very outspoken on this: 'We should retain public service and fairness. I did not hear enough about that. There’s a lot of talk about we’re all in this together – but we’re NOT all in this together'.
Donald: The biggest onslaught, I reckon, came from Lord Beecham: he had some pretty wicked shafts about Mr. Pickles being a bit like an over-generous Oliver Twist - giving half his dinner away and then finding he wanted it after all! And Lord Beecham may have hit the nail on the head, I’m afraid, in saying that the new localism is more about localising blame than localising opportunity and genuine decision-making.
Bill: Yes, that bloke from Cornwall – the one who’s been making such fun of us – has picked up on that one. He refers to Baroness Hanham winding up for the government – when she insisted that localism is going to happen. 'Don’t look to central government for the answers – they will not be there'. His comment here is: 'Isn’t this just like the Duchess in Alice in Wonderland, chucking the squealing baby across to Alice when she could no longer cope with it herself'. Baroness Thornton delivered an identical verdict in rather more parliamentary terms: 'The Government are abrogating their responsibility towards some of the disabled, the elderly and the vulnerable in this country'.
Minister: I suppose I must put on a paper hat and wish you chaps a Merry Christmas: somehow I don’t think it’s going to be a happy new year!

The curtain falls.

Act 8

An office in the Ministry of This and That. Two civil servants seated at desks. They have a wary expression – as if trouble lurks not far away. 

Minister: Well, how are things going on the mobility front? You tell me that a consortium of providers has peppered our proposals pretty thoroughly.
Bill: Precisely, Minister! Their Don’t Limit Mobility tears our proposals into shreds – makes them look foolish and illogical.
Minister: You issued a provisional statement I suppose?
Charlie: Yes Minister. We’ve said that ‘the mobility issues faced by disabled people will not be neglected'. We say we will protect the benefit and ensure that it goes where most needed: ‘we will be working with disability organisations about the changes to ensure that disabled people have the mobility they need'.
Minister: It strikes me we could well have had more discussion with these folk before getting ourselves into this mess!
Bill: Yes, this Don’t Limit Mobility stresses two points we’ve been worried about: one, our proposals may well contravene Article 20 of the UN Convention on the Rights of Persons with Disabilities and two, they also conflict with the government’s Personalisation Agenda. These folk would have to accept what the Authority dished out instead of being free to make their own choice.
Minister: Begins to look as though we’re up the creek without a paddle!
Charlie: Yes Minister, and I’m sorry to say that the PM rather put his foot in it during last week’s PM Questions. He was asked for an assurance that disabled people in care homes would still have access to individually tailored mobility support. He must have been poorly briefed – we must find out who fell down on the job.
Bill: Yes, he said the government wanted people in care homes to be treated in the same way as people in hospital: that’s a line of argument we dropped ages ago.
Minister: Some egg on our face I suppose?
Charlie: Yes Minister! Here’s a letter to a newspaper headed – 'How can the Prime Minister be so Ignorant about Disabled People?' The writer says that for weeks people have been pointing out the fallacy of comparing sick people in hospital for a few weeks (and not in a state to roam around) with disabled people living most of their life in a care home. He concludes - ‘I find it worrying that the Prime Minister should remain so ignorant (or so poorly briefed) after so much trouble has been taken to enlighten him'.
Minister: We keep going on about this being a highly complex area. Perhaps Look before you leap would have been a useful adage to follow.
Bill and Charlie: Yes, Minister!

They slump back in their chairs as the curtain falls.

Act 9

An office in the Ministry of This and That. Two civil servants seated at desks: they look as though they wish Easter was a bit nearer! Bill Bloggs is back from a course on ‘Explaining to the Public’.

Minister: Well, Bill, give us the benefit of your new-found wisdom.
Bill: Well, Minister. The Course Director began in cautionary mood – quoted Admiral Jackie Fisher’s dictum: 'Never apologise! Never explain!’
Minister: That’s all very well for an admiral striding his quarter-deck – or wherever admirals stride. It’s a bit different for us ministers who are supposed to convince the public that we’re on the right track.
Charlie: ‘Yes Minister. And we don’t seem to be doing all too well at that – not in the opinion of the Reform Research Trust.
Minister: I thought that was a Right-of-Centre think-tank that was rooting for us!
Bill: Up to a point, Minister. Broadly they approve of what we’re setting out to do, but don’t think we’re making a very good fist of it. They say we’re failing the test of practical reform. A big mistake was to give protection to certain areas and then argue that cuts of up to 20% should not lead to worse services in unprotected areas. Public can swallow teaspoons but not tablespoons!
Minister: They’ve awarded us gradings, I hear. How have we come out?
Charlie: Somewhere round the middle, Minister. “Marks for effort,” I suppose!
Bill: The other thing we need to face is the reaction to Maria Miller’s attempt to explain disability policy in the Guardian. I think she might be a convert to Fisher’s 'never explain' dictum!
Minister: Tell me the worst
Charlie: She argued that her proposals had not been properly understood, but that argument was 'rubbished': in the article. 'Judging by the powerful messages posted to Miller most concerns about the reforms appear not to be based on lack of information but on the very precise knowledge of the system that people who rely on benefits have to acquire’.
Minister: You can’t fool all of the people all of the time! Who said that? There’s been more on the Mobility Allowance for care homes, I suppose?
Bill: Yes! Here’s a forecast that 'any mobility system in the hands of local authorities will lead to a Post-Code Lottery of very different systems. It would throw up a mass of appeals and complaints that would plague DWP into the distant future'
Minister: We’ve got as many plagues as Egypt already: God preserve us from any more!

The Minister flings up his hands in horror as the curtain falls.     


The publisher is The Centre for Welfare Reform. 

Cuts - Yes, Minister © Geoff Tudor 2011.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.

Article | 02.04.11

intellectual disabilities, social care, Article

Also see