The Book of Exhumations; spilling the beans so we can all smell the coffee
I have been involved in disability politics long enough to have a nuisance value, you see I know where the bodies are buried. I want to move on like so many others but closure requires a proper burial and some form of justice. Potential fraudsters are easy to spot they carry people’s hope but never deliver on them or worse commit actual crimes. Fraudulent systems are much more difficult to spot because they purport to be neutral when they are not and unlike fraudulent acts, in a fraudulent system there is no crime. Why be a potential fraudster when it is easy enough to just operate in a fraudulent system? For example why commit tax avoidance when tax evasion is easier and legal? Now I am not leading an investigation instead I am leading change. Gandhi said forgive the sinner but condemn the sin; so let us analyse and reconfigure the sins within the system.
There is a fault line in our society between those who trust themselves to do the right thing but not other people and those who trust both. There is another fault line between those who trust the people and those who trust organisations. The Disability Resilience Network chose to trust the people and the organisations shaped by them. To those who ask why and point with alarm to the 18,000 breaches of the Co-vid regulations we too point to the same example and the more than 60 million people who were compliant and indeed are still following the regulations.
These faultiness are powerful too in Government policy. You can see these fault lines play out in the commissioning of public services. You can also see it in the commissioning of back to work employment support. On behalf of the Disability Resilience Network I want to suggest a system that trusts all the people but also delivers on the Government’s objectives of value for money, transparency and competition.
The labour market has essentially been about a contractual relationship between the person looking for work and the person offering work. The disability labour market has required state intervention to ensure employers don’t discriminate against disabled applicants. The state has also been required to provide training and support to those seeking work such as becoming aware of vacancies or obtaining reasonable adjustments e.g. accessibility support at interviews. Following the Freud report of 2007 there was a significantly expanded welfare to work industry even though Freud himself noted that there was no evidence to suggest that the private sector providers were better than Job Centre Plus (page 6). Curiously the market was incentivised through the opportunities offered to the providers: few large contracts, long-term contracts, only two or three providers per package area so little competition, job seekers who were able to exercise few choices about the support they needed and none about who they got that support from and indeed they were further cowed by the threat of sanctions so had little agency in the process. These job seekers were attached to providers in a black box ruled environment because the providers were in competition with one another and so there was no incentive to share best practice in case it led to the loss of a competitive advantage. The more harmful downside was that the jobseeker knew more about sanctions or the threat of sanctions than they did about the kind of employment support on offer further undermining their trust.
Because the value of the employment support was fixed contingent upon the job seeker’s membership of one of around a dozen categories, the system like previous systems was bedevilled by providers helping the easy to help into work called “creaming” and neglecting the harder to help into work called “parking.” Essentially Freud had borrowed his ideas from the food distribution industry but instead of the retail model of the corner shop accessed directly by the consumer he had borrowed the wholesale model whereby you could access affordable food if you were attached to a supermarket first.
The outcome based payments also brought a sting in the tail. The providers often had to wait for the designated deadweight (the numbers who would have gained a job without any support, typically estimated at 5.5%) in the programme to expire and then for the job entrants to maintain their job outcomes for specified payment periods so this brought them into real or potential cash flow problems. To avoid this it appears they borrowed money against future job outcome payments and charged management fees down their supply chains in recompense for the interest on these loans and the risks they were taking. The problem was that these fees extracted value from the amount or quality of the employment support that the disabled job seekers could command. The result was that even more disabled people were parked meaning they didn’t get an employment support service. The results for the ex incapacity benefit group were so bad that it was possible to joke that it you were more likely to get a job if you were not on the programme.
The above account maybe historic but it is recent history, it demonstrates the risks in commissioning services and actual fraud did occur – several operatives lost their jobs and liberty for forging records of job outcomes and in a system open to fraud the directors of at least one major provider pocketed millions of pounds from DWP contracts that should have been helping disabled people obtain work.
So how might it all be different? Firstly give the disabled jobseeker an assessment of the support they need to obtain work.
Then give them the money charged to a card like a credit card and allow them to contract for the employment support that it has been identified would make a difference to their prospect of employment.
Create incentives for them by allowing a wider range of support needs to be identified such as debt or money counselling and allow them to contract with a broader range of providers such as individuals with extensive knowledge of the local labour market, specialist charities with extensive knowledge of the occupational therapy needs of their health condition but also specialists in basic skills too.
Register these more diverse providers on line and compel them to make performance data available on the same site along with more details of the barriers to the labour market that they were helping people to overcome. On the basis of this more transparent system the Government would soon learn of both the type and price of interventions that helps disabled and non-disabled people to secure work.
Such a transparent system would allow disabled people to band together and form cooperatives of consumers with similar type needs> These cooperatives could act to reduce the cost of employment support meaning more people further away from the labour market would afford the support t they need to get into work.
The provider industry could also gain because knowledge of the successful interventions would draw more entrants into the market. These providers could also collectivise by forming cooperatives of providers to reduce office, travel and the terms for obtaining credit. The Government could favour providers who have a business model limited liability partnership, because they are able to expand through equity releases rather than borrowing credit. Such a system of open rather than closed capital aligns consumers and providers to their mutual advantage and has been governed by primary legislation for some twenty years.
A DEL AME Government switch could operate so that the savings to the public purse of more disabled people coming off benefits and obtaining sustainable employment could be recycled into more employment support to disabled jobseekers. By this means the incentives would keep increasing the amount of employment support funding available and generating more outcome based payments for the providers. Ultimately cooperatives of consumers could contract with co-operatives of providers in a marketplace regulated by Job Centre Plus through the operation of enforceable floor standards e.g. minimum wage jobs with in work training to encourage progression.
Now there may be faults in this proposition but in a week when people have been arrested for abusing the furlough scheme and millions of pounds of public money is currently being recovered there is a need for a system that incentivises need and disincentivises greed whilst helping more disabled people secure work.
The Voluntary and Community Sector (VCS) is a wealthy sector in its own right. It too commission services either for the Government or in its own right. It has the power to test this proposition. I ask the many procurement experts in the VCS who will read this blog to work with their heads of services and finance to test this proposition and to set new standards and practice for ethical procurement and commissioning. It is perhaps the easiest way of doing more with less.
Finally we need the disability community to form communities of disabled consumers who can stop good policy being frittered away in poor commissioning. The Disability Resilience Network will lend their support to this vital task, who will join us?
To the Government and DWP we ask if we can have a new commissioning strategy?