Also like just to harp on the "board of people with more knowledge on mental and physical disabilities" part, can we acknowledge the logistics of that?
Like let's take the UK as an example. In the UK, there are*:
- 15.1 million disabled people (around 1/4 of the population)
- 9.6 million disabled people unable to work
- 713,470 Professionally Qualified Clinical NHS Staff (141,000 NHS Doctors, 357,000 NHS Nurses, 23,544 Midwives, 20,245 Ambulance Staff and 171,681 Scientific, Therapeutic & Technical Staff)
*first two stats are from gov.uk, the third is from NHS Workforce Statistics - July 2024, I decided not to include private healthcare stats both as to keep it simpler and as presumably they wouldn't be on government boards.
So from that let's get some quick ratios from that:
- 21:1 for Disabled People and Clinical Staff
- 107:1 for Disabled People and Doctors
- 41:1 for Disabled People and Nurses
- 641:1 for Disabled People and Midwives
- 746:1 for Disabled People and Ambulance Staff
- 88:1 for Disabled People and Scientific, Therapeutic & Technical Staff
Now, you might be seeing why this might be a logistical issue. At best, we have a ratio of 21 to 1.
So if every disabled person decides they can't work, they'd have to share that assessor with 20 other disabled people.
If every assessment takes 1 day, someone will have a 21 day wait. Now that's incredibly unlikely because 1) that doctor is gonna need days off, and 2) if you're going to have a good, in-depth assessment where you can be sure you don't reject any actual disabled people, you're gonna need multiple days and maybe multiple weeks or months.
Say it takes 1 week for each assessment, that means someone has a 20 week wait which is about 5 months.
Say it takes 2 weeks for each assessment, that's a 10 month wait.
Say it takes 1 month for each assessment, that's a 20 month wait which is almost 2 years.
And what are those 20 other disabled people meant to do during that time? Do you expect them to work even though they, by their assesment, can't? Or are you going to give them benefits during that time?
Which brings us back to the original problem where you are potentially paying people who can work to not work, does it not?
Now you might say "not every disabled person can't work" which is a fair point. So let's just take a look at the ratios between the disabled people unable to work and the NHS clinical staff.
- 14:1 for Disabled People UTW and Clinical Staff
- 68:1 for Disabled People UTW and Doctors
- 27:1 for Disabled People UTW and Nurses
- 408:1 for Disabled People UTW and Midwives
- 474:1 for Disabled People UTW and Ambulance Staff
- 56:1 for Disabled People UTW and Scientific, Therapeutic & Technical Staff
Okay, that cuts our hypothetical waiting lists down by a third, but that's still ~3 months, 7 months, and 1 year and 2 months.
So I'd say that the point still stands.
And here, we are operating on the best case scenario, but is a midwife really qualified to assess whether someone with acquired brain damage is able to work or not? What about rheumatoid arthritis? Or C-PTSD? Or COPD?
I'd argue no which brings our ratios up to 23:1 and 14:1, and so making longer waiting lists.
And the actual suggestion was doctors - which is also debatable because like a lot of disabled people, I've had to explain conditions I have to doctors so are they really qualified- and those ratios are 107:1 and 68:1 which are pretty stark ratios.
An assesment takes 1 day? Someone has to wait, at best, 68 days. It takes 1 week? That's 68 weeks which is over a year. It takes 2 weeks? We're creeping towards 3 years. It takes 1 month? 5 years and 8 months.
Obviously, this wouldn't typically happen all at once - though if you are suggesting a hypothetical system for a new society, it would - but it's not like there's a cut-off where there'll be no new disabled people. It will be a rolling issue.
And, we have to also have to take into account that doctors can't spend all their time assessing whether or not disabled people can work. That's not in their job description. We primarily want them to be doctors.
So say we allocate a certain amount of time for assessments. How much time are we gonna allocate? Because the smaller the amount, the longer those waiting lists get, but the bigger the amount, the more the quality of overall healthcare will fall.
And the suggestion wasn't just 1 doctor. It was a board of doctors and uh, yeah that's gonna make those waiting lists a lot longer. If those boards have 2 doctors who are working round the clock on them, you're doubling those waiting lists.
So under this proposed system, what is our best case scenario?
If you want to minimise the amount of time someone actually able to work is able to access benefits, you'll need to assign 1 assessment to 1 doctor and give them 1 or 2 days to complete it.
If you want to make sure that no person genuinely unable to work falls between the cracks, you're gonna need much longer assessments with multiple doctors who are specialists for that/those condition/s which means much much much longer waiting lists.
And if those waiting lists are multiple years long, that does mean you'll be accomodating people who genuinely can work who are faking, and at that point, doesn't this all seem redundant?
Because unless you decide to not accommodate those on the waiting list, which will absolutely harm disabled people, you're just doing the thing you didn't want to do in the first place.
We've just created a logistical nightmare that doesn't solve the original "problem" that person had.
And we're not even getting into the fact that the whole "there are people pretending to be disabled who aren't actually disabled so they don't have to work" thing is just ableist rhetoric. It's just an extension of "you're not disabled, you're just lazy" rhetoric and scapegoats the disabled for society's problems.
This whole "problem" rests on the fact that people don't believe disabled people when we talk about our disabilities. That's it.
So, congrats buddy, you couldn't solve your non-existent problem! 🙂❤️