HIV and Sickness Benefits
posted: 03/05/2011
Before the May Day holidays the Department of Work and Pensions got a lot of press coverage by claiming that its reforms of sickness benefits were working. It claimed three quarters of the people applying for the new Employment and Support Allowance (ESA) are either fit for work or stop their claim before they’ve had the medical assessment. They claimed this proved the need to urgently reform benefits, and that Ministers are right to reassess everyone on incapacity benefit.
Don't give up on benefits with HIV
People living with HIV who are claiming benefits for sickness – either Employment Support Allowance or Incapacity Benefit - should not feel intimidated. Benefit experts and the National AIDS Trust point out that the system isn’t working properly for people with HIV. But people with HIV very often win if they don’t give up, stick with their claims and get expert help. Very many people with HIV win if they appeal.
False logic
The Department of Work and Pensions is wrong to claim that lots of refused claims and high rates of drop outs from medicals prove the new system of ‘Work Capability Assessments’ is working. For people with HIV these show the system is seriously failing. People with HIV can and do win with help.
HIV and long term conditions
Research by NAT shows that people living with HIV are being found ‘fit for work’ despite medical evidence showing a range of serious physical and mental health problems. These include severe immune deficiency, co-infection with pneumonia or TB, fatigue, depression and debilitating side-effects from essential HIV treatment.
Deborah Jack, Chief Executive of NAT (National AIDS Trust), commented:
‘The refusal of 39% of ESA claims is not conclusive evidence that Work Capability Assessment (WCA) is effective. These claimants may be found ‘fit for work’ under the rules of WCA, but many face very real health-related barriers to work which have been overlooked during the assessment process.
NAT is also extremely concerned by the high drop-out rate of 36% before a decision on the benefits is made. Dropping a claim does not prove someone is not eligibile for Employment Support Allowance. NAT continued ‘An independent review of the Work Capability Assessment revealed serious problems with decision-making and administration, and real failures in the way the DWP communicated with claimants. Stopping a claim halfway, points towards fundamental flaws in the system – which are yet to be resolved.’
More information
If you live in NW England with HIV and and have problems with benefits please contact our support team
DWP statistics can be found here
NAT’s report ‘Unseen disability, Unmet needs - A review of the impact of Work Capability Assessment on people living with HIV’
The Work Capability Assessment (WCA) is the test undertaken to determine whether a person is eligible for Employment and Support Allowance (ESA). The WCA aims to identify claimants who have ‘limited capacity for work’ or ‘limited capacity for work-related activity’, so that they may receive the right support to help them live well and (where appropriate) return to work. Those who are found ‘fit for work’ are not entitled to receive ESA. The test contains a series of questions, called ‘descriptors’, which relate to physical and mental functions, and from which claimants score points.
The report of the Independent Review of the Work Capability Assessment
In October 2008, Employment and Support Allowance (ESA) was introduced to replace Incapacity Benefit and Incapacity-based Income Support as the primary income support benefit for people who are unable to work due to disability or illness.
Permalink
Benefit Problems?
posted: 08/04/2011
People living with HIV in NW England on incapacity benefit who are told they will be reassessed, should call the support team at George House Trust for help and advice. Everyone on Incapacity Benefit will be reasssessed and moved onto another benefit - usually Employment Support Allowance, sometimes Job Seekers Allowance. This change of benefits can often be a bumpy journey.
George House Trust advisers will be able to give initial advice and further support as needed.
Alternatively people may call THTDirect 0845 12 21 200 between 10am to 10pm weekdays and from 12pm until 6pm at weekends.
Easing the stress of change
Many people are finding these assessments very stressful and complicated. Unfortunately the evidence shows that many people with HIV are wrongly refused or put in the wrong ‘stream’ of benefits and told they are fit for work. With the right advice and help this can often be prevented, and if not support and help offered with reviews and appeals. The success rate is high when people get expert advice and assistance. Many people with HIV win these appeals.
NAT and THT have produced a useful benefits advice factsheet for people with HIV
THT have more useful advice for people with HIV who are on benefits, applying for benefits or considering taking paid work which could reduce their entitlements to benefits.
It helps people find out their benefit rights and how best to apply, and deal with reviews and appeals.
Permalink
Charging Migrants for HIV Treatment
posted: 04/04/2011
The government has said it will soon change the rules about charging people from abroad for most treatment at NHS hospitals in England. At the moment the rules do not affect many people in North West England with HIV but that is likely to change. New Rules will probably appear in June.
The government has also announced another, bigger review of NHS charges. This will look at anything and everything and is intended to save the NHS a lot of money.
The next step is the department of health will publish the new rules for NHS hospital and clinic charges and guidance quickly – probably before June.
They have just published their response to a public consultation so now we know something about what the new rules from June will probably say. George House Trust gave evidence and comments to this consultation.
The Department of Health's plans for the June rules are
- They won’t change which treatments will be charged for yet – but may do so later.
- The rules will be changed to make it clear that refused asylum seekers who get Section 4 and Section 95 payments do not pay for NHS treatment
- Unaccompanied children will no longer have to pay, but children with parents here can be charged
- They will make clear in the new rules that anyone who has begun HIV treatment that is free of charge (e.g. because they have an asylum claim which has not been finally decided) will continue to receive free HIV treatment
- They will keep putting up posters about charging for treatment in hospitals and clinics, even though they know this frightens some people that need treatment away and can lead to discrimination by hospitals
- They will change the guidance that tells doctors to think about the cost of treatment, because this encourages discrimination
- They will start a new system of telling the UK Borders Agency about the people who owe the NHS money. This will mean people will be refused permission to stay longer, applications for citizenship may be refused and people will be refused a visa to return to the UK if they leave
- They will consider introducing a rule that will force visitors from overseas to have health insurance
- They will look at charging people for primary care (treatment by family doctors)
Free HIV treatment for all?
The Government still has not decided whether to make HIV treatment free for everyone who needs this on public health grounds, like for all other sexually transmitted infections. They say they are still considering this and will report “in due course”.
Next, an even tougher review
They have also announced another major review which is designed to save the NHS a lot of money. This will look at
- Changing the residence rules, including the definition of ordinary residence
- Changing some or all of all the types of treatment and types of people who do not have to pay for NHS treatment
- Making people pay for primary care (that is treatment by family doctors and dentists)
- Changing which bit of the NHS has to pay when people cannot pay
- Making the procedures for checking who should pay tougher before treatment begins
Making the procedures for collecting charges tougher
- Using new ways to collect charges
- Requiring migrants to have health insurance
- They will consider anything and everything else.
They try to soften this tough new cost-saving review by saying “the NHS is, and must remain, ultimately a humanitarian organisation. In undertaking the review, we will be mindful of the NHS’s core values, in particular its obligations to provide urgent treatment to any person irrespective of their status or ability to pay, to protect the vulnerable and respect our obligations on healthcare provision under international treaties . There is no intention to consider policies that would deny access to any group, only whether an individual should be charged. It will consider the full benefits and costs of introducing new charges including risks of deterred or delayed treatment and any other societal costs. In addition, we will ensure that public health considerations are fully factored into proposed rules and processes (ensuring in particular that access policies do not compromise the identification and control of infectious diseases).”
A comprehensive package of confirmed proposals will be put to full public consultation on completion of the review work, in 2012. We may consult separately at an earlier stage on some options, such as primary care charging.
You can read the details of the government's proposals for the June regulations and this new review here. The new review details begin on page 24.
Proposals and Review report
Permalink
HIV Teenagers to Adults
posted: 21/02/2011
Older teenagers with HIV are our HIV pioneers because they are the first generation of young people growing up with HIV. Being the first at anything is often exciting, but with HIV it can be much less fun and more of a struggle.
Making the change better
The Children and Young People HIV Network are working to make it easier to move from being a teenager with HIV to being an adult with HIV.
Young people with HIV have two main challenges
- growing up from a child to adult with HIV (e.g. beginnning sex and relationships with HIV)
- moving from children's HIV clinic and education, into adult HIV services and employment or claiming benefits with HIV.
The Children and Young People’s HIV Network have now finished checking all the expert articles and books about changing from child to adult with HIV in a ‘literature review’.
They looked to learn lessons about improving the change from child to adult, including learning from experience with other conditions like diabetes and epilespy.
The HIV child to adult change literature review is here
The review
- has statistics about young people with HIV in the UK
- finds existing policies and guidelines for the child to adult change
- looks for useful lessons from other longterm conditions, like diabetes
- considers the needs of carers and family
- considers rural areas with very low numbers of young people with HIV.
Professionals tell us
Last week we pointed out the useful article where HIV health workers describe helping teenagers to make the change from child to adult with HIV, which is in the 200th issue of HIVTreatment Update.
Teens talking life with HIV
Two young people making these changes talk about their own lives. JD Bailey (20, female) talks about growing up with HIV, and Max, (19, male) talks about telling others about HIV
‘Transition of care from a paediatric to adult setting is not specific to HIV … However there are important differences … with HIV which may make this process more difficult’ Lyall, 2007.
Permalink
Rise for HIV in Spending Review
posted: 09/11/2010
The Government has commited itself in the recent Spending Review to include specific amounts for HIV social care needs within the local authority grant for the next five years. Remarkably the funding identified for ‘AIDS Support’ is increased from £25.5 million this year to £36.2 million by 2014/15.
George House Trust and other HIV organisations have been in a campaign over the last few months lead by NAT (National AIDS Trust), to persuade the government to at least specify an amount for HIV within local authority budgets.
Following the Spending Review all the grants for special needs – including the AIDS Support Grant – are absorbed into the block grant given to councils, known as the Formula Grant.
However, the government says it will tell councils how much of their Formula Grant is for HIV. These are the figures.
Deborah Jack, Chief Executive of NAT, says:
‘NAT is extremely pleased to see a commitment from the Government to increase funding for HIV social care following our recent campaign. This commitment shows an acknowledgment of the importance of funding these services, and recognition that the rising numbers and ageing population of people living with HIV will result in both continuing and increasing social care needs within this group.
‘However, we do remain concerned that with the removal of the ring-fence around this funding and the increased emphasis on local flexibility, there is a risk that HIV social care funds could be spent elsewhere. NAT encourages all local authorities to ensure the needs of people living with HIV in every area are met, and this means using the funding committed to HIV social care to provide the services necessary.’
Further information (including the figures above) are in a
letter on Local Government and the Spending Review from the Secretary of State for Communities and Local Government
Permalink