Thursday, 16 October 2014

Access to Work - the government's in charge of another car crash

The government is actively making decisions that make it harder for disabled people to find and stay in work.

This, despite their rhetoric of work being good for you.

You'd think a government scheme that brings in £1.48 for each £1.00 spent on it (ref. 1 below) would be a flagship scheme, widely trumpeted and funded to the gills. But no, Access to Work, a fantastic scheme, that met the costs linked to meeting disabled people's access needs so they wouldn't disadvantage either employer or employee is being screwed around with, and is turning into a car crash.

Disabled workers are being made to wait 6 months upwards for decisions on whether the scheme will cover their needs. For some, this is too long, and people are having to leave jobs before decisions are made.

Previously, Access to Work was administered from multiple regional offices. Individuals would be linked to a specific advisor, who would understand the detail of their conditions, work, and requirements. This meant less admin time for both worker and government employee as explaining every last detail of work roles, conditions, and needs only needed to happen once.

Now, those regional offices have been closed, and a smaller number of central offices have opened. Those experienced in the system have lost work, and new staff have been employed. Workers no longer have a dedicated advisor, so have to go into minute detail every time they contact the AtW office. Hours can be lost to repeated phone calls - all time spent on admin that a non-disabled worker doesn't have to do. And all costing taxpayers' - our - money, as an inefficiency has been added to the system.

I have a small amount of self employed work as a printmaker. I need to go to art fairs to sell my work - just relying on internet sales isn't enough. I am medically unfit to drive, so need to take my work - including framed prints up to 60cm square - on the bus, or in taxis. I struggle to lift and carry heavy items, so need help with this.

Formerly, AtW would help with taxi costs (within reason) to get to fairs, and a support worker, to help with physical tasks I can't manage. Bear in mind this is stuff a non-disabled person could do alone. However, recently AtW are asking for proof I have a profitable business before they'll consider me eligible for support.

How many self-employed people turn a profit in the first couple of years of operation?

I am only taking the same risks that a non-disabled person might take, but to have my access costs funded, I'm being asked to prove I'm paying NI and turning a profit immediately. To do that, I need to get to fairs, to expose my work to the public. To do that, I need support to get to those fairs. To get that support to got those fairs I need to apply to AtW. And if I cover the the support myself, I'm having to earn half as much again before I turn a profit because 50% of my earnings would go on access support... You see the Catch 22?

Access to Work should be more widely available and better funded. It can really act to remove barriers to work for disabled people, and secondarily creates employment through both the infrastructure of the scheme, and through the employment of trainers, mentors, support workers and interpreters.

I strongly believe if there is any contraction in the Access to Work scheme the government is both shooting itself in the foot as fewer disabled people will be able to stay in work, and will be making yet another decision that actively worsens conditions for a group of people who already face systemic discrimination.

The government can choose to act to remove barriers to work for disabled people here. Challenging systemic discrimination should not be falling on the shoulders of those who already carry the burden both of that discrimination, and live lives that carry the challenges of impairment. As a government, you have the capability to lift that burden significantly, and not to do so is to shirk your duty. Those who have been placed in power by the country should use that power to better the lot of those with the least, and disabled people are amongst those both with the least, and who will struggle the most to change their own situations.

Ref. 1:

Monday, 13 January 2014

Steroid & anaesthetic injections in hips

I had steroid and anaesthetic injections in both hips just before Christmas to try and reduce the burning nerve pain I have down the outside of my legs, and to make it clearer whether the pain I have is coming from my hips or back (or both, and to make it clear what is coming from where.)

Before the procedure I was given very little information, and nothing I could find online was particularly clear or detailed. My main anxiety was down to this lack of information. I knew it was a common procedure with low complication rates, and that if it didn't help, it was unlikely to make things worse.

A friend's sister is having the same jab, but in a different place, and wanted a bit of info, so I sent the following as an email. It seemed sensible to put that here so maybe it will be useful for someone else, too.

The procedure was amazingly low discomfort - so much that I'd not worry about getting my back done, and am thinking of asking about that.

I went in early in the morning, it's counted as day surgery, but it's not done with any sedation or anything, just local anaesthetic where the injection will be done. I was allowed to eat & drink as normal beforehand.

I walked into the theatre & hopped on the table, they swabbed my hips with iodine stuff and stuck sterile drapes over my midriff, with just two holes where they needed to get to the skin. They did the anaesthetic injection which was a little stingy using a thin & not very long needle. They did a couple of jabs of anaesthetic each side, using the same syringe & needle for each. 

A portable x-ray machine had been wheeled in shortly after I lay on the table. They
 took a first image, and they popped the first big injection in - it was a spinal needle, so 4-5cm long or so, with a cannula around it. They took another image to check it was in the right place, then took the needle out leaving the cannula in place. Then they attached a syringe to the cannula and popped the steroid / anaesthetic mix in, checking after it was all in with another x ray.

These were lowish dose x-rays, so several in the same day isn't a problem,

At one point there was a dull pressure ache down my thigh, as the steroid went in, but the whole thing was far less painful than anything my body does to me.  Each side took about 5 minutes maximum. 

When they had finished, the peeling off of the sterile drape was the most painful part, as the adhesive part of the drape gave me a free waxing >_<

After this, I was wheeled up to recovery, then to the obs ward to have a cup of tea & biscuit, and show the nurse I could walk - which I could.

I had no increased pain at all, it was like the burning in my legs was switched off. This is a good response, and some increased pain for a couple of days can be experienced. As the local wore off, before the steroid kicked in my hips were a little grumpy, but less than they had been.

 I went to the shop I do odd shifts at for my shift straight from the hospital, sitting on  hard chair thee for about 4 hours with no more than my regular pain.

 Pain wise, it's been 2 months now and my thighs sometimes have a bit of soreness, my hips ache a bit, but it's dialled right down, and has let me get a lot more exercise. I feel like it might be starting to wear off, annoyingly, but I need to see how it goes. I've not needed my crutches since the jabs, and have been able to reduce my tramadol intake by 1/3.

Overall, it's a very straight forward procedure, and although unpleasant, is IME less unpleasant than dental work and a lot less sore than the pain of trapped nerves.