Another Jigsaw Piece

Doctors to Help Reduce Welfare Beneficiary Numbers

Social expectation is powerful.  What people expect of us, along with society in general, is powerful--for good or ill. 

New Zealand is embarking upon a programme of changing social expectations of welfare beneficiaries.  The fruit of old nostrums lies rotten on the ground.  It's time for something different.  The government is trying to set a social expectation that its not acceptable to remain on a perpetual benefit unless circumstances are particularly pressing.  Lifestyle beneficiaries are to feel the heat of social expectations upon them. 

Sickness beneficiaries, whose numbers have exploded over the past twenty years, are required to go to doctors periodically to get medical approbation for remaining on a sickness benefit.  Now doctors are required to diagnose what is required medically and physically to get the beneficiary back to work--which will be a very different conversation to those of previous years.
  This, from Stuff:

Doctors are being encouraged to question unemployed patients on their career goals as part of sweeping welfare reforms, which critics fear will penalise the disabled. But advocates say getting patients off the benefit is part of a GP's job, and work-focused conversations need to start in the doctor's clinic.

The biggest changes to the welfare system in more than two decades came into play last month, with seven main benefit categories cut to three. The previous sickness and invalid benefits, collected by about 140,000 people last year, have been replaced with either Jobseeker Support or Supported Living payments.

The working assumption of all state beneficiary welfare programmes prior to the present sea-change has been that no-one likes to be on a benefit, that all really, actually, truly would prefer to be working.  Therefore, to imply to beneficiaries in any way that being on welfare is less than ideal would only serve to rub salt in the wound and be a form of "beneficiary bashing".  No longer.  Doctors are now required to play a more holistic role--they must embrace the assumption that work is more beneficial than idleness and ensure that their diagnoses and prescriptions and recommendations reflect that reality.  Most doctors are welcoming the change. 

But health and disability panel member Ben Gray, a GP and senior lecturer at Otago University's Wellington School of Medicine, said there was no doubt that the physical and mental health benefits of working were huge. "On one level, finding them a job is not our job. But our ability to manage some of the problems that are the barriers to why they can't get jobs are our core business. If someone can't get a job because they are stoned all the time, then I should be talking to them about what we can do about their addiction."  International research has shown consequences from being out of work include poorer mental and physical health, increased rates of mortality, and risk of cardiovascular disease, lung cancer and respiratory infections.

No doubt there is plenty of work to do to navigate such a sea-change successfully.  There will be lots of tweaking needed to navigating and sailing skills.  But it is a beginning.  And a welcome one. 

Societal expectations, based upon common sense nostrums are powerful.  When doctors start telling beneficiaries that one of the most powerful things they can do to their well being and long term health is to get a job it will doubtless have an effect.  Social expectations from opinion leaders always do.  One more jigsaw piece in place.