Benefits system does not account for realities of terminal illness

Today’s Daily Mirror has highlighted the case of Jane Windle  , who has been declared fit to work in spite of having terminal cancer. 

A lady in bed talking to her nurse

Mrs Windle was diagnosed in 2001 with slow-growing carcinoid tumours and initially given six months to live. Her condition leaves her breathless and causes pain whenever she stands up.

The Department for Work and Pensions (DWP) will cut Mrs Windle’s access to the £140-a-week Disability Living Allowance (DLA). In response to her case, the DWP have said: “We have never been aware that Mrs Windle's cancer is terminal. That would make her eligible through a fast-track claim, which she declined.”

The DWP is, in a sense, being economical with the truth here. For the purposes of access to welfare, the legal definition of being ‘terminally ill’ is someone who has six months left to live. Mrs Windle implies in her interview with the Mirror that her doctors think she might live longer than this.

Terminal illness definition

This case and others like it show that the current legal definition of ‘terminal illness’ –  someone with a condition likely to cause their death in the next six months – is no longer fit for purpose nor fair on people who have a terminal illness. The definition has been used as far back as 1992, and was no doubt created with people with rapidly progressing, terminal cancer in mind.

The trouble with this, of course, is that due to advancements in medical care, people are living longer with conditions that in the past might have led to them dying rapidly. This is to be welcomed, of course, but it also means that these same people are often living with high needs for care and support. Perversely, people can be denied access to fast-track financial support because they are not as close to death as a piece of outdated legislation requires them to be.

Surely access to financial support should be determined by the level of need? The government is notoriously bad at this. About half of current work capability assessments that find people fit to work are overturned on appeal. Finding people with a terminal illness fit to work when they believe otherwise suggests a real lack of understanding about the profound physical, mental, and emotional impact terminal illness can have.

Financial support

Ultimately, stripping financial support from someone who needs it because they don’t meet the arbitrary six-month window is a false economy. It could well lead to them having further health problems – both mental and physical – leading to hospital admissions and greater cost to the NHS.

A more sensible approach would be for the DWP to work with a person who has a terminal illness, their doctor and perhaps even a financial advisor to determine the level of financial support that they need to remain independent. Some people might need no financial support, others only a little, and others an increasing amount as they come closer to their last days.

The current system, however, punishes people who fall outside the six month fast track system, even though there is no evidence that it is a reasonable definition of when someone is ‘terminally ill’.