An Acceptable Sacrifice

During the coronavirus crisis, ‘underlying conditions’ has become just the latest throwaway remark reminding disabled people that society doesn’t value their lives.

(Illustration: Rose Wong)

The coronavirus crisis has given the non-disabled population a taste of what it is like to experience disablism. Discrimination in the workplace, the punitive social security system, the ever-present fear that someone you know will be a victim of government neglect — what has been for too long the everyday reality for disabled people is now being experienced by much broader layers of society.

But as this is happening, the situation is deteriorating even further for disabled people. If we shield ourselves from the virus by staying at home, we risk either being dismissed from our jobs or the punitive Universal Credit system. From the familiar refrain of coronavirus victims having had ‘underlying medical conditions’ to the guidelines which are used to determine who gets lifesaving treatment when there are limited resources, it is clear that disabled people are becoming an acceptable sacrifice.

This should not be a surprise when the measure of who has a quality of life worth saving is so closely tied to capitalist values of productivity. Recently, the Clinical Frailty Scale used to determine who received medical care came under fire as it seemed to target people with learning difficulties and ‘stable disabilities’. Even now, the Scale relies on an incredibly dehumanising view of what determines quality of life.

A coronavirus patient who is ‘completely dependent on personal care’, yet is not expected to die anytime soon would still be recommended for palliative care under this system. I am 25 and have friends my age who would be left to die if this was applied to them. Their lives are great when they have the support they need to do the things non-disabled people often take for granted. They use social care support to get up and about, and Access to Work (once they get past disability discrimination in job recruitment) in order to do their jobs.

But the coronavirus crisis is making these things increasingly impossible. And it is exposing the degree to which our society treats people as units of economic activity. Disabled people are deemed not to be ‘productive’ because they cannot be viewed as the autonomous and rational individual posited as the subject of capitalist society. We do not efficiently create surplus value for bosses, nor can we be said to perform a socially reproductive role, because disabled people themselves require something which is described as ‘care’ rather than ‘assistance’. As many are coming to realise, we are an expense, a burden on the state and  society — and are therefore disposable for the sake of profit.

Paying a Disproportionate Cost

Even when disabled people aren’t directly killed by the virus itself, they are the ones who pay the price for many of the measures intended to protect the population. In order to fund the NHS and save resources, the Coronavirus Act allows for the ‘switching off’ of Care Act duties (and the equivalent in the devolved nations) for local authorities. This meant that the right to social care for disabled people disappeared effectively overnight.

In Scotland, where the SNP-controlled Scottish government has ‘switched off’ their social care duties, people’s lives have been put in serious danger. Almost immediately, reports emerged of disabled people having their entire care packages cut, with some reporting that they are now unable to bathe. In the midst of a pandemic, this puts lives at risk.

The Coronavirus Act also allows for safeguards in the Mental Health Act to be suspended, requiring only one doctor to involuntarily detain someone. It also allows for incredibly long extensions in the amount of time someone can be detained. Institutionalisation is an evil that the Disabled People’s Movement has been fighting for decades. But these relaxed safeguards threaten to take us back even further than we have slipped under austerity.

This presents an extraordinary threat to disabled people’s civil liberties; but in the context of social care cuts, it also threatens our lives. Already, reports from Europe have emerged of queues of coffins exiting care homes and other institutions. With an increase in numbers of service users and a likely drop in the number of staff working in care facilities, these institutions will become a morgue for many disabled people sent there.

The European Court of Human Rights, whose standards social care provision will soon be based on, has found against disabled claimant in cases where they haven’t had the social care support required in order to be able to use the toilet. The bar for social care after ten years of austerity is already incredibly low, with most service users only receiving it when they would otherwise not be able to feed and bathe themselves.

The Coronavirus Act is a further attack on social care. But even by its own twisted logic, it will diminish NHS resources more than it will save them. Disabled people denied the social care they need in order to live safely in their own homes will fall ill and end up in acute hospital beds or psychiatric wards. And those unwell and incapacitated in hospital now? They will require assistance and time to recover.

In order to receive it, they will need to access social care and continuing healthcare. Without it, these people will have to stay in hospital, using hospital beds rather than being able to return to their own homes. After years of cuts and restrictions, this Act is paving the way to end social care and care in the community — and that will kill disabled people far faster than coronavirus ever could.

Against Disablism

Disability is not an inevitably. Nor is a eugenics approach. But both are implied by capitalism and its approach to human worth. Before capitalism, disability as we understand it did not exist. Prior to the industrial revolution, most work was undertaken in family units, with different family members contributing what and how they could. Capitalism invented a fundamentally different form of production — and imbued work with a new meaning. The creation of production lines and factories meant work became far more individual, and people were thus categorised in one of two ways: disabled (non-productive) and non-disabled (productive) in order to establish their value.

This analysis, which is known as the ‘individual model’, is based upon notions of disability as a ‘lack’, a ‘defect’ or a ‘tragedy’. The Disabled People’s Movement rejected this model, arguing instead for the ‘social model’ which holds that disability is not the same as impairment — it is a social relation and construct. In other words, it is governed by our material circumstances and the historical context we live in.

Of course, capitalism also causes disability and impairment through poor working conditions, or housing conditions, or insufficient healthcare. So any fundamental dichotomy between disabled and non-disabled is a false one. We are all vulnerable, and none of us can truly be cocooned from the societies in which we live.

Recent events have shown that what we once considered social care is dead. ‘Care’ as a concept is patronising and does not go anywhere near the aim of independent living. This means far more than the feed-and-clean model that many non-disabled people seem content to leave us with.

A particular tragedy within the Labour and trade union movement is the near constant sidelining of disabled people’s organisations and activists. All too often disability charities —which are not run by disabled people — are used as a substitute. Even under the National Care Service proposed by Labour in December 2019, disabled people wouldn’t have the right to even attend a union meeting or go to the pub.

In response, disabled people’s organisations have proposed a National Independent Living Service which cements the right to live independently in the community into domestic law, with the personal assistance needed to make this a reality. These sorts of proposals are necessary to truly move away from a society that values people based on their economic productivity.

This can’t start after the pandemic; it needs to start now. We have already seen that local authorities are willing and ready to cut disabled people’s support before the Tory government has even allowed for it. This must be opposed. Solidarity is the best form of mutual aid — socialists should engage with disabled people’s organisations, and understand that ours is a struggle for a fundamentally different world.