- Category: Disability
- Published on Friday, 27 September 2013
- Written by Richard Atkinson
Many thanks to Oliver Wilson for starting to address the issues surrounding the politics of disability within the IS Network. I am replying, not in fundamental disagreement, but in the hope of extending and deepening the debate. In particular I want to explore a notable absence in writings to date on the social model of disability – the key, historical role of the capitalist state in creating, regulating and enforcing ‘disability’, in all its aspects. I suggest that the unprecedented assault on benefits, rights and services now being experienced by disabled people requires this reassessment.
The Social Model of Disability1
It is easy to forget just how extraordinary an achievement was the social model. A small group of disabled people, largely independent of and ignored by the rest of the left, developed a materialist analysis of the history of disability. Not content with the usual processes of academic refinement and proliferation, they then honed down their analysis to its most crucial ideas and, with these ideas as their slogans, set about the liberation of disabled people in the UK.
To an amazing extent, they succeeded. Several generations of disabled people discovered that, using the ideas of the social model, they could, collectively and individually, speak out clearly for themselves, without professional mentors. Government was forced to adapt. The closure of the institutions was accelerated. Disability Living Allowance (DLA) was introduced in 1992 based on the ideal of self-assessment. Care provision was gradually reformed to move closer to independence and user control. And, in 1995, the Disability Discrimination Act (DDA) was introduced.
Faced with these achievements for the social model’s almost Leninist concentration on the next, concrete objective, and the ideas that would get us there, academic criticisms often seem rather beside the point. Tom Shakespeare,2 for instance, rightly complains that the social model tends to ignore, or at least bracket and defer consideration of, impairment and the experience of impairment. Impairment, he points out, is universal: part of everyone’s experience of the body and the link between disabled and non-disabled people. Very true, but an academic truth if it does not lead to a political argument we can use.
My question though is whether, as a political intervention, the social model needs to be sharpened, its politics retooled. Certainly there is a widespread sense that the disability movement moved into a doldrum period under Blair – half accepted, half distorted by the state, institutionally increasingly compromised. Having won formal rights through the DDA, the movement seemed uncertain and divided about how to turn these into substantive gains. If it has now revived – through Disabled People Against Cuts (DPAC) primarily – it is because disabled people are now having to fight to defend every gain we have ever achieved.
I believe the social model is in need of reforging to be an effective weapon against radically different challenges. Specifically, we need to think again about the state. The first wave of social model activism was ambiguous and consensual about disability and the state. 'Society', not further defined, was what oppressed disabled people and created disability out of impairment. The state was assumed to be, by contrast, at least neutral and capable of positive change.
That assumption brought results, in part because it was cutting with the grain of state policy – particularly in closing the old nightmare institutions. But in retrospect the rights-based turn, which culminated with passage of the DDA, can be seen as letting the state disclaim any further responsibilities to disabled people and move instead onto the attack.
The capitalist state
By the state I mean of course the capitalist state – one ultimately controlled by a ruling class devoted to the self-expansion of capital and dominated ideologically by the presumption of maintaining and expanding capital's domain. And it was the capitalist state, precisely and far more than any other agency, that, I would argue, first created disability and continues to create it today.
I take the state to mean the entire complex of institutions centralised under the direction of a ruling class. We conventionally define the state by its monopoly of the use of armed force but the capitalist state acquires additional functions which flow from the essentially private and fragmented nature of capitalist production. The state must ensure the framework of law in which capitalism operates and create and re-create the ideological underpinning of that law. And the capitalist state, in a central not a secondary role, must assume responsibility for general social welfare when that role can no longer be fulfilled either by religious institutions or by the ruling class individually.
In that welfare role the state has, always and everywhere, a double function. It maintains and supports but also it disciplines and socialises, both at the same time. This much can be seen from the central role given to labour discipline in every ruling class debate there has ever been on ‘welfare’. Furthermore, I would argue, that welfare role has repeatedly required and enforced the transformation and rebuilding of the state itself.
But the capitalist state is also a contested, porous and fissiparous set of institutions. It is contested between classes – as working class organisation grew stronger the state responded and gave ground, and more recently that process has gone into reverse; porous because, as its role expands, the state cannot avoid the entrance of subaltern classes and ideologies into the ranks of its functionaries; and fissiparous both geographically and between different disciplines involved in its work.
As a result of these complexities, while the state can and will respond to new ruling class imperatives it will do so slowly, disjointedly and with internal resistance – and only to the extent that a new shift in class power does not force the ruling class to retreat from its aims.
A very short history of disability
As the state took over responsibility for general social welfare from the Church and the manor – a process which first took a definite legal form in England in 1601 with the first Tudor Poor Law – it found itself obliged, for the first time anywhere, to take on systematically the needs of "the lame, impotent, old, blind and such other among them being poor, and not able to work".3 And so began the process – continual since – of classification, assessment, selective support, exclusion, discipline as deemed necessary, the concomitant prejudice and stigma – in a word, dependency – that came to define disability.
This has been rightly explained by social model theorists as a consequence of changes to the nature of work as the universalisation of wage labour, in both agriculture and the developing manufacturing industry, closed down earlier, more communal ways of organising work within which disabled people might still find a place. But there was a parallel ideological shift as well, marked by the central place given to the inability to work in defining disability in the first, and every other, Poor Law. Pre-capitalist views of what we now call disability focused either on specific impairments (blindness, epilepsy or learning difficulty, for instance, each had their own complex of attitudes and beliefs surrounding them) or on the cause of the disability (with victims of war often having a special status). An abstract, general definition of disability required an abstract, general definition of labour.
As capitalism developed new techniques had to be adopted to keep abreast of the needs of capital. Incarceration became increasingly the preferred option as the 18th and 19th centuries moved on, for the threatening hordes with physical or mental impairments but without the means to support them. The asylums and workhouses then became the proving grounds for a medical profession in need of state sponsorship, and disabled people the raw material on which doctors could sharpen their skills and theories – the medical model of disability, which prescribes that the state cedes power in the realm of disability to doctors, began its rise to dominance.
Then, as the working class challenge to capital grew from the late 19th century change was enforced again. A mass welfare system with its accompanying mass bureaucracy was eventually adopted by every capitalist state, giving ground to, but also heading off and controlling, working class contestation of power. Workhouses and asylums became care homes and hospitals. But it was slow, slow, agonisingly slow, for disabled people in particular, forgotten for long even in the socialist movement, massacred and euthanised at the high points of reaction, even as their ranks were swollen by the ruined bodies and minds of two world wars. Only the last wave of working class insurgency, in the 1970s, produced, finally, a disability movement in which disabled people themselves found a voice.
But the last shall be first, we are assured, and now, as a sclerotic capital in a final search for markets and growth, gnaws at the body of the very state that sustains it, disabled people, the last to benefit in the post-war class settlement, are the first to lose. Coalition cuts to welfare fall completely disproportionately on disabled people. Care services are the bulk of discretionary council spending and so are the main victim of cuts in local government funding. Cuts in advice services and legal aid make our hard-won rights unenforceable. And our long fight for pride and independence is sullied and slandered in wave after wave of government sponsored press poison – joined as ever by a few privileged disabled people.4
Rethinking the social model
The state’s orchestrated assault against disabled people has caused, or brought into focus, some tensions in the disability movement, as sympathetically summarised, and discussed here, by Jenny Morris. There was always a tendency, detectable in the early years of the movement, to downplay the fight for an adequate income, as compared to freedom and rights, because it seemed to define disabled people as needy or vulnerable and to concentrate on their impairments.
Add to this the role of public sector trade unions that, rightly concerned to save jobs, could be seen as obstructive in campaigns against the old oppressive institutions and against ‘care’ arrangements that prioritised the needs of the care provider not the disabled person – this was a challenge to create a radical, political trade unionism which could offer an effective lead to both care workers and disabled people, a challenge which was not often met – add all this, and the alienation of some disabled activists from the mainstream left, as noted by Oliver Wilson, may be sufficiently explained. This particular tension can only get worse as more and more trade union members are drawn into a primarily disciplinary role in relation to disabled service users – unless disabled people and ordinary trade union members can get together to fight for an alternative.
Then there is the distinction between ‘sickness’ and ‘disability’ which is real – I have MS which is a disability; I may also get ill as well – but very fuzzy in the cases of chronic conditions such as, say, Crohn’s disease. Insistence on this distinction at all times misses the point that ‘sickness’ as much as disability is a social construct, and can be the cause of comparable oppression. And it makes little sense in the context of predominantly mental conditions.
Most disturbing perhaps has been capitalism’s ability to, apparently, accept, take over and use for its own ends the slogans of the disability movement. So the long argument against the ‘medical model’ of disability is taken over by the giant insurance and health companies – the likes of Unum and ATOS – and their clients in the state, and used in their hands to promote a ‘social-psychobiological’ model of ill health and disability whose founding principles are that doctors are too expensive, not to be trusted, and replaceable with suitable computer programs; and that claimants are always lying. In fact the point of the medical model was that it identified an, often near total, power imbalance between doctor and patient (or inmate). To replace it with the power imbalance of an impersonal ATOS assessment is radically to pervert the intent of the original thinking.
In the same way the disability movement’s emphasis on disabled people’s creativity, and strength is turned against us by a parade of high-achieving disabled people – some of whom consent to be used in this way, many of whom do not5 – whose example is used to pour scorn on the rest of us. If we ask for independence, this is redefined as finding work – any work at all – with enforced penury as the only alternative. If we demand a voice we are given endless consultations whose outcome is always predetermined. Negative discrimination is outlawed – ineffectively – but it then turns out that what we needed was positive discrimination which is not on offer. We may apply for any unsuitable job we want but there can be no question of suitable jobs being created for us around our abilities.
So, in conclusion, we must not in any way ditch or weaken the social model but we need to sharpen its edge for the battles ahead. In those battles our main enemy, I suggest, will not be a diffuse prejudice or disablism – although we must continue the work of educating people away from such attitudes – but the capitalist state. The state it was that created our condition and the state it is that maintains us in artificial dependency, through the welfare system which is its primary means of disciplining us, through its shrinking ‘care’ provision with which it can control our daily activities, and through the rationed healthcare provision – no longer a National Health Service but private capital hiding under the capacious cloak of the state – under which we eke out our lives.
The enemy dictates the order of battle and we will need to use every opportunity to set the state against itself, through use of the law, though alliances with radical workers within the state and through relentless pressure on the political class who mediate between the state and the rest of society. We need to ally with any other victims of state oppression, such as non-disabled benefit claimants and ordinary workers. And we should be clear that the primary source of our oppression today, as before, is in fact the capitalist state in its welfare function.
The experience of disability today
Many disabled people will perhaps be unwilling to accept the link I am making here between Poor Law history and disability. Are we really to be defined by the DLA we receive and the services we, sometimes, with determined advocacy, squeeze out of the council? Aren't people of all classes disabled? Well, no we don't define ourselves that way but we are, quite thoroughly, so defined by the capitalist state. And yes, our bodies will fail us all in the end, whatever our class, but not everyone is equally demeaned by that process. What is I think unique about the oppression of disabled people is that we can never, once we become disabled and apart from a tiny minority with truly independent means, escape from the supervision of the capitalist state. That supervision may be benign at times or it may be cruel – and it can change from one to the other with dizzying speed in the current ideological climate – but we can, for the most part, never be truly independent of it.
Even in our minds the state can colonise us. Every disabled person I have spoken to about this agrees that their inner speech has been infiltrated by the waves of negative propaganda about disability and dependency. We all now have an internal monitor demanding that we justify what benefits and services we receive and aggressively challenging us for not working, or not working more. And we have our speeches prepared in response, and anxiously rehearsed to an imagined interrogator, explaining why, although we just managed to achieve this long prepared-for goal, or performed exceptionally well in that daily task, it’s all so hard and we can’t maintain it.
The present situation of disabled people in the UK demands, I think, that we are clear-headed about the history of the state and disability. We need to reinterpret history yet again to understand how capitalism, with its universalisation of commodity production and wage labour, foreclosed all other options for most people with impairments, except to become clients of the state that the same capitalism created for that purpose. And how the state then defined, regimented and demeaned us – created the very category of disabled person for us, created 'disability' – when we could not, unaided, sustain ourselves by our labour.
If we are not clear about this we will be divided and defeated. The future for disabled people will then be a survival income with minimal services and support. We will be 'independent' – they will not re-institutionalise us. We will get just enough help, from technological fixes or badly paid carers, to live. We will have our 'rights', on paper. A tiny minority will ‘succeed’ in escaping dependency and be used as a permanent rebuke to the rest.
And if we want to fight for an alternative we must be equally clear about our history. We must redefine 'work' and 'job' in ways that allow disabled people genuinely to contribute to the work of humanity's common future in whatever ways best suit our impairments. We must pursue all the demands in DPAC’s UK Disabled People Manifesto and more. Then we can hope to put an end to 'disability' as a state-sponsored social status and be simply people with impairments which do not, however, define us.
This is a formidable programme but disabled people, closer than many to the root realities of the body, drawn together in solidarity by common experiences and oppression, are formidable people.
1. Nearly all significant documents of the social model can be found in the Disability Archive UK. For the fullest treatment see The Politics of Disablement (1990) by Mike Oliver, available in the archive as a series of pdf’s. For a useful recent review of the field from a Marxist perspective see 'Marxism and Disability' (2011) by Roddy Slorach in International Socialism 129.
2. See The Social Model of Disability: and Outdated Ideology (2002) by Tom Shakespeare and Nick Watson.
3. The Poor Relief Act, 1601.
4. Like paraplegic Dr Stephen Duckworth, poster boy for Capita as they try to win the contract for harassing disabled people from ATOS
5. Hat-tip to Stephen Hawking and most of the Paralympic athletes