I really do not understand what is going on.

This government, this Labour government, is introducing policies that David Cameron’s Tories would not dare suggest. Last week, it was the authorisation of “top up” payments for health care. Now it is an attack on the security of tenure traditionally enjoyed by council house tenants and it will be the underprivileged, the physically and mentally ill in particular, who will suffer in the name of weeding out the scroungers.

So many of my patients live in the twilight world of benefit traps. Ben Goldacre will be taking a look at some of them on Radio 4 tonight at 8.00 pm. Some of my patients are unemployed and looking for work. A larger number of them are on incapacity benefit (full details of Incapacity Benefit here) . Some of those labelled as “incapable” are genuinely unable to work because of illness.

Others have been surreptitiously pushed from “Jobseekers’ Allowance” onto incapacity benefit.

It works like this.

Derek, a fifty-eight year old labourer, develops genuine back trouble. A few months later – by which time he is on incapacity benefit - he is much better, thank you, but genuinely worried about injuring his back again. There are lots of things he could do – for example, work on a supermarket checkout – but the pay in these jobs is so poor that there is little to be gained by returning to work. The “Jobcentre Plus” ("Plus what?" you may well ask) are happy to have him off their books and so encourage him to see his doctor. Derek has taken to rubbing his back a lot, particularly in public, and always as he walks into his doctor's consulting room. Derek’s doctor is not prepared to confront him by refusing certification. You cannot tell that someone does not have back trouble, and so Derek is certificated for the rest of his working (sic) life.

Derek has always been decent, hard working man. He did not have much time off work before his back injury. Psychologically, he is now damaged. He is labelled as an “incapable” human being and so becomes one. There are many others with whom one is less sympathetic but it is always hard for the family doctor, when faced with La Malade Imaginaire, to be as robust as he should. If someone else takes over the task, there is a grave risk of the seriously mentally ill being forced back to work.

It is a job for Solomon.

Now there is to be another Labour barrier to those genuinely wishing to struggle out of the poverty trap. Another Labour barrier which will keep more people on incapacity benefit. Imagine the howls of derision that there would be from the Labour Party if this paragraph appeared in the Tory Party manifesto in the run up to the next election:

New tenants would have fixed-term contracts under the plans, with regular reviews every few years... If a tenant’s financial position improved he or she would be encouraged to take an equity share or to move to the private sector. If they refused they could face higher rents. The right to a council home is also likely to be tied to a requirement to have or be actively looking for a job.

The Times

Derek has been in his council house for over 25 years. He turned down the right to buy it during the Thatcher give-away on principle (unwisely from a personal point of view). Now, if he does go back to work, he will find his increased pay swallowed up in higher rent. Derek stays at home.

Another tax on enterprise. Another restriction of social mobility. Another disincentive to work.

Every Labour government has ended its term in office by handing over a financial crisis of its own making to the next administration. Gordon Brown will be no exception and yet, incredibly, he seems to be on the crest of a wave of new found popularity. The video above is from an obviously partisan source…but can you fault it?

A reader draws my attention to a useful site : "Entitled to..." which will guide you through the Benefits bureaucracy [NHS Blog Doctor]