UK: Errol Graham starved to death after withdrawal of benefit payments

Errol Graham, a 57-year-old man from Nottingham, was found starved to death in his high-rise flat after the Department for Work and Pensions (DWP) removed him from all income support payments.

His death has fuelled public outrage over brutal welfare sanctions adopted by Labour and Conservative governments since 2008.

Errol weighed just 30kg (four-and-a-half stone), or 66 pounds, when his body was found by bailiffs after they broke down his front door to evict him for rent arrears. The flat had no gas, electricity or phone service. Two tins of fish with a use-by date of 2013 were the only food items in the kitchen.

A three-day coroner’s inquest held one year later, in June 2019, found that Errol died of starvation. Evidence presented at the inquest exposed multiple and systemic failures by GP services, Nottinghamshire Health Care NHS Foundation Trust (NHCT), Nottingham City Homes and the DWP.

The department cut Errol’s benefits after he failed to attend a Work Capability Assessment (WCA) appointment in August 2017.

In the anodyne words of Assistant Coroner for Nottingham, Elizabeth Didcock, there were “a number of missed opportunities to better support Errol” between April 2015 and his death in June 2018. This included a complete failure to treat—or even monitor—Errol’s long-term depression and hypothyroidism for more than three years, despite him being sectioned under the Mental Health Act in June 2015.

“The safety net that should surround vulnerable people like Errol in our society had holes within it,” Didcock concluded. Yet she made no formal orders for remedial measures, accepting the DWP’s worthless assurances that it would undertake a “Safeguarding Review.”

Errol’s death only came to public attention thanks to determined efforts by family members, led by daughter-in-law Alison Turner. She contacted Disability News Service (DNS), providing its editor, long-time disability rights campaigner John Pring, with evidence from the coronial inquest. Pring broke the story on January 23, and it was reported widely by mainstream media outlets five days later.

Alison said the DWP’s policies “killed” her father-in-law. She told the Daily Mirror, “I want a guarantee that he wasn’t going to die for no reason—that they will see his death, take on board the seriousness of what they’ve done and learn from it.”

“I want them to learn so that nobody else has to die.”

Turner, who is disabled and the mother of a child with autism, spoke of her anger toward the DWP. “They looked me in my face and had the cheek to tell me that everything they did was by the book and was acceptable. None of it was acceptable.”

The coroner spoke of a safety net with “holes.” But the final years of Errol’s life were a freefall plunge, with overstretched NHS services, callous tenant management practices by the NCH and the DWP’s punitive welfare sanctions all combining to pass a death sentence.

Systemic neglect

Errol suffered from long-term depression, a condition which worsened following the death of his father in 2004. In January 2006, Errol overdosed on sleeping medication and attended the Emergency Department at Queens Medical Centre in Nottingham.

In 2009, he was diagnosed with hypothyroidism (an underactive thyroid gland) and prescribed Thyroxine, with regular blood tests needed to monitor thyroxine levels in his system. (Errol had previously suffered from an overactive thyroid but was overtreated with radioactive iodine and tipped into hypothyroidism as a result).

Assistant Coroner Didcock recounted in her findings the testimony of Errol’s GP who told the inquest his patient was “a proud man, who felt he should not disturb others” and was “reluctant to engage with services.” In April 2015, Errol attended his local surgery where he shouted and behaved aggressively “as he felt the surgery were not helping him, and that he could not get an appointment.”

Less than one month later, on June 1, Errol was behaving oddly and was admitted to Highbury Hospital under Section 2 of the Mental Health Act. The coroner recounted evidence from Errol’s daughter-in-law Alison, “who described that his flat at that time was in a very poor state, with barely any food and no lightbulbs. She said Errol had cut the cables off electrical equipment and had hung them around the flat.”

A consultant psychiatrist who treated Errol at Highbury told the Inquest that Errol reported feeling withdrawn, anxious, and acting out of character following the death of a close friend. Errol was thought to have possible acute and transient psychosis “in the context of psychosocial stressors,” the coroner reported.

Errol remained in hospital for nearly two weeks after he was “sectioned,” with short periods of day-leave beginning on June 8. But on June 13 he did not return to the hospital. Didcock explained, “Police were notified and saw Errol at home, a warrant was applied for but rejected by the magistrate, and the Crisis team were asked to visit.”

The crisis team visited Errol on June 17 and concluded there was no need for readmission. The coroner remarked that Errol’s psychiatrist from Highbury showed a high level of care and concern by visiting him at his friend Liz’s home on June 25 (a practice which is unusual for an in-patient psychiatrist). He found no symptoms of psychosis and concluded Errol was not acutely unwell. A visit by the Community Assessment Team (CAT) followed on July 9, but despite noting that he had stopped taking Citralopram medication for depression and Quetiapine (a sedative prescribed at Highbury) there was no follow-up visit.

The coroner noted that Errol remained “very vulnerable” and found “there should have been more assertive follow up at this time—an appointment offered, or a telephone call to Errol in the subsequent three to four weeks.”

On August 23, Errol’s friend Liz called the Crisis team to warn that his behaviour was again of concern. But this was not considered a “re-referral” and no attempts were made to see Errol. Despite serious multiple health problems, Errol was not seen by a single doctor, psychiatrist or nurse between June 2015 and his death three years later.

Work Capability Assessment

Assistant Coroner Didcock noted, “It was striking at the Hearing how little was known about Errol’s daily life from the summer of 2015 onwards.” Errol withdrew from his family, doubtless under the impact of deteriorating health. After November 2015, he received no further notifications for blood tests or other check-ups from either his GP or Nottingham NHS Health Care.

But Errol did come to the attention of the DWP. Its actions from August 2017 would have catastrophic consequences for Errol and his family.

For many years, Errol received Incapacity Benefit due to serious long-term depression. But in 2008, as part of the Labour government’s punitive welfare reform measures, he was transferred to Employment Support Allowance (ESA). This newly created payment was made conditional on completing a Work Capability Assessment (WCA), including a questionnaire and/or face-to-face interview.

The entire process is designed to dehumanise and shame applicants.

WCAs have been used to deprive thousands of people suffering a mental and/or physical disability of their right to income support and have been criticised by the United Nations and disability charities on human rights grounds. The Maximus corporation (annual revenue of US$2.39 billion) has administered WCAs on behalf of the DWP since March 2015. The company has struggled to drive down costs (i.e., move people off benefits and reject new applicants) to deliver increased returns to institutional shareholders, such as Blackrock and Victory Capital Management.

In August 2016, Errol’s entitlement to ESA was “reviewed” by the DWP. He had already completed questionnaires (known as ESA50 forms) and face-to-face interviews in 2013 and 2014, but a DWP official concluded that because Errol had not seen his GP since 2015, “the claimed level of disability was unclear.”

On this occasion, Errol was not asked to complete a questionnaire (he had previously returned these without any problem). Instead, an appointment for a face-to-face WCA was sent to Errol on August 17, scheduled for August 31. Errol’s lack of health care triggered warnings in just one arm of the British state—the DWP. Its intervention triggered no follow-up with either the NHS or Errol’s GP. The DWP’s interest was entirely punitive.

After Errol did not attend his WCA appointment, the DWP sent two letters asking him to explain his non-attendance. This was followed by a telephone call and a text message. Two misnamed “safeguarding” visits to Errol's home took place on October 16 and 17, but Errol did not respond. His ESA benefit was stopped by the DWP on October 10, 2017.

The DWP was unable to clarify why it stopped Errol’s benefits prior to the so-called safeguarding visits. All sources of income were removed from Errol without any further enquiries and despite a long-term medical condition “that was unlikely to have improved significantly,” the coroner noted. She found that his loss of income and housing support “were the final devastating stressors, that had a significant effect on his mental health.”

The actions of Nottingham City Homes (NCH) were the final contributing factor in this catalogue of state neglect and hostility. NCH is the arm’s length management organisation (ALMO) that managed the high-rise flats on behalf of Nottingham City Council. Errol’s Housing Benefit—paid directly to NCH by the DWP—was stopped on October 17, 2017. After attempts were made to contact him by mail and phone, NCH’s Rent Accounts Manager visited Errol’s flat and spoke with him through the front door. “Errol shouted ‘What do you want?’ on two occasions, and started to punch the door,” Didcock recalled.

Extraordinarily, the NCH did not inform the Rent Accounts Manager that Errol was a vulnerable tenant. It claimed the information was not known, although Errol had disclosed his long-term depression when he filled out his tenant application form. While she criticised the NCH, the coroner concluded that “all appropriate procedures that led to the Court Order for eviction were followed.”

Official cover-up

Didcock’s findings amounted to a cover-up of the DWP’s role. Despite acknowledging that ESA was Errol’s only source of income, she stated, “I cannot say on the balance of probabilities that the cessation of Errol’s ESA led directly to his death.” Instead, she appeared to place the onus back onto Errol, stating, “He did not ask for help from family, NCH, his GP or other support agencies, or contact the DWP to explain his circumstances.”

Having highlighted several “missed opportunities” on the part of Errol’s GP, NHS Health Care, and the DWP, she concluded there was not “a direct causal connection between any of these missed opportunities when considered alone, and Errol’s death.”

Didcock found the DWP currently has “no requirement to seek more information before making a decision to cease benefit following a failed safeguarding visit.” But she issued no “Regulation 28” orders for remedial action to prevent future deaths. Instead, Didcock accepted the DWP’s commitment to carry out a “Safeguarding Review” and welcomed what she described as the DWP’s “commitment to listen to clients and to those representing them, and to ensure that the DWP were focused on support and safety for vulnerable people.”

Errol’s family had every reason to respond with anger to the coroner’s findings, which effectively swept the DWP’s actions under the carpet. In a final act of class justice, the family couldn’t afford a lawyer to represent them at the Inquest, DNS reported, while the DWP employed an award-winning barrister from Parklane Plowdon Chambers.

The DWP has since announced an Independent Serious Case Panel investigation into Errol Graham’s death, but the panel is made up entirely of senior civil servants from the DWP, with no commitment that the findings of their investigation will even be made public.

Last month, Alison told DNS, “It’s truly shocking what the system does to people. I have lived in fear ever since wondering what the future holds for me as a disabled person, and my child who will also rely on the system for support, as her autism amongst other conditions means she is unlikely to be able to live independently.

“I truly fear that the failures that let my father-in-law down will one day fail me and my child.”

Errol’s death was not an isolated occurrence. On December 2, DNS published "The Case for the Prosecution”, presenting the stories of those known to have died after they were denied ESA payments. David Barr, Michael O’Sullivan, Paul Donnachie, Ms DE and John Carré all killed themselves after being found “fit for work” despite serious mental illness. Mark Wood starved to death at his home in Oxfordshire, while Jodey Whiting took her life in February 2017 after her benefits were removed for missing a WCA interview—she was in hospital at the time.

In the cases of Carré and O’Sullivan, coronial inquests found the WCA process had deliberately excluded medical evidence that favoured their claim to benefits.

The true number of deaths caused by the DWP’s hostile environment against sickness and disability claimants is unknown. But between March 2014 and February 2017, around 10 ESA claimants died each day after they were deemed “work ready” and placed in a Work Related Activity Group (WRAG). In the same period, around one claimant died each day after being deemed “fit for work.” Another 12 people died each day while waiting for the DWP to decide their Personal Independence Payment (PIP) claims. This equates to an annual death toll of more than 8,000 people.

In response to Errol’s death, the Guardian, Daily Mirror and pro-Labour Canary cited Labour MP Debbie Abrahams as an opponent of the DWP’s punitive measures. On January 27 she told Parliament, “Particularly worrying are the deaths of vulnerable claimants like Errol, following the DWP stopping their payments. This is in spite of departmental procedures which are meant to protect vulnerable people. This has to be looked at as a matter of urgency.”

Labour’s “opposition” is a fraud. Tory minister Justin Tomlinson replied immediately to Abrahams that the hated fit-for-work test was “Labour’s Work Capability Assessment.” It was the Labour government headed by Gordon Brown which introduced ESA payments and WCA tests in 2008. And they did so with a vengeance. DWP statistics show almost two-thirds of claimants were declared “fit for work” by the DWP in 2009 and 2010, dropping to a quarter of claimants declared “fit for work” in 2014 (at the first stage of the decision-making process).

The WCA tests aimed to undermine any conception of the state’s responsibility to support those with an illness or disability. The Blairites’ sleazy spin urged DWP “clients” to concentrate on the “positives” by “looking at what you can do, not what you can’t do.” WCAs would be managed by a private company—Atos won the initial £500 million contract—with doctors, physiotherapists and nurses deciding eligibility based on a “Logic-integrated Medical Assessment” or “LiMA” designed by Atos and the DWP!

Needless to say, this grotesque parody has nothing to do with any genuine medical assessment (indeed, advice provided by claimants’ own treating doctors is frequently ignored).

More than a decade after the global financial crisis introduced endless austerity, a vicious regime of Work Capability Assessments, welfare sanctions and bogus “fitness for work” criteria are being used to hound the disabled, sick and unemployed from any source of income, driving many to premature death. The Labour Party and its apologists who introduced and supported these measures have blood on their hands. A 2008 editorial from the Guardian, “The benefits of welfare reform outweigh the risks,” supported the axing of Incapacity Benefit and the introduction of WCA’s, asserting, “there is no clear boundary between inability and unwillingness to work.”

For those like Errol and his family, the stakes could not be higher, with working class lives regarded as expendable. As Errol Graham’s partner, Diana Burton, told DNS, “In this day and age, this shouldn’t happen. It’s like we have gone back to Victorian times. Someone should be held accountable for it. If DWP hadn’t stopped his money, he would still be here today. Definitely.”