By Matthew Smyth and Andy Yorke
A Marxist analysis shows that marginalisation and oppression of disabled people is inextricable from capitalism itself and the exploitation of the working class as a whole. This situation has evolved historically and in recent decades, due to campaigning by disability groups, there has been a sea change from segregation in often barbaric institutions such as asylums to independent living in the community and limited integration into work, under a regime of benefits and for-profit care providers.
Always underfunded and inadequate, this system has been constantly threatened with cuts from inception, with the Starmer government threatening a further round, claiming such measures are ‘unsustainable’ and ‘disincentivise’ work.
Capitalism has created the conditions, infrastructure, wealth and science to liberate disabled people as well as women and other oppressed groups, but its basis in private property, profit and the continuous accumulation or growth of capital block this. The current age of capitalism’s decline as a mode of production, with decades of stagnant or falling profit rates in production, has driven a deepening crisis, austerity and reaction, as past gains are undermined or reversed.
An economic analysis of disabled people’s relation to capital will allow us to understand the underlying relations that have guided policy and attitudes to the present day, and show that the path to true liberation for disabled people cannot come from piecemeal reforms to capitalism, but from socialist revolution.
Mobilising in defence of the rights already gained is part of the struggle to rebuild the workers’ movement on the basis of a transitional programme, leading from today’s struggles – including rights of disabled people to work, to equal pay or benefits equivalent to full-time minimum wage, and benefits to cover the additional costs of living – to overthrowing capitalism and creating a socialist society.
What is disability?
Popular ideas of disability tend to limit it to the most extreme or obvious conditions which often exclude the ability to work: physical disabilities, blindness and deafness, or serious, long term mental health disorders like schizophrenia. However in reality there is a spectrum of disabilities, including ‘hidden’ ones, and these conditions represent the point at which incremental impairment crosses the line of being unable to work, at least without large and expensive adjustments.
This conception leaves out injuries and conditions that are semi-permanent, long-term and require support, whether congenital, arising from working life, or creeping in with age. More recently awareness has developed of common cognitive impairments that may simply reflect normal human variability: approximately 1.5 million people in the UK have a learning difficulty; 700,000 (more than one in 100) are autistic. Besides this ‘neurodiversity’, another ‘invisible’ impairment is the increasing numbers affected by chronic fatigue syndrome (ME), an estimated 250,000 adults and children.
In Britain, workers (as well as applicants, contractors and self-employed) are covered by the Equality Act 2010 (EA), which covers those suffering from a huge number of conditions, from congenital disabilities to long term illnesses or injuries that affect people’s ability to work. This broad legal definition means that 24% of the UK population or 16.1 million people have a disability, according to the DWP’s latest figures, and spending on disability benefits has risen by a third to £48bn since the pandemic and is predicted to rise again to £63bn by 2028-29, according to the Thatcherite Institute for Fiscal Studies.
The increase in recorded disability is often attributed to longer life expectancies and conditions associated with age, such as Alzheimer’s. However, other factors include longer life expectancies for babies born with debilitating conditions, increasing numbers of working-age disabled people and skyrocketing levels of mental distress.
For many of these conditions such as dwarfism, downs syndrome, and wheelchair users, the stigma associated with their visibility is greater than the degree of impairment (if any). These conditions exist on a spectrum that merges into what is viewed as ‘non-disabled’. The cut-off is dependency on benefits due to inability to work, or work adjustments, i.e. related to capitalism’s social relations of production.
So where does human diversity end and disability begin? Is it simply a social construct that can be abolished by fighting for benefits and changing peoples’ attitudes? A Marxist analysis points to disability being a form of oppression fundamentally rooted in capitalism and which flows from its relations of production.
Capitalism and Disability
Under capitalism, everything produced is a commodity, even labour. As Marx discovered, the law of value realised through competition disciplines all capitalists, with the value of a commodity determined by the socially necessary labour time required to produce it. This is based in turn on the average worker working a typical level of machinery with an average work intensity and level of skill.
Some capitalists can ‘beat’ this average by investing in better machinery and raising the productivity of their workers, others lag behind the average, lose profits and go bankrupt. Some small firms at the start of the industrial revolution became giant monopolies, then multinationals as capital was concentrated and centralised through this process, which went global like never before in the neoliberal ‘globalisation’ period.
Socially necessary labour time is the touchstone of capital in all its relations with workers. It covers not just the time necessary to produce the value that goes into paying the worker, but, unlike any other commodity, workers are capable of producing new value, ‘surplus value’ above and beyond their wage (which is our worth to the capitalist, the price we are paid, governed by the labour market). This surplus value is the source of the capitalists’ profit.
Competition between capitalists and ultimately capitalist states forces them to lower their necessary labour time in order to increase the surplus labour time, which can produce surplus value. So the employment of workers who take longer, or need more fixed capital adjustments to produce value equivalent to their wages (or are perceived to do so) will increase the necessary labour time of that particular enterprise or nation. Hence all capitalists want to, and want their governments to expel disabled workers from production, in order to protect their profits.
Historically, workers who were sick beyond a certain minimal level, or worse were injured and permanently unable to work at the average rate or produce any surplus value at all, would be sacked. The law now forces employers to tolerate sickness within limits, hence bosses police this dimension of work rigorously.
There is a constant struggle by employers to avoid their obligations and use redundancies, sick absence controls, ‘capability’ procedures, and harassment and bullying to offload disabled workers. Zero hours contracts and other forms of precarious work have developed to circumvent these extra costs.
Under the EA, a boss can only sack a worker who is injured or mentally ill after a period of a few months if no ‘reasonable adjustments’ (legally a very low bar) are possible, i.e. whenever these eat into profits too much. British bosses are now in revolt over Labour’s very moderate Employment Rights Bill which proposes to expand the right to sick pay from day one of work, even if this remains at the poverty level of statutory sick pay.
A worker who is off work a lot from an injury or mental illness is a risk that the capitalist calculates, given the demand for labour and now legal rights – often long-term sickness is an excuse to get rid of an older worker or union member. However, people with a permanent disability who the capitalist knows cannot ever work at the average rate – or the section who cannot work at all, and on top of that require support from the state, deducted as taxes from their profits – have always been seen as an outright burden.
Despite the many, varied forms of disability, from deafness to paralysis, depression to dementia, all are judged by these two ruthless criteria: surplus value production or the tax burden on capitalists. Hence the most inhumane measures, verging on the barbaric, that are quite openly discussed in the bosses’ press and among political parties towards the disabled and implemented in certain periods, reinforcing prejudices ingrained in society.
In previous modes of production no such identity or label of disability existed. It arose naturally from the capitalist ideology of the isolated, self-reliant ‘individual’ that is based on owning property and engaging in the anonymous market, with the family as a unit of consumption, its unpaid domestic female labour hidden away in private houses.
Under capitalism, disability is seen simply as an individual attribute, in a person’s genes or psyche or injuries. In reality, it is determined to a much greater degree by the capitalist system’s property and profitability, with its social relations, institutions and ruling ideology shaping and underpinning popular attitudes.
By contrast under primitive communism, societies like the Maasai herders do not regard people with a disabling condition as a single, unified category toward whom they relate by a standardised set of behaviours. Those with a congenital disability or acquired impairment like a hunting injury are generally at some disadvantage but to a degree sheltered by the extended family or kin group. In pre-capitalist class societies there was similarly no single label but at least among elites, stigma and exposure for visible, severe disabilities seems to have been common in both Greece and Rome.
Among the peasantry, more cooperative forms of production of all the necessities of life based on the household meant jobs could always be found for those with impairments so that they played some useful role. This does not exclude infanticide, neglect, prejudice or bullying, and of course many died in childhood from their condition who today survive to live adult lives.
But disability oppression has been systematised under capitalism, with its emphasis on the individual worker contracted to the capitalist, their productivity judged by the iron rod of socially necessary labour time. Capitalist ideology stigmatises those that do not work (other than the rich!) and the nuclear family is too weak to support someone unable to work, even with women’s unpaid labour. Both help propagate prejudice and stigma among the working class.
There is also the constant principle, applied from the earliest days of capitalism, that those who do not work must get less than the wage of the poorest paid forms of work – be it the poorhouse or modern benefits – or it will undermine discipline and ‘disincentivise’ people to work. Now capitalism’s decline means a drive to re-discipline the workforce and slash welfare in the pursuit of raising profit rates, further eroding disabled peoples’ position in society and deepening their oppression.
From Poorhouse to Proletariat
Capitalism has gone through different stages of its development over the course of hundreds of years, from primitive accumulation of capital based on slavery, enclosure (the dispossession of the peasantry to create a proletariat) and colonisation, to the industrial revolution and imperialism. This has changed the ways that capitalism manages disabled people’s claims and rights.
As capitalism developed, Tudor-era poor laws became an obstacle to forcing the rural poor, their land expropriated, to work or to migrate to find it, further disciplined by the brutal anti-vagrancy laws. The poorhouse or workhouse developed at the end of the 17th century to house the paupers unfit for work, including ‘the sick, the insane, defectives, and the aged and infirm’ in the language of the time. The 1834 Poor Law ‘reforms’ explicitly linked ‘relief’ (really a ration) to entering a workhouse and submitting to its discipline, which ‘treated the poor with incredible savagery’ (Engels). But as the industrial revolution developed, this institution was marginalised.
Pauline Morris notes in her influential history of institutionalisation Put Away, ‘the operation of the labour market in the nineteenth century effectively depressed handicapped people of all kinds to the bottom of the market, and it is clear that among the legions of destitute and vagrant who existed in Victorian England, there were many who fell into the category of ‘feeble minded’.’ Besides workhouses and jails, the 1808 County Asylums Act created the first public asylums, which by 1900 confined over 74,000 people, often for most of their lives.
The founding principle of any provision of relief was to deter ‘able-bodied malingerers’ using benefits to escape wage labour. A survey of urban workhouses carried out by medical journal The Lancet in the mid-1860s found that ‘a harsh and repulsive regime intended for the repression of idleness and imposture had been and was still applied to persons suffering from acute diseases, permanent disability or old age’, many of which were directly the product of injury or disease at work. In Das Kapital, Marx exposed the ‘human sacrifices’ to profit, cataloguing how industrial processes poisoned, maimed and killed their workforce, concluding:
‘Capitalist production… is very economical with the materialised labour incorporated in commodities. Yet, more than any other mode of production, it squanders human lives, or living labour, and not only blood and flesh, but also nerve and brain.’
Thrown originally into workhouses as part of the poor and unemployed where they weren’t cared for within the family, this became institutionalisation in sanatoriums and asylums in the late 19th century, total institutions based on segregating the disabled in terrible regimes of neglect and brutality.
The approach of the twentieth century saw the development of an imperialist world order, focused on huge colonial empires of a handful of great powers and a struggle for semicolonial spheres of influence in those states outside these formal empires. This saw rising racism, nationalism and militarism, and a concern for the health of the male population as potential soldiers for the trenches of coming world wars. It also saw increased oppression of disabled people.
Winston Churchill exemplified this trend in a letter to Prime Minister Asquith in 1910: ‘The unnatural and increasingly rapid growth of the Feeble-Minded and Insane classes, coupled as it is with a steady restriction among all the thrifty, energetic and superior stocks, constitutes a national and race danger which it is impossible to exaggerate.’ While rejecting sterilisation, the 1913 Mental Deficiency Act legalised the lifetime detention of the ‘feeble-minded’ and ‘mental defectives’.
Along with ‘social Darwinist’ ideologies to justify capitalism, colonialism, and elite wealth and rule, attitudes towards the disabled hardened into a vicious discourse that they were a ‘burden’ and ‘parasites’, or represented the degeneration of the race and nation, often supported by parliamentary representatives and union leaders in the workers movements. This sparked quite mainstream ideological movements for eugenics, leading to the use of sterilization policies, particularly in the USA and Scandinavia. In the ‘midnight of the century’ this plunged into outright extermination under the Nazis.
The fabled 1945 Labour government that launched the NHS and modern welfare state excluded disabled people, with the only benefits aimed specifically at disabled people relating to industrial or war injuries. They deliberately set it at subsistence level, to avoid undermining work incentives and uphold the contributory National Insurance principle.
With segregation came stigmatising laws and ideologies, from ‘ugly laws’ in the US banning the ‘deformed’ from public spaces, and forced sterilization policies which saw 60,000 mostly women sterilised by 1958. The rising eugenics movement was particularly concerned as to the ‘biological quality’ of the working population to supply capitalism’s needs for a large, sufficiently healthy workforce and, as the era of imperialism opened, for soldiers. The 1898 Boer War revealed how many young men from slum backgrounds were unfit for military service, while during WWI the military discovered that nearly 50,000 men had lost limbs at work in peacetime.
The post-WW2 economic boom and the new economic consensus expanded the welfare state, and the social and class movements of the 1960-’70s included an expanding, often militant movement by disabled people and campaigners against institutionalisation and for social inclusion, creating the modern policy of ‘independent living in the community’ and support to enable working where possible as well as care for those who can’t.
As Marx observed, when considering the costs involved in supporting ‘paupers’ in Victorian England, including ‘the demoralised, the ragged, and those unable to work’, ‘capital usually knows how to transfer these from its own shoulders to those of the working class and the petty bourgeoisie.’
Campaigning helped expose a series of abuse scandals, creating wider public awareness and leading in the 1990s to legal rights for disabled people, enshrined in the 1995 Disability Discrimination Act (the precursor to the EA which combined all equality rights) and helping set up the first independent living centres in 1984. These were backed by government policy and seen as an opportunity for the private sector by the Tory government.
Under New Labour the disability rights movement was co-opted by the state, with charities and NGOs pushing aside the movement’s own organisations, while insufficient investment meant that the system of long-stay hospitals remained intact. This has seen a decline in independent living centres for an ever more individualised provision.
Overall, the postwar boom enabled the imperialist countries to develop a welfare state and expand rights, pushed by a strongly unionised working class and from the 1960s the revolts and movements of the oppressed. The process of expansion of the definition of disability to include mental health for instance, as well as push for deinstitutionalisation and social inclusion is only partially advanced in the semicolonial world, if at all, despite changes in discourse and policy at the level of the UN and other imperialist-controlled institutions.
Disability and Socialism
The Russian revolution shows the alternative to top-down reforms and their individualist, isolating benefit regime, under attack from austerity policies driven by crisis. We need to defend and extend existing rights and benefits, while debating a programme of how to transform this into a genuinely socialist, integrated welfare state for all. Disability oppression is fundamental to capitalism, and can only be overcome with its overthrow and replacement by a socialist system based on human need rather than the demand for ever increasing profits.
A socialist economy would democratically oversee the production of use-values to fulfil mutually agreed goals. In this process there is no room for socially necessary labour time, because there is no room for private profit. Labour time would be reduced to a unit of measurement, simply used to allocate resources. Wages would be increasingly equalised and based on an individual’s living costs and needs, not their capacity to perform certain tasks.
Only a workers’ state based on workers’ soviets and democratic planning could integrate disabled people as much as possible into work and wider social life. Besides an integrated health, mental health, and social care system, education and empowerment would dispel prejudice and stigmatisation.
Workers’ democracy, democratic planning and workers’ control over production would ensure necessary adjustments are built into the workplace to allow the fullest participation of all, while safe workplaces would reduce disability.
Expropriating Big Pharma and retooling its resources for human need would lead to a focus on overcoming diseases and genetically caused impairments rather than the billions currently poured into tweaking lucrative medicines to extend their patent life. The socialist transition would see ‘disability’ as a category of oppression wither away, leading to a communist society based on the principle: ‘from each according to his abilities, to each according to his need’.
