“Some vulnerabilities are natural, inevitable, and immutable. Others are created, shaped, or sustained by current social arrangements. While we should always strive to protect the vulnerable, we should also strive to reduce the latter sort of vulnerabilities insofar as they render the vulnerable liable to exploitation.”
Robert E. Goodin, Protecting the Vulnerable
Social Insurance HQ, Nicosia. Through an open doorway, there are thick piles of paper wrapped in string marked ‘Resignations’. A harried-looking woman sitting behind a computer screen casts drawn dark brown eyes at each person who walks through her office door. Lines of people wait and wait for the few personnel available to give them forms and information. There is a uniform expression on everyone’s face; barely suppressed irritation, like the feeling of sitting in a traffic jam.
This is the latest stage in my family’s mission to support my mother in her time of need. As a cancer patient, her needs are paramount, and I’m trying to get the Social Insurance personnel on board with this worthy cause. I find myself repeating over and over to anyone who listens that one-in-three families in Cyprus will have to face the devastating news that one of their members has cancer (Source: PASYKAF). That the Social Insurance department should cooperate more with the Welfare Department to handle these cases more efficiently and provide support. It doesn’t seem to sink in, because when you haven’t faced it yourself, the wall of denial about cancer is completely solid.
The lady surrounded in ‘Resignation’ papers is helpful and sorts out the paperwork for the live-at-home caretaker the Welfare Department finally, after eight months, agreed to help to finance. She was the second lady I asked, because the first one sent me home with a pile of papers to sign after informing me that she didn’t have an email address and could not print the papers I wanted to send her by email from my phone right in front of her. I did ask why the personnel in the Social Insurance department do not have email addresses, since it is 2018. The answer is a shrug and a direction to speak to their superiors. I do mention it to one of their superiors. His answer was a shrug and a direction to speak to his superior. In the Kafkaesque psychology of the whole situation, the personnel in this government department seem ultimately so burned out they can no longer care about anything except going home as soon as possible. As I will explain later on in the article, this has a sinister and negative consequence.
I go downstairs to the ground floor to the cashiers to pay for the caretaker’s Social Insurance contributions. It’s a long wait, there are maybe 100 people waiting to pay as most employees are paid on the last day of the month. When I get to a teller, she looks at me warily when I hand over the confirmation paper. She then informs me that there is a fine on top of the contributions. I explain the circumstances; that the whole process was delayed while we waited for the Welfare Department to approve the subsidy for the live-in caretaker for my mother. That we struggled to pay her salary whilst fighting the initial decision to say ‘no’ to our request for financial help. That the Anti-Cancer Association had to get involved. That I had to petition the Minister of Social Insurance and Welfare. That we couldn’t afford to pay the social insurance contributions until the Welfare Department approved the financial assistance. She shrugged and directed me to speak to her superiors. Her superior directed me to speak to her superior on the third floor.
I made the trek back to the third floor where there were more people doing what everyone does in the Social Insurance – waiting. Finally I spoke with the superior of the superiors. He was apologetic but firm that the social insurance contributions have to be paid, along with the fines. I said, yes, here is the first receipt proving that we will pay them and more will come once the Welfare Department arranges the salary for the caretaker in the next month. Then, my mother’s pension may stretch to covering the contributions, but not the fines. Out of curiosity, I asked what would happen if our family were simply unable to pay them, would my mother be taken to court. Yes, was the answer. Many people are sick or elderly, or have problems, says the superior. And do you send them to court too, I ask. At this point, the superior had the grace to look embarrassed. But clearly, yes, all those vulnerable people – the sick, the elderly, the unemployed, women – are subjected to being taken to court over the social insurance contributions they cannot afford to pay because of financial or health duress. The man looked helpless; it is clear there is no plan to help the vulnerable other than prosecuting them. The superior ventures a guess that it’s the Welfare Department’s problem, not the Social Insurance Department’s and we should apply for more money from them to pay the contributions. That means more time and effort from our family, of course. But why don’t they liaise and do more to support, after all, it’s the same ministry.
I start to feel sick during the conversation. Cancer and Alzheimer’s are the most devastating diseases, they ravage not only a loved one’s health but the family’s financial and emotional resources. Working and productivity drop to the lowest priority compared to the challenge of taking care of that sick person and easing them through their terrible condition. When it is clear that the only response the Social Insurance department civil servants can muster is to send them to court, passing the buck of their responsibility to the judges and lawyers, then there is a humanitarian crisis in Cyprus. Because vulnerable people are being prosecuted by people who just see them as numbers. Mothers, daughters, sons, fathers, all stripped down to what they can pay to the state. Haven’t they paid enough? Didn’t the people of Cyprus rescue the state during the financial crisis? Wasn’t there a lot of praise from the ministers about the people’s hard work? At what point does the state show some appreciation for the human beings pouring their money into its coffers? It is abuse of power when the authorities do not provide the services they are supposed to provide in return for the money paid in taxes. It is abuse of power to delay the much-needed financial assistance for cancer patients and then turn around to fine them for unpaid contributions due to financial hardships. Even worse, send them to court! What happened to us? When did we become so callous, unhelpful and hardened?
Let me be clear that the social insurance contributions must be paid by those who can afford them, but for those who cannot afford them, the humane approach is not to sue them, but to find solutions. To do this, the system must modernise. Email accounts and more open communications would be a good first step. Set up social insurance offices in each district – in Nicosia there are only two, one in Strovolos and one in Ayios Dometios. That is why there are bottlenecks and personnel who don’t have the emotional resources to care even when confronted with the most extreme case of vulnerability. The Social Insurance department must look at its shortage of human resources and hire more personnel to help carry the load of the 500,000 people living in Nicosia. Otherwise, yes, they will be overwhelmed and unable to do anything other than send as many cases as possible to the courts. But it is not the courts that must do their jobs. The personnel in the Social Insurance department must do their jobs, and prosecute only the extreme cases of employee abuse – withholding salaries or firing without cause, or failing to pay social insurance even though they can afford it.
The Social Insurance and Welfare departments need to liaise, to create communications between them and the anti-cancer and Alzheimer’s associations. To support the families in dire straits with concrete and morale measures. To pinpoint the biggest stresses on the family’s productivity and take helpful steps to assist.
To those who say it’s tough luck if you get sick or become elderly, let me repeat that one-in-three families will face cancer in their lives. One-in-three. In Nicosia with 122,000 households (2013 figures) that means 40,260 households will have to deal with this health challenge.
It’s easy to prosecute the vulnerable. So easy. After all they can barely defend themselves. And I’m sure that the SI personnel comfort themselves with the thought that the courts will – in most cases – just fine people in financial or health difficulties. But that’s not where it ends. Because the police collect court fines in Cyprus, they can often intimidate and abuse their power when collecting. Imagine a cancer patient receiving a call from a police officer demanding money. How helpless would that patient feel? How heartless is it to use the full force of the law on vulnerable people?
It’s harder to do the right thing by the people whose sacrifices make it possible for departments such as the Social Insurance and Welfare to exist. It’s harder, but better for the country’s morale.
Any minister of good conscience – and I am sure that the current minister has a good conscience – should not overlook what is going on, and start reforming in a positive way. Primarily, think of the word ‘dignity’. Let people have their dignity. The elderly have given everything they had to society; their children, their work, and their presence. Women are often the primary caretakers of the family and have less opportunities to earn a living. Cancer patients, Alzheimer’s patients, they and their families deserve support, not more pressure.
Dignity. Respect for the citizens who pay for the salaries of government employees.
It’s the bare minimum in a democracy.