Between 2013 and 2017 Universal Credit replaces six means-tested working age benefits. Backed by a punitive system of tiered sanctions and fines, Universal Credit represents a major expansion and intensification of personalised behavioural conditionality and indicates the ubiquity of conditionality at the heart of twenty-first century UK social citizenship.

AbstractA strong international reform agenda has been established around the idea that benefit recipients must be ‘activated’ to find jobs. This approach, which has found support across the political spectrum in times of affluence and austerity, rests on previously contested assumptions about human motivation, choice, action and personal responsibility. This article considers the largely untested assumptions within UK welfare-to-work policies and marketised employment services, which are designed to control and modify behaviour through compulsion and incentives. It examines those assumptions in relation to conceptualisations of human agency drawn from social policy literature. A gap is identified between accounts of agency grounded in the lived experiences of social actors (policy-makers, front-line workers and service users) and hypothetical models of individual agency (e.g. ‘rational economic man’) which have been more influential in policy design. It is argued that scope exists for understandings of agency to encompass the motivations, intentions and actions ofallsocial actors involved in the policy process. This highlights the power dynamics of context creation, the universal potential for malevolence and the weight of moral significance. Conceptual and empirical insights point towards understanding the enactment of agency as relational, dynamic, differentiated, interconnected, interdependent, intersubjective and interactive.

British policy-makers have increasingly sought to intensify and extend welfare conditionality. A distinctly more punitive turn was taken in 2012 to re-orientate the whole social security and employment services system to combine harsh sanctions with minimal mandatory support in order to prioritise moving individuals 'off benefit and into work' with the primary aim of reducing costs. This article questions the extent to which these changes can be explained by Wacquant's (2009) theory of the 'centaur state' (a neoliberal head on an authoritarian body), which sees poverty criminalised via the advance of workfare. We present evidence of an authoritarian approach to unemployment, involving dramatic use of strategies of surveillance (via new paternalist tools like the Claimant Commitment and the Universal Jobmatch panopticon), sanction and deterrence. This shift has replaced job match support with mandatory digital self-help, coercion and punishment. In relation to Work Programme providers, there is a contrasting liberal approach permitting

The idea of the active welfare subject has become irresistible to both policy makers and academics and has taken a lead role in the transformation of twenty-first century social security systems. Two distinguishable approaches have emerged – the dominant model and a counter model. The dominant model emphasises moralised individual responsibility for ‘wrong choices’ and mandates behavioural change to become active. The counter model situates benefit recipients in the present as disempowered creative, reflexive and resourceful beings. This article develops conceptualisations by comparing benefit recipients’ accounts (from an exploratory qualitative study) of lived experience with both models.

Smoking is associated with statistically worse outcomes after ESS based on average SNOT-16 scores. Although no investigator has proved that the effects of smoking on sinonasal health are reversible, we counsel smoking patients considering ESS about the desirability of smoking cessation (for this and many health reasons), and the possibility of a poorer postsurgery outcome should they continue smoking.