While cuts to benefits and services will affect most people in the UK, disabled people have arguably been ‘the hardest hit’ - but while this makes the newspapers on a regular basis, academics have been slower to try and piece together what has been happening. So with the fantastic Ruth Patrick, we organised a one-day event in Leeds last week, exploring disability and welfare reform in a climate of austerity. We’ll have more from the conference in the coming weeks, including audio recordings and blogs based on 15 great speakers.
But for now, I wanted to explore the keynote speech given by Prof Paul Gregg. Paul is one of the most rigorous and high-impact social policy academics in the UK, and was involved in the creation of the infamous ‘Work Capability Assessment’ (WCA) which governs access to incapacity benefits. However, as we’ll see below, he has become a staunch critic of the way that this has been implemented, making very public warnings about its effects – and as I was writing this, Labour has committed to reviewing the WCA that they introduced. Most excitingly, Paul also gave us some first thoughts on what a new, radical strategy for disability, work and welfare reform could look like, which I try and summarise here – although obviously this post reflects my take rather than necessarily reflecting his own views. The slides from Paul’s presentation are available here.
Incapacity benefits as a policy problem
To craft policy ‘solutions’ is to have in mind a policy ‘problem’ that needs solving. The first part of Paul’s presentation was a deconstruction of everything that’s wrong with the way that the debate works on incapacity benefits (i.e. benefits granted on the grounds that people are too sick/disabled to work, now called ESA), continuing his analysis at a TUC event earlier in the year:
- The share of the working-age population claiming out-of-work benefits (‘benefits reliance’) is lower in the UK than most comparable countries – as I showed using Paul’s data in a previous post.
- Welfare spending is not ‘out of control’ (indeed, it was more under control 2001-2 to 2007-8 than at any period since WW2).
- Because some people ending up claiming benefits for long periods of time (over 1/2 million people have claimed incapacity benefits for longer than 10 years), there is a long lag time between recessions and the number of people claiming benefits. So ‘fifteen years after a recession, you still see an echo’ in the claim rates.
- Still, while benefits reliance rose until the mid-1990s, benefits reliance went down every year from 1993 until the economic downturn.
This doesn’t mean that there is no problem – but rather that the way this problem is described is often massively over-blown.
The ‘nasty strategy’
Still, there are large numbers of disabled people who don’t work and claim benefits, and in an ideal world many of them would be working .
There are ‘two clear strategies’ for how to respond to this. Current policy follows the first strategy of reducing eligibility for benefits, by making the assessment (WCA) harder. Unlike the headlines that the test is finding only 7% not to be fit-for-work, Paul pointed out that the proportion who are assessed in the WCA who ultimately get ESA is over 50% (excluding those who stop claiming before being tested, and including the results of appeals). And while this is a bit lower than the old incapacity benefit, more people are claiming due to the recession, which means the numbers moving onto benefit hasn’t really changed (see figure below).
However, he estimated that 0.5m would be pushed off incapacity benefits, primarily because certain groups will soon no longer be entitled to them (particularly time-limiting for those who don’t have the ‘most severe’ disabilities and whose partner works). In his words, “little has changed, but big things are about to happen.”
Paul was scathing about this approach. Partly this is because it is the ‘nasty strategy’ that is ‘hostile’ to disabled people, taking no account of the impact on their lives. Perhaps the worst element in his eyes was that the new assessment was introduced without trials or monitoring of its effects, against the advice of Select Committees and others. Instead “it’s an iterative process based on how loud the scream is. And for vulnerable groups this is a stupid system to introduce.”
Partly, though, its a self-defeating strategy because it makes people less likely to go back to work. Disabled people are more likely to ‘hunker down’ and cling onto their benefits rather than take the risk of working and then having to go through the claims process all over again. The appeals process means that many people who ultimately receive benefits are not referred on to welfare-to-work providers to get the support they need in returning to work. And claimants are less likely to have a positive relationship with their welfare-to-work provider – critical for positive outcomes – because of the resentment the system causes.
Beyond the nasty strategy
The present WCA, according to Paul, is a subervsion of its original, pioneering aims. The ideal is to give people help that focuses on what they need to get back to work, rather than the particular benefit they’re on. This is a mutual process between the welfare-to-work provider and the claimant, and can include any sort of support, including workplace adaptations and volunteering. Some parts of the new Universal Credit lean towards this, but this is in ‘profound dissonance’ with a hostile assessment process that destroys the relationship that is needed to underpin such ideals.
What I found particularly interesting, though, was that Paul said “we’ve got to turn our attention to employers here” rather than claimants - setting out new ideas that could be the basis of a ambitious new strategy on disability, employment and welfare reform:
- Retention: the first challenge is to get employers to keep on workers who develop health problems or disabilities; when this happens, “the job you hold is almost always better than the job you would get if you left and got a new job.” A suggestion I really liked was that sick and disabled people should have the same rights as women on maternity leave - that is, they have the right to return to work after maternity leave, the right to request part-time work, and other flexibilities that go beyond the existing requirements for ‘reasonable adjustments’. He also suggested incentives for employers to deliver rehabilitation during sick leave, and possible financial penalties for employers to make staff redundant while they are on sick leave.
- Return-to-work: as Paul says, this is a harder challenge in many ways. He suggested improving the support given to claimants (better incentives to help those furthest away from work, more multi-agency work for those with multiple needs). And he appealed to employers’ social responsibility to improve on this, as happens more in the Scandinavian countries. But this is perhaps an area where even more radical thinking might be required.
It is striking that one of the intellectual pioneers behind the WCA strategy provided such a damning verdict of the current system. But more helpfully, this is the start of what now needs to be done: some rigorous, creative thinking on where we go next. Paul noted that he doesn’t think that this is a complete strategy. But in setting out his thoughts last week, I thought that Paul started a conversation that we must now be having. So enormous thanks to him for agreeing to give the talk at the event, and this is a challenge to the rest of us to build on this in the coming months and years.