The WCA's devastating effect on public health

By Savi Hensman
November 17, 2015

A controversial ‘fitness for work’ test has almost certainly had a devastating impact on public health in England, new research suggests. And the increase in death and illness uncovered in this study may be the tip of a larger iceberg.

Harsh treatment of people requiring social security has already been blamed for many deaths. A study in the Journal of Epidemiology and Community Health by researchers from the University of Liverpool and Oxford University, examines the impact on mental health.

Between 2010 and 2013, more than one million people not in paid work due to disability or sickness were reassessed using the Work Capability Assessment (WCA). In those areas with higher rates of reassessment, there was an increase in suicides, mental health issues, and antidepressant prescribing.

Once other factors which could have led to a rise in mental health problems were taken into account, an estimated 590 additional suicides, 279,000 extra cases of mental ill health and 725,000 more antidepressant prescriptions appeared to be associated with the WCA nationally.

A distinguished team undertook the study. For example the lead researcher, Dr Benjamin Barr in Liverpool, was awarded a National Institute for Health Research Fellowship in 2010. Professor David Stuckler at Oxford has written internationally-acclaimed books on the links between health and economics

An accompanying news release First do no harm pointed out that this was “is an observational study, so no firm conclusions can be drawn about cause and effect. None the less, the researchers point out that they were at pains to adjust for other potentially influential factors, and that the observed increases in mental ill health followed – rather than preceded – the reassessment process.”

While further research is required, these findings highlight the level of damage probably arising from the WCA, which may rise further as yet more people are assessed. In addition to those diagnosed with psychiatric problems, many people with physical health problems such as cancer are at heightened risk of depression.

According to media reports, a Department for Work and Pensions spokesperson tried to defend the government’s record, saying "This report is wholly misleading, and the authors themselves caution that no conclusions can be drawn about cause and effect.” Also “it is concerning that they provide no evidence that the people with mental health problems highlighted in the report even underwent a Work Capability Assessment."

Further studies would indeed be helpful but it is reasonably certain that heightened levels of death and illness in areas where more people have been subjected to the WCA are not coincidental. However it is indeed possible that a few of those harmed by the WCA are secondary victims, for instance people traumatised by the death of a family member who had been reassessed or was terrified of the prospect.

Future research may throw light on an even wider problem – the longer-term impact on individuals, families and communities, even if not (immediately) fatal. For instance those committing suicide often have children or grandchildren and the effects on these may take years to become apparent.

In addition, there are physical health conditions that may have been exacerbated by the WCA but without immediate consequences. For example while a few people undergoing or awaiting tests may have had heart attacks or strokes triggered by the stress, more may have found their risk levels increasing, leading in time to avoidable illness or early death.

In looking at findings on major health concerns, from pandemic influenza to the impact of global warming, it is possible to focus on statistics and forget the human dimension. But on this occasion numerous qualitative studies and news reports of individuals subjected to the WCA help to paint a picture of the personal cost, for those fortunate enough not to have been through it themselves.

The WCA is part of a range of government measures aimed at transferring money from the poor to the rich while stigmatising disabled and unemployed people. The devastating impact on public health is gradually becoming clearer. Some may say there is also an impact on the spiritual health of a nation that has allowed such harm to be inflicted on the defenceless. It is time to put an end to this destructive policy.

*Comment on WCA health impacts by Bernadette Meaden

* First do no harm

* If you would like to help scrap the WCA please take part in our survey

* More information here:


© Savitri Hensman is a widely-published Christian commentator of politics, religion, welfare and allied topics. An Ekklesia associate, she works in the care and equalities sector.

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