Reform’s ‘working welfare’ would undermine, not assist, recovery
The right-wing think-tank Reform, in its report Working welfare: a radically new approach to sickness and disability benefits, has urged that social security support for sick and disabled people be further slashed, in order to encourage more to work. This echoes government rhetoric but would be harsh, unjust and damage public health.
The House of Lords had rejected cutting payments by almost £30 per week to many people too sick or disabled to work. But David Cameron, the Prime Minister, made it clear he was determined to go ahead. He also defended sanctions against claimants, which leave some destitute and have led to deaths.
“We want a benefit system that's there for people who can't find a job who need support”, he said in the House of Commons. “It shouldn't be a lifestyle choice and if people can work, they should work. That's why we have a sanctions system and I believe that sanctions system is fairly applied.”
Reform’s report too is based on the flawed notion that getting tough with people too ill or severely disabled to hold down a job will help them to recover. It recognises that policies designed to get such people into paid work have failed.
But instead of admitting that maybe they need such support, more drastic measures are urged. The authors include Charlotte Pickles, a former adviser to the Work and Pensions Secretary Iain Duncan Smith, so perhaps this is not surprising.
“Evidence shows that work is good for people’s health and wellbeing and being out of work is detrimental to it, including for many people with mental and physical disabilities”, states the report. “In the UK many disabled people want to work but are trapped on what remains a broadly passive system – almost three quarters of claimants who have had their Work Capability Assessment (WCA) are in the support group with no requirement to engage with, and little access to, support services.”
But numerous sick and disabled people do work, in part because they cannot afford not to – employment and support allowance only pays for a fairly basic existence for most people on it. However sometimes they cannot do so safely.
Being serious ill is hardly a pleasant ‘lifestyle choice’. Hospital episode statistics for 2014 -15 give some idea of the scale of the challenge. There were about half a million hospital admissions for patients aged 16 - 64 with malignant neoplasms, nearly as many for diseases of the circulatory system and even more for assorted injuries and 170,000 mental health and behavioural disorders.
Behind each of these there is a personal story, often involving pain and fear, not only for the person concerned but also family and friends. Even if someone does not die of cancer or in a motor vehicle accident, indeed gets better, their body and maybe mind may have undergone serious damage, sometimes irreparable.
Then there are people born with conditions which make holding down a job near-impossible, e.g. those with severe learning disabilities and often others conditions such as epilepsy.
Being sick or disabled often involves extra costs, from needing more heating or having to wash clothes more often to requiring occasional taxis because of panic attacks or frightening hallucinations. Also there may be little chance of replacing broken household items or repaying debts, as when one has been unemployed but gets a job.
The report suggests that the government “set a single rate for out-of-work benefit. The savings from this rate reduction should be reinvested into Personal Independence Payment – which contributes to the additional costs incurred by someone with a long-term condition – and into support services.”
But the government is already planning further restrictions on the availability of PIP and social care and community health services are starved of funds. So many people would be much worse off, though some working people getting PIP might receive slightly more money.
“Moving to a single out-of-work allowance is also a key precursor to a more personalised system focused on what a claimant can do,” the report continues. “The claimant and health adviser should, where appropriate, jointly produce a rehabilitation plan, and this should come with a personal budget. Those with mild or moderate health conditions that, with support, could be managed should be expected to take reasonable rehabilitative steps – some level of conditionality should therefore be applied.”
Yet of course numerous patients and the health professionals who work with them, and who are often far better qualified than these “health advisers” would be, already make strenuous efforts at rehabilitation. The idea that a miracle cure would occur through threatening to take away the income on which someone relies to survive seems fanciful.
And if, say, someone has quit work because it proved too stressful – e.g. an ambulance worker with post-traumatic stress disorder after being brutally attacked – returning to a working situation may badly damage health.
Likewise if someone has very limited energy, this might be more fruitfully used in enabling them to get to the toilet, make themselves the odd cup of tea and maybe occasionally play with their children, rather than shelf-stacking until they collapse.
In general poverty and lack of control over one’s life are among the factors which can lead to ill health. So the end result would be to worsen public health, as well as inflicting distress on individuals, families and communities.
Better access for disabled people, including more flexible working, would help some people to get into work, but funding for 'access to work' support is being squeezed. More rehabilitation (e.g. for stroke and heart patients) and preventive health programmes, as well as early years support, could also reduce long-term ill health and impairment.
However, Reform takes aim at the wrong target. Its prescription would do more harm than good and result in a less physically, mentally and spiritually healthy society.
* Read Working welfare here
* Ekklesia associate Savitri Hensman is the author of Sexuality, struggle and saintliness: same-sex love and the church, which can be ordered from The Book Depository, AbeBooks, and Waterstones, price £12.99, or as an ebook at £3.99 from firstname.lastname@example.org.
© Savitri Hensman is a widely-published Christian commentator on politics, religion, welfare and allied topics. An Ekklesia associate, she works in the care and equalities sector.
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