Ministers are considering measures to cut rising spending on disability benefits, and the possibility of merging personal independence payment with universal credit, a new government green paper has revealed.
The health and disability green paper, Shaping Future Support, focuses on reforming personal independence payment (PIP), employment and support allowance (ESA) and the disability-related aspects of universal credit.
It was published just as MPs were about to start their long summer recess.
For much of the Department for Work and Pensions (DWP) document, ministers detail the progress they say they are making to improve the assessment processes for disability benefits, and they ask for suggestions for how to improve the system in the short-term.
It is only in the final chapter of the report that they begin to hint strongly at the need to cut projected spending on disability benefits.
They say that rising spending on disability benefits “suggests there is more we can do to enable independent living and employment” and that they want to “explore making bigger changes to the benefits system” that will mean the system is “more affordable in the future”.
In a section titled Why Further Change is Needed, they point to the increasing numbers of claimants who are assessed as having limited capability for work and work-related activity (LCWRA) under universal credit (UC), or who are placed in the ESA support group.
A forecast in 2012 suggested 15 per cent of all those eligible for ESA would be placed in the support group, says the green paper, whereas current figures for ESA and the LCWRA group of UC show this is now nearer 75 per cent.
And the green paper claims that spending on PIP and ESA (and its earlier and later equivalent benefits) has risen in real terms from about £8 billion in 1980-81 to £31 billion in 2020-21, and is forecast to reach £40 billion within five years.
It also suggests that ministers could create a “new single benefit” so as to simplify the application and assessment process, presumably by merging PIP – which is supposed to contribute towards the extra costs of disability – with the income-related universal credit, although it does not say how this could be done.
This new benefit, it says, could put more focus on supporting people with their extra costs, or alternatively place more of an emphasis on helping people to find and stay in work.
It then offers case studies of four countries – Australia, France, New Zealand and Switzerland – that approach disability benefits in a different way to the UK.
It is likely to concern disabled activists and claimants that three of the countries chosen by ministers appear to provide a less generous system, or at least offer less control to disabled claimants over their support.
In Switzerland, for example, there is a “helplessness allowance” designed to contribute towards extra costs, but it is awarded “only in exceptional circumstances”, while in New Zealand the equivalent to PIP is means-tested and reaches a maximum of only £34 a week, and in Australia disabled people must provide receipts to prove they have spent their funding on goods, services and other support related to their disability-related needs.
There are other hints that ministers want to reduce the number of disabled people who claim out-of-work benefits, with the green paper suggesting that it wants to provide better support for those who are found no longer eligible for LCWRA and to “explore whether there are better ways to target financial support at people with the highest needs so that people do not feel discouraged from trying out work”.
Another warning is that ministers want to “consider” whether any changes should be made to the WCA or PIP assessment criteria, as “some of the activities referred to may have become less of a barrier to independent living and employment”.
It also says that the COVID-19 pandemic “has resulted in more people working flexibly, including working from home”, which “may mean that barriers to work have reduced”.
There is no mention of any of these ideas or the need to address spending increases in the press release published alongside the green paper.
There will now be a 12-week consultation on the green paper, which will include a series of events across England, Scotland and Wales.
The green paper, which will be followed next year with a white paper offering “detailed proposals”, focuses on support for working-age disabled people, and applies only to Great Britain, although some aspects only apply to England, and some just to England and Wales.
There is also no mention in the 46,000-word document of any of the deaths of disabled claimants that have been linked to DWP’s actions and failings.
Instead, the green paper refers to some claimants who “may feel afraid of having to use the benefits system”, to claimants who “sometimes struggle to apply for benefits and can find health assessments difficult”, and to how “a sizeable minority of people are not content” with the ESA and PIP systems.
There is therefore no mention of the findings of a coroner, who concluded in January that flaws in the PIP system were “the predominant factor and the only acute factor” that led to a young disabled mother, Philippa Day, taking her own life.
And the green paper fails to mention the 97 internal reviews DWP has carried out into the deaths of claimants since July 2019.
In many of the sections of the green paper, the government provides no clear suggested policies, or offers only a set of vague principles, such as when suggesting advocacy for some claimants, and discussing how to meet disabled people’s mobility needs.
Much of the paper is taken up with describing changes DWP has already carried out, such as the easing of strict conditions and the use of sanctions for those on out-of-work disability benefits, or policies – like its new Access to Work “passport” – it is still working on.
For the moment, ministers say they have put aside the idea of a single assessment that would test eligibility for both PIP and ESA/universal credit, partly because they operate under different time frames and also because they assess “different ways in which people’s disabilities and health conditions affect them”.
But they say a single assessment could still be possible if they decide to make significant changes to the structure of the benefits in the longer-term, for example by introducing a new single benefit.
Testing a new “integrated health assessment service” is continuing, though.
This would bring the two assessments onto a single digital system, which DWP says would “make our processes more effective and efficient and improve people’s experience”.
And the green paper says DWP wants to make greater use of “triaging”, making early decisions on more “straightforward” claims so claimants only have to go through face-to-face assessments “if absolutely necessary”.
It also discusses its moves towards a more “holistic” approach to making decisions on claims, which allows staff “to take extra time, if needed, to make a decision on benefit entitlement following a health assessment”.
One proposal likely to secure support is to test a simplified application process for those disabled people who are not terminally ill, but who have “severe and lifelong conditions that will not improve”, are “unlikely ever to work again”, and will “always need extra financial support to live independently”.
Members of this new “severe disability group” would use a “simplified process without ever needing to complete a detailed application form or go through an assessment”.
Many parts of the green paper offer few suggestions for reform, such as the section on the much-criticised Disability Confident scheme, which focuses only on marketing and making it easier for employers to sign up, rather than addressing its highly-publicised flaws.
One of the first user-led organisations to comment on the green paper was the National Survivor User Network (NSUN).
Mary Sadid, NSUN’s policy officer, said: “Overall, the green paper reflects a deeply flawed logic that continues to run through government departments: employment as a route out of poverty and hardship.
“This is an employment and disability green paper, fixated on avoiding ‘health related inactivity’, that links worsening health outcomes for disabled people with unemployment, instead of recognising the impact of poverty.
“In 2020, 40-50 per cent of those receiving PIP/ESA had a primary condition related to mental health.
“This green paper fails to offer hope of breaking the cycle of poverty and struggling with your mental health.”
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