Any government would take fright at the astonishing rise in people on disability benefits. It began pre-pandemic, but really shot up afterwards. Rishi Sunak said this week that the number had tripled: “So do I think our country is three times sicker than it was a decade ago? The answer is no.” That is the great question. What if the answer is yes?
Today’s Office for National Statistics figures on life expectancy tell a miserable story: already stalling pre-pandemic, it has fallen to 2010 levels. “It’s not had the expected bounce back,” says the King’s Fund, “pointing to deeper problems with the health of the nation and the resilience of the healthcare system.”
The predicted rising costs of our declining health are hair-raising. The OBR forecasts disability benefit spending to increase by a startling 35% between 2023-24 and 2027-28, to £52.8bn, with 500,000 new claimants. This is a far steeper rise than equivalent countries, says the author of Institute for Fiscal Studies (IFS) research, Sam Ray-Chaudhuri; “The UK stands out.” And not due to generosity: the UK has one of the lowest out-of-work benefit rates.
The government promises a massive cull, writing benefit savings into its bogus accounts for 2025, so Labour will have to proceed or stop it.
So has claiming benefits become any easier? The government’s website makes it look deceptively simple: just fill out a form and Bob’s your uncle. Ask Citizens Advice, however, and the obstacles to claiming the personal independence payment (Pip), which the government is moving all disability cases on to, overflow the caseloads of its advisers.
When applying on paper with medical letters for evidence, only glaringly obvious cases of disability are accepted. The bulk are called for face-to-face assessments, run by Capita, to complete often distressing tests to prove what you can’t do. The IFS says a third of new claims are for mental health conditions, with anxiety, depression and stress rising: but proving those is hard. If they fail, there’s a mandatory reassessment: as ever, at the tribunal stage 70% of decisions are overturned, with benefits finally granted after a 16-week wait.
Explaining disability benefit complexity would fill this page, but Pip is just one of the disability benefits that is included in the rise, alongside employment and support allowance, Jeremy Hunt’s answer to push people towards work, among others.
Why this soaring number of claims? This government was always brutal on benefits, with Iain Duncan Smith’s notorious “fitness for work” tests setting the tone. Stigma came from the top, as research showed. There was a sharp increase in the use of words like “scrounger”, “cheat” and “skiver” in reporting disability and a vogue for shockumentaries on “disabled” claimants running marathons – and shows like Benefits Street, with their juicy “characters”. One good anecdote trumps official figures that show Pip fraud and error rates at just 1.9%.
“The system is not working as it was designed to work,” Rishi Sunak told the BBC this week. Indeed, Pip was designed in 2013 to cut claimant numbers, the previous system declared “out of control”. So have they gone soft? Absolutely not, says Rebecca Rennison, Citizens Advice policy manager. There’s no sign of weaker claims. If the system was more lax, applicants’ success rate would rise: it hasn’t. The right talks of cheats, workshy laziness, snowflakes wimping out over normal anxiety, a country that has lost its work ethic and sense of shame; so buck up and toughen up those benefit conditions.
The dismal truth is that, as the ONS says today, we are a sicker country. The London School of Economics’ Prof Richard Layard, labour economist and co-editor of the annual world happiness report, says: “We are the only country where happiness has not recovered since Covid.” There has been a great increase in long-term sickness and “NHS waiting times give us the highest number who can’t get health treatment when they need it, among similar countries”. Ray-Chaudhuri says: “There has been a general worsening of health. The raised excess mortality figures suggest it, as do health surveys.”
I spoke to those seeking explanations for this threefold increase in officially recognised disability. The cost of living, says Citizens Advice, has made people higher up the income scale claim for the first time for extra costs of disabilities they have absorbed for years. Some say Covid cash has made people feel less stigma about claiming, more aware of entitlements.
The Institute of Psychiatry, Psychology & Neuroscience refers me to Dr Annie Irvine, of King’s College London’s ESRC Centre for Society and Mental Health, who researches the effects of work, welfare reform and living conditions on mental health. She talks of reasons why people are not fit to work: extreme poverty, no childcare, domestic violence, debts, insecure housing, precarious jobs that don’t give guaranteed hours each week, fear of inflexible employers who make no allowances. Hardship and struggles reduce people to a state that means they can’t cope with work; but “the benefit system insists that every experience is described in mental health terms. That’s the only box there is.” Their mental health is indeed bad, she explains, “but that’s often the result of their lives, rather than a recognised mental illness,” after years of vanished services that might have helped sooner.
Those sound like wise words. A country battered by austerity cuts, with public services reduced to emergencies only, has inflicted real damage on people. Ray-Chaudhuri says bleakly: “We are a poorer country.” People are sicker in poorer countries.
What will Labour do? Liz Kendall, shadow work and pensions secretary, utterly rejects Sunak’s allegation that people are claiming disability benefits needlessly. “We are an older, sicker nation. Poverty and ill health are inextricably linked, after a decade of cuts that took support away, with years of healthy life falling, and appalling waits for treatment.” Of course disabled people want to work, she says, but root causes need tackling first, not “pushing people into any old job”, a strategy that is bound to fail.
The figures are “terrifying”, she says. “The Tories hope it’s a wedge issue, casting us as pro-scroungers,” but the answer is support, not “a meaner, nastier system”. We know not to bother asking Labour about budgets yet, but the figures are indeed terrifying.
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Polly Toynbee is a Guardian columnist
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This article was amended on 12 January 2024 to make clear that Dr Annie Irvine was speaking in her capacity as a researcher for King’s College London’s ESRC Centre for Society and Mental Health.
