Drawing on ongoing analysis of benefit receipt due to be published this autumn, we can confront David Cameron’s ignorant narrative with some real-world evidence.
Today’s press stories on Employment Support Allowance (ESA) show that politicians and the media are stuck in a mid-1990s timewarp when it comes to sickness and disability benefits.
Far from representing the immobile bloc of long-term worklessness so often assumed in public discussion, the sickness and disability benefit caseload has changed dramatically over the last 15 years, driven by tumbling rates of receipt coupled with increases in severity of impairment.
Failure to recognise the scale of these changes has led both the previous and the current government to indulge in undisciplined and unrealistic expectations about the potential for caseload reductions.
This quotation from David Cameron neatly summarises the received wisdom on IB/ESA:
“For too long in this country we have left people on welfare for year after year when those people, with help and with assistance, could work, and so we’re producing a much better system where we really put people through their paces and say that if you can work, you should work.”
Drawing on ongoing analysis of benefit receipt due to be published this autumn, we can confront this narrative with some real-world evidence.
There are three areas where the shortfall in realism is particularly striking.
(1). “For too long in this country we have left people on welfare”
It is well known that sickness and disability benefits were extensively used in the 1980s and 90s by UK and other governments to encourage some unemployed workers – especially older male industrial workers – to leave the labour market.
Rates of IB receipt rose dramatically, with huge disparities between regions, and between men and women, which could not be realistically explained by differences in health and disability status alone. This ‘hidden unemployment’ is the origin of the lack of public confidence which has continued to dog IB to this day.
But rates of receipt for Incapacity Benefit/Employment Support Allowance have been falling for years, and have fallen most for those groups and areas which were most affected by the policies pursued in earlier decades – older men in industrial areas. The pattern has been one of strong convergence, with regions moving much closer together and falling receipt among older men.
The process is illustrated in Graph 1 below with regional data for one of the groups with the highest rates of receipt, men aged 55-59. There are still gaps between regions, but they are far smaller than in 1999 and a far more consistent with regional differences in health and disability status.
This suggests that if there was a significant ‘hidden unemployment’ component in the IB caseload in 1999, it is now largely a thing of the past – and prompts the question of just how low rates can be expected to go.
Graph 1:
(2). “We have left people on welfare for year after year”
When politicians talk about sickness and disability benefits, they invariably focus on long-term claims. As these benefits need to support people with long-term disabilities, it is inevitable that a significant share of the caseload is long-term in nature.
But IB/ESA are not just for the severely disabled, and long-term claims are the exception, not the rule, except for severely disabled recipients. It is true that at any point in time, long-term claims make up a majority of the caseload, but this is simply due to the arithmetic of stocks and flows.
Taking the caseload over time the pattern is reversed, as illustrated in Graph 2 below, where the picture at one point in time – with a clear majority of claims running for five years or more – is the mirror image of the picture over a five year period.
Characterising the IB/ESA caseload in terms of long-term receipt while neglecting the huge numbers of people moving into and out of the system every year is an arithmetical error which fosters unrealistic expectations and blinds policy-makers to the fact these benefits are also there to support people with temporary and less severe conditions.
Graph 2:
(3). “Those people, with help and with assistance, could work”
Over half of all IB/ESA recipients are now also in receipt of Disability Living Allowance, rising to two thirds among the long-term IB recipients with whom the prime minister is concerned. The rise in DLA receipt is one of the major trends in welfare of the last two decades, reflecting demographic change and trends in disability prevalence.
While many of the DLA recipients who dominate the long-term IB caseload would like to work, their support needs are of a different order to those with less severe impairments. It would obviously be absurd to suggest that putting ‘people through their paces’ and telling them that ‘if you can work, you should work’ are going to make a difference to the employment chances of DLA recipients.
Graph 3:
These developments raise serious questions about how much further the sickness and disability caseload can be reduced without impacting on people in highly vulnerable situations.
This is not shroud-waving: if government intends to maintain a functioning system of support for sickness and disability, it needs to recognise that with IB receipt at low levels compared to a decade ago, any further reductions come with increased marginal costs.
As things stand, those costs are increasingly falling on sick and disabled people, and not on the exaggerated social stereotypes variously described as the ‘hidden unemployed’, ‘discouraged workers’ or ‘benefit scroungers’.
In their zeal to cut caseloads, policy makers have for years been ignoring obvious trends and pursuing self-defeating strategies in the teeth of evidence. It’s high time they recalibrated their expectations to the realities of what has been happening to benefit caseloads since the 1990s.
That would mean asking how the system can meet the twin objectives of supporting people for the duration of their inability to work and maximising the employment chances of people with long term conditions.
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198 Responses to “The three things Cameron should know about sickness and disability benefits”
Joanna Sholem
@Number10gov Please read&circulate this information abt disability&reconsider WCA assessment criteria in light of it. http://t.co/d9giswj
Robert
What you have to ask is how and why Labour under Blair saw this as being about work shy and scroungers, we all know the American were angry they could not enter into the British insurance market as they have in Germany and France and other countries, Germany has an insurance based market in which people earning over £45,000 have to find their own insurance for health and also unemployment so the yanks are in that country.
Here we have had under Blair UNUM Provident, which is an American company kicked out of the state who ended up here, and is desperate to target into our NHS market, so of course Blair responded the Welfare state is under attack, and I think everything we had is under attack, NHS welfare, social housing.
Blair then we had Brown, who told us DLA was a waste of money and he wanted to remove it, but hell that’s Brown for you thick as a plank of wood.
So here are my problems I take each day 12 tablets mostly pain control, but also drugs to control my fits. I have no bowel and bladder function, but I’m lucky that my bladder keeps fluid in, so for me to empty my bladder I have to use a catheter up through the penis into the bladder four times a day, if I do not then my kidneys will become painful and sometimes I will need to go into hospital for treatment. My bowel, the wave motion of the bowel does not work, so I have to take drugs to turn the stool into a fluid which means I will have mishaps some times daily.
so what is wrong, I have a lesion of the spinal cord at the L5 causing what is Parapligia, nothing works from my waist down, and no sexual function does not work.
SO I cannot work, oh boy yes I can given the right job, but thats the problem what is the right job for me.
Well I can show you if you do not believe me, I kept the jobs which are providd from my special disablity help.
Scafolding working passing up poles to people, my job center and Remploy felt this would be good.
Painter decorator, I could paint skirting boards.
Self employed passing out brochures.
Self employed charity collection worker, it would be great because people would feel sorry for me.
Long distance lorry driver.
Ok the jobs we are being offered are just the jobs they have on their books, Remploy just use the job centers computers, so if they have nothing then they just tell you to come back.
Remploy had a job listed on their notice board for a office temp, I said to them what about this, they said ok you will have an interview, I never had the interview they told me it would not be suitable for me as I was disabled, of course they have to pay me the full min wage, they employed a young person on the lowest rate of the min wage.
My special advisor mind you is eighteen years of age, she knows a lot about disablity and working.
The fact is this is all about getting us onto lower benefits dumping us onto JSA removing DLA and making life shit.
I know Sue hates anyone knocking her loved Labour, but Labour and the Tories are backing each other on this.
Declan Gaffney
Tom
I analysed the rise in DLA here [https://www.leftfootforward.org/2011/02/rise-in-disability-living-allowance-explained/]. Piece doesn’t conclusively account for all the changes, but it does separate out demographic factors from others. Increased awareness for mental health looks to be a strong candidate factor when it comes to younger people. I’m more sceptical about advancing awareness as the major explanation more widely. Demographic change alone is playing a big role for a start, and there is an open question is whether rising population prevalence of severe impairment within age groups is also at work.I don’t think we have the evidence to answer that at the moment but we can at least say that the standard a priori assumption, that prevalence should be falling with improved population health status, is no longer tenable (see Berthoud’s work cited in my reply to DavidG). There’s just an awful lot we don’t know about disability, much more than people generally realise.
Dawn Willis
http://t.co/IAVRUWK THIS IS RESEARCH WE'VE BEEN WAITING 4 PLS RT #spoonie #disability @BrokenofBritain Evidence! We're not all "scroungers"
karen machin
.@MarkOneinFour and brilliant analysis here re benefits – http://bit.ly/qLsACR