Robert Jenrick is not wrong that Britain’s welfare system has lost the plot. Reform UK’s new policy paper, Making Welfare Work, confirms what the numbers have said for years: since 2002, the share of disability benefit claimants whose main condition is mental health or behavioural has risen from a quarter to nearly half, now 1.6 million people.
But a diagnosis is not a cure, and now that Reform’s plan is actually on paper, significant gaps remain.
Take the central proposal. Under Reform’s plans, cash support above the standard Universal Credit rate would be reserved for “severe” cases, delivered through a new Personal Independence Payment and Health Security Allowance. Conditions such as terminal illness, profound learning disability and blindness would qualify automatically. Others, including ADHD, anxiety and depression, would face “enhanced scrutiny.”
I agree with the principle. I have argued repeatedly that the welfare system should provide more help to those with the most severe disabilities rather than spreading resources so widely that those who genuinely need substantial support lose out.
The trouble is who Reform proposes getting to conduct its assessments: GPs.
For physical conditions with clear clinical evidence, that may work. But Reform itself identifies mental health and behavioural conditions as the source of much of the growth in claims. Here, diagnosis and evidence of functional impairment are not the same thing. A GP may reasonably diagnose anxiety, depression or ADHD, but that does not necessarily establish how severely the condition limits someone’s ability to work, nor does it protect against the influx of ‘coaching’ that can be found online for these invisible conditions.
That is the fundamental eligibility problem Reform has yet to solve. No one can say the current formulaic system works, but Jenrick’s plan risks placing another time-intensive assessment task at the feet of an already overwhelmed GP service without resolving Britain’s diagnosis problem.
Nor is diagnosis the only problem with Reform’s welfare remedy.
Like many before them, Reform has struggled to grasp the fact that many disabled people do want to work. Its plan is much stronger on restricting access to welfare than creating routes out of it. Disability Support Accounts, its main tool for helping people manage the cost of disability, list “employment-related adjustments” among the things they will fund. But those exist to offset costs, not build a route into a job.
Return to Work Cover, the paper’s other big idea, only helps someone who already has a job, or is self-employed, and has gone off sick. Neither policy does much for a claimant with cerebral palsy, multiple sclerosis (MS) or a spinal injury who has never had a job yet wants one.
That is not to say these ideas are without merit. Return to Work Cover, modelled on the Dutch system, saw disability benefit applications fall by around 40% following its implementation in the Netherlands. It would undoubtedly give employers a stronger incentive to support employees back into work. But it also transfers more risk onto employers.
Reform has said firms with five employees or fewer would be exempt, and employer National Insurance contributions (NICs) would initially be cut by 0.2 percentage points to offset the cost elsewhere. But that hardly helps small businesses just above the five-employee threshold, businesses with no HR department and no occupational health budget. How are they supposed to deal with this?
An NIC cut spreads the average cost across the economy, but it does nothing to remove the risks facing an individual employer when one employee develops a long-term health condition. A large company can perhaps absorb that risk, but a small one cannot.
The result is that recruiters will favour candidates who appear less likely to go off sick. A reform intended to reduce welfare dependency could perversely make employers more reluctant to hire disabled people.
There is also the mandatory community work proposal for some Universal Credit claimants. Under it, a £3,200 grant per claimant would cover supervision and training. Only claimants on Universal Credit and seeking work — rather than those in a health-related group, and so exempt from having to seek work to keep receiving UC — would be subject to the scheme. The party’s costings show a modest net saving even in the first year, growing to over £1 billion annually by the early 2030s.
It is not without positives, but some of the details raise fresh questions rather than closing old ones.
Most of all, full, non-time-limited revocation of benefits for missing a shift is a harsher sanction than any workfare scheme this country, or others, has tried. The paper itself mentions how Iain Duncan Smith’s mandatory work activity was struck down by the courts in 2011; the same legal challenges can return quickly. Leaving the ECHR and repealing the Human Rights Act might insulate this next version, but designing policy on the assumption that this has already happened is naïve.
There is much in Reform’s diagnosis that I agree with. Real compassion means enabling independence through work while concentrating the greatest support on those who genuinely cannot work, as the paper seems to acknowledge. But it is much better at identifying what is wrong than explaining how its alternative would help.
It tightens access to benefits, but still relies on subjective medical evidence where claims have grown fastest. It risks making employers more cautious about hiring disabled people. And while it talks repeatedly about work, it offers surprisingly little to someone with a serious disability who wants to enter the workforce for the first time.
Reform has got much of the diagnosis right. Its prescription still needs a great deal more work.
Original photo by ThisIsEngineering.