Over the past two decades, Britain has become both healthier and sicker, closer to full employment and yet ever more inactive. Let me explain this apparent contradiction. In 1981, there were 570,000 men and women of working age who claimed long-term sickness-related benefit. Today, it is called incapacity benefit (IB) and the figure is five times higher. The number of long-term sick stands at a record 2.7 million and they cost the government £7.7bn a year in benefit payments.
The 2.7 million figure dwarfs even the highest count for UK unemployment – the International Labour Organisation’s 1.39 million. In fact, Britain has the worst sickness benefit rates in western Europe. Compare the combined unemployment and sickness rates across the EU 15 in 1999, which show that Britain had 11.8 per cent of its population not working, with France’s 8.7 per cent and Germany’s 8.5 per cent, and the idea that Britain has conquered joblessness starts to lose meaning. The figures might make sense if we were all becoming unhealthier, but judging by most measures, we are healthier than we have ever been.
There is another contradiction. According to a survey by the Disability Rights Commission, 1.1 million people who claim IB want to return to work. Yet the figures also show that, once you are on IB for a year, you are very likely to stay on it for the rest of your life. So why has such a large chunk of Britain’s working-age population become sick and stopped working?
They don’t like talking about IB at Cliffy’s pub in Easington, County Durham. “It’s a matter of pride,” says Bob Johnson, 39. Easington has the worst IB claimant rate in the country: 21 per cent of the district’s working-age population claim sickness-related benefits, compared to just under 3 per cent in counties such as Surrey, Buckinghamshire and Cambridge-shire. “People go on the sick and they end up on IB and they’re stuck there ‘cos there’s no jobs,” says Johnson. He worked in Easington Colliery until it closed on 5 May 1993. He tells me that he then went “on the sick” for a year with a bad back. He starts pointing to people in the pub. “He’s got a job, he’s got a job, he’s got a job, but what about the rest? There’s no jobs around.”
Johnson is doing groundwork now, laying flagstones and other heavy-labour jobs, but he often has to travel far from home and family. “I’ve been to nine counties to find work,” he says. “You don’t get petrol money or travel money. You have to travel for four hours and it’s a 12-hour shift. It’s a hard shift and you’re away from your family.”
An employee of a drilling services firm lists all the places where he has worked in the past year: “I’ve been to Nottingham, Halifax, Halliwell, Ardrossan, Glasgow, Barnsley, Gorebridge . . .” The rest of the list is lost amid an argument over whether Gorebridge was this year or last. In the search for jobs, these men have become migrant workers in their own country.
Jack – he doesn’t want to tell me his second name – chips in. “It’s minimum wage up here,” he says. “You’re lucky to get £6 or £7 an hour.” He’s on and off IB. “Twenty years ago, the main street was chock-a-block. Now the supermarket has to have two-for-one offers on everything so people can afford it. We used to have a healthy community, but now the community is shattered. The seafront is all there is here. That’s about it. I’d rather see the black [the coal]. Friday might as well be Monday now.”
The consensus at Cliffy’s – that a lot more people would be off IB and working if there were jobs around – is supported by Christina Beatty and Professor Steve Fothergill of the Centre for Regional Economic and Social Research at Sheffield Hallam University. Their investigations suggest that 1.2 million IB claimants would be in work if the UK economy were as strong in former industrial areas as it is in the Home Counties. Beatty explains that the claims are not fraudulent; these people really are sick. According to the Labour Force Survey, however, roughly three million people in Britain manage to work despite having a significant health problem. When demand for labour is weak, those with health limitations and long sick periods on their CVs will always be the last to be employed. The Sheffield research team found that 53 per cent of people on IB had left work for reasons unrelated to health. People were getting sacked or taking voluntary redundancy and then claiming IB.
“The Department for Work and Pensions says that there are jobs everywhere, but they are not exactly on your doorstep,” argues Beatty. “No matter how much people are trained or how much you make them job-ready, there are no jobs for them.” Beatty mentions her own father. “He’s 66 and has a heavy manual job [in London], but he’s still working because there’s still demand for him even though he’s got arthritis.”
The history of IB is not just about market forces. During the 1980s, the old Department of Employment was happy for people to claim sickness instead of unemployment benefit. It issued quotas to job-centre managers to keep unemployment figures down. The National Audit Office spotted this political chicanery, but too late. By 1995, there were more than 1.8 million long-term sick. In Easington, 56 per cent of the claimants have been on IB for more than five years.
Yet the decline of heavy industry does not explain everything. Thirty-eight per cent of claimants nationwide are on IB because of mental health problems such as depression, anxiety and stress. This might explain why, even in areas such as Darlington and Hartlepool – more buoyant economically, and where jobs are available – IB rates remain twice the national average.
Take Caroline McKenna, 22, who lost her job two years ago. Unable to find another, she developed sleeping problems and depression. It was not long before she began claiming IB. “I tried medication and I tried counselling,” she says, “but they didn’t work for me. My doctor was really helpful, but the problem with being out of work and depressed is that, as each day goes by, it gets harder and harder to be motivated. Sometimes it was a struggle just getting out of bed. I had no direction and didn’t know what I wanted to do with my life.”
With intensive counselling and advice, the charity Tomorrow’s People helped get McKenna back into a job. Its use of work advisers at doctor’s surgeries has been seized upon by the Department for Work and Pensions and will form part of Labour’s third-term reforms to incapacity benefit. “Our experience with clients,” says Julie Sexton, the charity’s programme manager, “is that the biggest barrier to getting people back to work is their huge lack of self-confidence . . . Things like lack of routine, the stigma attached to unemployment and the lack of direction mean that people start to believe that they’re worthless and that they’re never going to get back to work. That then becomes depression.”
Easington’s director of public health, Anna Lynch, also sees this problem. “It’s something to do with having the stuffing knocked out of you,” she says, “and it’s difficult to put it in a more tangible way. It’s like being knocked off your feet and you are very slow to get up again because everything seems against you.”
The evidence linking unemployment with ill-health is beyond dispute. But have cutbacks and reforms to benefit created even more depression? In 2004, the unemployed got a 50p increase in payments, 2 per cent below inflation and the lowest rise since 1974. Jobseeker’s allowance is now worth £55.65 a week for a single adult aged over 25; according to research by the London School of Hygiene and Tropical Medicine, he or she needs at least £91.
So are the increases in IB rates the result of not treating the unemployed with dignity? Christopher Prinz, a social policy analyst for the OECD, suggests that there are other factors. “I think there is much more recognition of these sorts of problems than there used to be,” he says. “Also, with the increase in stress in the workplace and changing work patterns, we could well be seeing a shift from physical ailments to mental health.”
Whatever the reasons for people going on IB, Kate Welch seems to be able to get them off again. She leads the Action team in Easington, one of 63 around the country. In her room, a cracked wooden board reads: “I can find the win-win in any situation because I am passionate, enthusiastic and inspiring.” Anywhere else, that might seem a bit too Jerry Springer, but not in her office.
The Action team does what it says on the tin. The organisation, linked to Jobcentre Plus, is supposed to get people back into work, but it can be “creative, flexible and innovative”. Welch tells me that this summer she ran a kite festival, started up free complementary therapy courses such as Indian head massage, got 5,000 volunteers to spruce up their community with plants and hanging baskets, and even ran Easington’s very own Pop Idol.
What has all that got to do with getting people back into work? “It’s about getting people involved in courses, whatever it is,” says Welch. “Free broth and stottie; come to a course on dogs and pigeons. Hook somebody in to something and you’ve got them coming to something that is part of their community. [The Pop Idol contest] just caught the imagination . . . Directly [from that] I can say I’ve got four people in work. But indirectly, we’ve got parents flowing through . . . coming to the Action team to look for work. It’s giving people hope: that sense of ‘Yeah, I can do it’ instead of ‘Oh no, there’s no jobs for someone like me’. One of the things about which I take issue with Steve Fothergill and Christina Beatty is that they kind of dismiss this supply-side intervention that goes on. What I would argue is: yes, you need a strong labour market, but you’ve got to give people the skills, and particularly the confidence.”
Over the past four years, Welch’s team has helped roughly 4,000 people back into work, of whom 75 per cent have stayed employed. But most of what she does – reshaping the atmosphere of a deprived community – cannot be measured with targets. Turning around a culture of depression is an intangible art.
And that is what I am told to take back to the politicians. Health isn’t black and white. All those on incapacity benefit are deserving, but some, with a lot of support, can go to work. Others will never and should never work. Incapacitated Britain needs an enlightened bureaucracy: one that realises people might want to work, but does not snatch their benefits at the first sign that they can be productive again. What is needed is carrots, not crackdowns. Suddenly removing financial sustenance from those who are “lounging” on IB will only push them into the abyss.