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22 November 2023

Punitive welfare reforms won’t help sick Britain

Repairing the NHS and social care is the best way to get the long-term ill into work.

By Anoosh Chakelian

Yet again, the government is trying to conjure up a dormant workforce from the sickbeds of the chronically and mentally ill. The Covid-19 pandemic led to an era of high job vacancies and record levels of people out of work because of long-term sickness. “Economic inactivity” – the measure of those of working age who are neither in nor seeking work – fast became a political preoccupation.

This quickly reached No 10 and the Treasury. The Spectator, in particular, has repeatedly highlighted figures showing five million people on out-of-work benefits. Its former political editor, James Forsyth, left the magazine last December to become Rishi Sunak’s political secretary. The conviction – that the potential to up-staff our economy lay in a population of people who were too ill or otherwise unable to work – stuck. And so has the myth of the “sick army”.

Economic inactivity is a problem, and needs attention. Being ill for a long time is miserable; being off work makes you poorer. The number out of work due to long-term sickness or disability reached a record 2.6 million in July 2023 – a similar number to those now claiming incapacity benefits. It’s a symptom of something going gravely wrong in British society.

But Jeremy Hunt’s Autumn Statement takes the sick army theory to its limit.

In a series of benefit reforms mainly focused on the unwell, disabled and long-term unemployed, the Chancellor today (22 November) announced that if a regular claimant fails to engage in a toughened work search process for six months, they will lose their benefits, free prescriptions, dentistry and access to legal aid. (Those who fail to find a job after 18 months will be forced to undertake a “mandatory work placement to increase their skills and improve their employability”.)

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Under tighter work capability assessments, the tests that decide whether and how much work a sick or disabled claimant is fit to do, hundreds of thousands of these claimants will receive £390 less a month and receive benefits on the condition that they participate in work-related activity (like courses preparing for work).

There are two reasons this risks destitution for people who are subject to either change. First, the state of the NHS and social care. The NHS waiting list stands at 7.8 million; the average median waiting time for treatment is 14.5 weeks and only 58 per cent are being treated within 18 weeks. This will make six months of job-seeking pretty painful for those who haven’t managed to see a doctor yet.

And social care – care in the community and care-home places – isn’t just stretched for elderly people. Because of the rising disability rate among adults, ten times more people of working age are now requesting social-care support than receiving it. Again, without this help, you are less likely to reach a fit state to prepare for work.

[See also: Jeremy Hunt has set a trap for Labour]

Then there is the fact restricting people’s benefits – when they have already been subject to caps and freezes over the past 13 years – is not conducive to work. It leaves people with less of what they need to search for and hold down a job: childcare, fuel, food, emotional resilience and financial security. After 13 years of Conservative governments introducing more and more conditionality, cuts and sanctions into the welfare system, we still have record numbers of long-term sick.

“I’ve always worked and I didn’t want to come out of work. But [benefit reductions] will just make things so difficult,” said Shirley Rigby, 66, a former admin assistant from Ellesmere Port, Cheshire who was made redundant in February and recently diagnosed with autism spectrum disorder. “It’s a question of: do I put petrol in the car, or do I walk it?” Even when she was working in a school office, she had to claim Universal Credit and use her local food bank (it was the Trussell Trust that put us in touch).

“The added stress and worry is not going to help me. In fact, it’s a huge risk to my health,” said Kim*, 39, from north Wales, who is disabled through early-onset osteoarthritis and a mother of four sons. “What would actually help is to be able to heat our homes and eat without the risk of falling further into poverty. I’ve just watched a bunch of rich people smiling, nodding and cheering as they threaten to take money away from some of the most vulnerable of us.”

While there was relief among anti-poverty charities and claimants alike that benefits will rise in line with September’s 6.7 per cent inflation rate (the government had threatened to use October’s lower figure), the cost-of-living crisis is still a reality for millions this winter – particularly those too ill to work.

“He [Jeremy Hunt] is still not helping with bill and food increases: winter’s going to be devastating – we can’t afford to use the heating or put the lights on, and we’re constantly having to think about what food we can afford to buy to keep healthy,” said Brian*, 54, from south-west London, a single father to a 17-year-old daughter and who is off work with long-term mental and physical health conditions. He relies on child benefit and employment support allowance.

“Threatening to take away benefits will only put more pressure on. If I can’t afford prescriptions or the dentist then it’s going to affect my health in other ways.”

It is hard to see Jeremy Hunt’s longed-for sick army rising up and entering work. What is more likely is further destitution – and more complex cases down the line for the ragged NHS and social care system.

*First names only used on request. These interviewees were contacted through the Changing Realities project.

This article was updated on 23 November to clarify the impact of work capability assessment reforms.

[See also: What’s printed on David Cameron’s ministerial briefs?]

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