Our social security system is one of the foundations of the UK welfare state – alongside education, health and social care. It provides a financial safety net for citizens who cannot make ends meet, for example due to being unable to work, being disabled, or being a carer.
Recent UK Government announcements relating to social security have caused serious concern about their effects on many thousands of people’s financial wellbeing. But their effects on the nation’s mental health will be just as profound – and dangerous.
The first, and most significant long-term, announcement was the green paper, Pathways to Work: Reforming Benefits and Support to Get Britain Working. This was a consultation document, though many of its most significant elements are notably not up for consultation.
The green paper includes some positive steps towards supporting people into work. For example, it sets out plans to expand employment support for disabled people and provide both individuals and employers with improved help to get or keep jobs. Evidence-based employment support, using the Individual Placement and Support approach, works – and it changes people’s lives. But it needs the rest of the system to align with its principles to be as effective as possible. If any of the essential elements are missing, it will not work as well as it should. And it could still be undermined by the way the benefits system works, for example through the harmful use of conditions and sanctions.
The green paper states that the Government will abolish the Work Capability Assessment (WCA). In itself, this is a welcome recognition that the WCA is an ineffective method of assessing a person’s ability to work, as well as being a harmful process for many who have to endure it. But the critical question is what will replace it. And if it means extending the scope of the current Personal Independence Payment (PIP) assessment, we will simply be replacing one ineffective system with another. An opportunity for real reform will have been missed.
More immediately, in its Spring Statement, the Government set out short-term cuts to some benefits, including PIP and the health element of Universal Credit (UC) this year. An analysis of the effects of these changes by the New Economics Foundation found that some 340,000 more people will fall below the poverty line as a result. Proposals to bar access to the health element of UC for those under 22 years will severely disadvantage young adults at a crucial time in their lives. Some of this may be offset by a welcome increase in the minimum wage, and legislation that will in future enhance workers’ and renters’ rights. But the overall impacts for the majority of people affected by these changes will be damaging.
Worryingly, many of the reductions in benefit payments or eligibility are specifically targeting people with mental health difficulties. This is in reaction to figures showing that a growing number of people, especially younger adults, are claiming both disability and incapacity benefits because of mental ill health. The age-old narrative that tries to divide the ‘deserving’ and the ‘undeserving’ poor is finding new forms in the denigration of mental distress as a cause of disability and disadvantage.
This is risky enough to those affected, whose lives will be made harder and poorer. But it also makes little sense economically. History tells us that reducing benefits leads to higher levels of mental ill health. So, it is likely that these measures will exacerbate the very problem they are intended to address. We also know from many people with mental health difficulties that PIP helps them to stay in their jobs. Taking PIP away from people may then lead them to lose their jobs: counterproductive for them, their employers, and the economy.
There is also a clear missed opportunity in the Government’s plans. The green paper recognises that delays in access to mental health care are putting people’s jobs and futures at risk. Yet the Government has yet to put mental health waiting lists on a par with those for physical health care. So, long waits continue, but out of sight, and with nothing like the priority afforded to waits for surgery. That is unfair, unnecessary, and economically unwise.
The relationships between work, social security and health are complex. Changes in one area affect all the others. That means policy decisions need to be made with the whole picture in mind. Potentially helpful moves (for example to employment support) may end up being counteracted by harmful changes (to benefit rules and rates) and the opportunity for positive reform is squandered.
A different response would be to act systematically: to address the causes of rising levels of mental distress and ill health; to speed up access to effective treatment and support; to build a fairer social security system that provides a safety net for everyone who needs it; and to help workplaces to become mentally healthier.
The Government rightly notes that our social security system is broken. But its prescription for fixing it may make it worse rather than better. There’s still time to turn this around and rebuild a safety net that works in pursuit of better living standards nationwide. We urge the Government to take this chance to begin a once-in-a-generation reform process that really works.
