Ten days ago, Rishi Sunak pledged more welfare reform, promising to address what he termed “sicknote culture.” It was a “moral mission,” he said, to overhaul the current welfare system, which was “unfit for purpose.”
Central to these reforms was:
- a proposed redesign of the main disability benefit, Personal Independence Payment (PIP), to people who claim for depression and anxiety
- proposal to move the responsibility of issuing fit notes from GPs to ‘specialist work and health professionals’
- terminating benefit claims for individuals who have been receiving benefits for 12 months but are not actively seeking available work
Where we are now
With almost one million ‘fit notes’ (previously called ‘sick notes’) issued in the East of England in 2023, and 24% of the region’s population classed as disabled – what will these reforms mean for them?
What are Personal Independence Payments?
Personal Independence Payments (PIP) are non-means-tested and designed to help with the additional costs of daily living, which is on average over £1,000 a month more for disabled people.
Why was PIP introduced?
PIP was controversially introduced in place of Disability Living Allowance (DLA) in the Welfare Reform Act (2012) alongside Universal Credit. As a recommendation of the think-tank The Centre for Social Justice (CSJ), then Work and Pensions Secretary Iain Duncan-Smith, one of the co-founders of the CSJ – claimed it would streamline benefit claims by simplifying the system, save the taxpayers money by outsourcing assessments to private ‘Specialist Healthcare Professionals’, therefore relieving the stress of those claiming benefits. He estimated the change would be complete in three years and cost £2 billion.
The result
Poor management meant the rollout was delayed. By 2022, some ten years later – and the full rollout still another three years away – the cost to the taxpayer is over £16 billion to date, and costs more than the system it was designed to replace.
Since outsourcing PIP assessments, roughly 50% are rejected. Of these, 5% are appealed and 70% of those appeals are successful. Since 2013, these appeals have cost the taxpayer £352 million, and delayed payments to thousands of people who were entitled to them.
In 2020, The Lancet published a report that linked a sharp increase in mental health problems among claimants to these welfare reforms, finding that one in three claimants had become clinically depressed.
Sick note culture? Or more culture wars?
It is often said that the definition of insanity is doing the same thing over and over again but expecting different results. The current trajectory of welfare reform appears to be just that – a rehash of past policies from blueprints laid by the government of 2010, hoping that this time it will work.
Half of PIP recipients suffer from poor mental health. Rather than try to fix the causes, Sunak appears to believe stripping away support for PIP claimants will miraculously spur them back to work. Framing the reforms as “giving back hope” to people who had lost all “dignity and meaning” fails to acknowledge that for most PIP claimants, depression and anxiety is a secondary condition and often complex. And, for many, conditions that can be directly linked to the stress his predecessors policies are responsible for.
For 14 years, the government approach to welfare has been centred around the idea that being tougher on disabled people will help them. Despite attempts to portray himself as the candidate of change in October, Sunak’s words ring hollow when his actions continue to perpetuate the same cycle of blaming and removing benefits from society’s most vulnerable. Genuine reform demands a departure from this punitive mindset toward innovative solutions that address the systemic issues at hand.
