Benefits: the disabled and deserving?
In yesterday’s Daily Telegraph, Iain Duncan Smith pledged to reform Disability Living Allowance (DLA). He plans to introduce an independent medical assessment, so that only those who really need the benefit get it. More than three million people now receive this benefit, three times as many as when it was introduced in 1992.
The Department of Work and Pensions (DWP) thinks a new, independent medical assessment might reduce the number of people awarded the benefit by around half a million. It will even get a friendly-sounding new name: the Personal Independence Payment (PIP).
That all sounds sensible in principle. But look at the reasons why claimants are awarded DLA and you can see why any reform will be controversial. Statistics give a detailed breakdown of the reasons people claim. It’s a spreadsheet of heartbreak: 564,000 people claim for help with arthritis; 390,000 people with learning difficulties; 259,000 people with psychosis. Smaller groups are claiming for all kinds of reasons: 22,000 have problems with drug and alcohol abuse; 35,380 claimants are terminally ill. It is strangely affecting to see such a litany of human misery tabulated into abstraction by civil servants.
There’s confusion about sickness and disability benefits, not helped by the fact that politicians keep changing the names of the schemes. DLA is there to help people cope with the additional costs of their illness. It isn’t means-tested: children and people who are working can get it, and it doesn’t matter how rich you are.
However, at present it is wrongly believed that DLA is only for people who are out of work. It is true that the number of claims is strongly linked to the local unemployment rate. The parliamentary constituency with the most claims is Knowsley in Liverpool (the safest Labour seat in the country). The Government worries that “receiving DLA in itself appears to reduce the likelihood of being in employment, even after allowing for the impact of health conditions”.
Incapacity Benefit (IB) was meant to compensate people for lack of earnings if illness meant they couldn’t work. About a million of those who claim DLA also claim this benefit. At the end of the last Labour government, IB was rebranded the “Employment and Support Allowance” (ESA), and an independent medical assessment was introduced.
Of those who go through that assessment, only three out of 10 are found fully unfit to work. Two out of 10 are found to be fit to do some work with help, and more than half are fully able to work. This suggests that without the assessment, large numbers of people would be waved through on to benefits they don’t really need. That is one reason ministers are now trying to do the same thing to DLA.
But will the same prove true if a similar reform is introduced for DLA? People who don’t support the change say that while IB was widely abused (not least by politicians who wanted to hide the full extent of unemployment), the same is not true of DLA.
Who is right? The fact that claims for DLA have trebled since its introduction doesn’t prove anything. Thanks to medical advances, more disabled children survive for longer, and we have more old people. The biggest increases have been among the young. And a quarter of the increase is explained by demographics. On the other hand, it is striking that DLA claims have risen even as the number of claims for IB have been falling back. Since 2003, the total of IB claimants is down by 320,000, but 660,000 more are claiming DLA. How many people “should” be getting the benefit is unclear.
At present, for some claimants there is just a paper-based assessment. The Government is concerned that this opens the way to bogus claims. Checking the form against the person’s own GP isn’t ideal either. That was how IB used to work, too, until the medical test was brought in. GPs have little time, and are generalists – not specialists in assessing support needs. One area in which DLA claims have increased is in mental health, illnesses that are notoriously hard for non-specialists to diagnose.
Most claims are based on checking with a claimant’s GP (46 per cent) or another source, such as ringing a carer (36 per cent). In 16 per cent of cases the information on the form is accepted as fact. In contrast, only 6 per cent of claimants are medically assessed by a specialist for the purpose of their claim.
The fact that so few people are independently assessed matters more because there is a now a little industry of companies that will tell you how to claim DLA. For example, the company Benefits and Work will help you to claim it in return for a fee – or you get your money back.
Its website says: “You can’t claim disability living allowance (DLA) for help with grocery shopping. But you may be able to claim for window shopping. Sounds improbable, doesn’t it? But it’s true. What’s also true is that when it comes to claiming DLA, relying on common sense could mean missing out on hundreds, or even thousands, of pounds a year.”
It promises “DLA tips and tactics” including “Dealing with ‘detective’ doctors” and “Why you should stay silent until the pen stops moving”. If that’s too subtle, it spells out that “a subscription to Benefits and Work costs just £19.45 for a full year. It comes with a full money-back guarantee.”
We need a more objective system. But there are costs to this too. First, there is the cost to the claimants. Many seriously disabled people and their families end up spending an eternity filling in forms and being interviewed by social services. The NHS, the school, the local authority, the social worker, the transport people… all demand the same information again and again. “They never read the forms,” one parent of a severely disabled child told me. Imagine having to fill in a tax return every month: except that instead of your income you are being asked about all the things in your life that most make you worry.
The Government is trying to reduce the number of assessments. In fact, the Queen’s Speech pledged to cut assessments of children with special needs. It would be good if the results of the new tests could be shared with other agencies and used to take out a whole bunch of other assessments.
The Government says it will cost £710 million to move over to the new system. But DLA now costs £12,300 million a year, roughly twice what we spend on unemployment benefit. So even a small decrease in the numbers claiming would save a lot of money.
Pensioners won’t be affected by the changes. But the Government says that it expects to reduce the spending on DLA for working-age people by 20 per cent over time. On the surface, that looks bad: surely the Government is prejudging the situation, implying that 20 per cent are falsely claiming? Actually, that target is set against a sharply rising baseline. The goal of the department is to get spending in 2014-15 back down to the level that it was at in 2009-10, which is just below the £12 billion mark.
The 20 per cent figure is really to do with accounting. The Government expects that the reform will save money. If it doesn’t put that saving in its budget plans, it would have to make bigger cuts elsewhere. I suspect civil servants at DWP have probably opted for a pretty cautious savings estimate.
I support what IDS is trying to do. But it’s important that the Government and the media get the tone right, too. Disability campaigners warn that the mistreatment of disabled people is increasing because they are being tarred as “spongers”. That’s profoundly sad.
People on DLA are not scroungers, and those who go out to work despite their disabilities deserve praise, not abuse. We need an objective and fair system to prevent abuse. But looking after people who are disabled is the hallmark of a civilised society.