Will a new Labour government lead to an improvement for those in receipt of disability benefits, many of those with mental health conditions, in the United Kingdom?
The Conservative government launched a Green Paper in April, entitled Modernising Support for Independent Living. In doing so, it could be suggested the decision was simply a way for a cash-strapped government to save money. It could also be considered that it was a governmental step slightly further towards the right in a bid to restrict the agency of Disabled people. Labour could have made a bold move and scrapped the consultation at this point, but they did not.
I work for a small charity in London in one of the most socially deprived local authorities in the UK as a Welfare Benefit Caseworker, and have lived experience of trauma, mental illness and trying to navigate an overly complex welfare benefit system. What is apparent both through my work and personal experience is the strong correlation between mental illness, the benefit system, poverty and ‘recovery’, or lack thereof.
It has recently been proposed that Personal Independence Payment (PIP) eligibility may become based on diagnosis rather than the impact that a person’s disability has on their mobility and daily living, and many of the people I work with are concerned at this seemingly huge step back to a medical model of disability. It is also concerning as diagnoses and labelling in and of themselves are a minefield. Taking personality disorders as an example, there is an increasing trend for this to be labelled as Complex Emotional Needs, which is not a formal diagnosis and may lead to exclusion from benefits, not to mention the further harms associated with either diagnostic term.
Disability benefits have been through may guises and name changes, and sickness and disability benefits as we know them did not even come to exist until the creation of the welfare state in 1948. Prior to this people were generally supported by their family and/or local community, and if not they sometimes ended up destitute and begging on the street.
During the Industrial Revolution there was a huge demographic shift to the cities, often meaning no one was available to provide care, and in 1808 the County Asylums Act led to the creation of asylums for ‘pauper lunatics’ as an alternative to workhouses and prisons.
The Poor Law was not abolished and replaced until the creation of the Welfare State in 1948, when the National Assistance Act was established and placed a duty on local authorities to provide care where no alternative was available – including to those with ‘mental disorders’.
In 1992 Disability Living Allowance was introduced and was the main disability benefit for just over 20 years, and in 2013 PIP was introduced and has gradually replaced Disability Living Allowance for most people. The remit of PIP is to support with ‘extra costs associated with living with a disability or long-term health condition’.
Reasons the Tories are considered to have introduced PIP? To cut costs, lessen eligibility and carry out more reviews that give scope to end entitlement altogether. The idea of introducing vouchers instead of payment was first mooted under Theresa May’s government in 2017, however due to her weak majority and strong objections this did not progress.
Jump forward 6 years and several Tory prime ministers later (Liz Truss, remember her?) to the Sunak government of April 2014 and the launch of the green paper and consultation. The consultation ended on the 12 July, and in between the launch and closing of the consultation there was the General Election leading a Labour supermajority, only slightly behind that of Blair’s landslide in 1997.
PIP can be a lifeline to those with mental health conditions. It gives people independence and freedom of choice in a healthcare system where they are often excluded and disempowered to make decisions that impact on their care. Replacing cash with vouchers would take away that autonomy, and Labour has been tight lipped on the subject; however, they are mentioning a “Back to Work Agenda” and stating Labour will have their own approach to welfare but that too many people are out of work. So far this does not seem to differ too much from Sunak’s ‘sick note generation’ rhetoric, and his comments that claiming PIP for those with mental illness is too easy. Really? Let’s look at personality disorders again: the DWP headline figures suggest 61 percent of applications with this diagnosis as the main condition are successful, however this hides the underlying figure that only 40 percent of initial applications are successful. My clients who were initially unsuccessful then must go through a mandatory reconsideration stage and ask the DWP to look at the decision again. This changes about 15 percent of cases in client’s favour, but if the decision is not changed, we then need to make a tribunal submission and await a hearing date, which is currently taking approximately eight months. The tribunal award around 70 percent of previously unsuccessful cases in the client’s favour, 70 percent! This demonstrates a huge failing.
So, in answer to my question, will a new Labour government lead to an improvement for those in receipt of disability benefits? It may be too early to tell but they have not openly criticised the language used by the previous government or reversed any of the previous government’s plans, for example migration to Universal Credit from legacy benefits, which increases conditionality and over time erodes payment. There is some hope though, in other policy areas they seem to have plans regarding improving life for those with mental ill-health: parity with physical health (how many times have we heard this?), recruiting 8,500 extra mental health staff, including those specialised in crisis management, and also reforming the Mental Health Act in a bid to ensure those detained are treated with dignity and respect. Sadly, the next full budget is not until 2025, and these plans have not yet been costed, so it is unlikely to happen anytime soon. Let’s hope, in the mantra of a previous Labour Primer Minister, “things can only get better”.
Mental Healthcare in a Failing State
This blog is part of our “Mental Healthcare in a Failing State” series which ran between July and October 2024. All the blogs in the series are available here.