Myths of absenteeism mask the true issues to be addressed on incapacity
THE commentary about incapacity benefit (IB) in last week's newspapers has been overcooked. But we can't blame the press for saying Peter Hain was mounting a "drive to end sick-note Britain": that came from the Department of Work and Pensions' (DWP) media centre.
Nor can we complain about them inflating the numbers of claimants to 2.7 million. The DWP has combined the figures for recipients of IB and income support, adding nearly a million "claimants not receiving benefit" to the totals they used to report.
The fog of misconception hanging over IB prevents the subject getting a proper discussion. The rules are complicated. IB is based on an assessment of people's capacities, not on the illnesses people suffer from. There are two points schemes, one for physical capacity, one for mental health.
Claims are verified by an independent, privately contracted service, not by GPs. IB is not a soft touch. It is not gained by throwing a sickie and getting doctors' lines. It is not given on the basis of a diagnostic label. We are not in the grip of a "sick-note culture": the number of IB claimants is falling.
Hidden within the myths there are difficult issues to address. IB covers many contingencies: it is partly a long-term sickness benefit; partly a benefit for unemployed people with disabilities; partly a route to early retirement for older workers in poor health. The balance of claimants is changing: there are fewer older people with physical disabilities and more younger people with psychiatric problems.
The government is introducing three major reforms. The first is for various benefits to be combined into one employment and support allowance. This means the kinds of assessment already applied to IB are going to be used for other people on benefits, and they are going to be used much sooner after someone becomes ill. Second, the tests of capacity are being rewritten. The new points schemes are only partly baked: the biggest changes seem to be that the scheme for physical disability will give less priority to physical movement, while the scheme for mental capacity will take more account of conditions such as autism and Asperger's. There will be an extra test, the "work-focused health-related assessment", based on the work people can do. Third, the supervision of benefit recipients is being increased. Inspired by the less-than impressive experience of the "pathways to work" programme, nearly everyone will be on a "support" scheme to encourage them to work.
What effect will this have? The emphasis on getting people into work could be helpful for people with disabilities but it may cause distress to those whose work and earnings have been interrupted by catastrophic illness and alienate people in bad health with little prospect of employment. The government thinks the new tests will lead to large numbers of people being refused. They may be right, up to a point. Many existing claimants would not qualify. But the proposed points scheme makes a much more explicit allowance for problems with social functioning, so some people will have stronger rights. This will cost. If you haven't kept up with this reform, rest assured there'll be another one coming soon.
• Paul Spicker is professor of public policy at the Robert Gordon University, Aberdeen.
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Saturday 25 May 2013
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