Disability employment - a welcome start
7 Mar 2019
Tony Wilson, Institute Director
Despite record breaking employment, disabled people are twice as likely to be out of work as those who aren’t disabled. And despite manifesto commitments, green papers, white papers and reviews, those odds have barely changed over the last decade. So it’s welcome that after making her first major speech as Secretary of State in January on Universal Credit, Amber Rudd gave second billing this week to setting out her priorities on disability, health and employment. And there is a lot to welcome.
Most importantly, the Secretary of State has set out a range of steps to improve how the benefits system works for disabled people – as she puts it, to “be the ally of disabled people… [to] support them and ensure that the assistance the government provides arrives in the right place for those who need it most.” The headline announcement is the decision to end the requirement for pensioners to be regularly reassessed for Personal Independence Payment (PIP). But alongside this Amber Rudd has also set out her plans to create a single, integrated assessment service for PIP and Universal Credit by 2021; to pilot a single interview to establish eligibility for both benefits at the same time; and to “look in detail” at decision-making before claims reach tribunal. All of these are potentially far-reaching reforms.
On the single assessment service, an issue long raised in independent reviews and in government green and white papers has been the problems created by having entirely separate assessments for PIP and for Employment and Support Allowance (ESA – which is now being replaced by UC). Applicants and health professionals need to submit often very similar information multiple times, and different systems aren’t able to speak to each other to share data. Moving to a single digital platform is no small task but it should begin to address this – making the process less burdensome for individuals, more efficient and with more consistent and better quality outcomes.
However while many people will no doubt welcome this, many more will likely need a lot more reassurance (particularly those whose experiences of assessment and health services have been less positive). Nonetheless the fact that the government is making progress on this, and is committing to put service users at the centre of its design, is a positive sign.
The pilots of a single interview covering both PIP and ESA/ UC then takes this on to its logical conclusion, by seeing whether it’s possible to assess eligibility for both benefits at the same time. This again has long been a goal for benefits reform – around 2.85 million people receive one of these benefits while 1.4 million people get both, so given these overlaps surely it should be possible to look at both at once? In principle this should of course be possible, but in practice it is far from straightforward. Different organisations are contracted to assess for different benefits; it’s likely that relatively few people apply for both at the same time; and entitlement for each benefit is assessed against different activities, using different descriptors and different point systems – all set out in secondary legislation. Often these differences are quite subtle (for example on assessing mobility), but in a worst case we could end up replacing two interviews lasting an hour or so each with one interview lasting more than two hours. And given some of the wider concerns raised around the quality and consistency of assessment (summarised in last year’s Work and Pensions Committee report), many may view this pilot with some caution.
Finally, the news that Ministers will “look in detail” at how decisions are made before they reach tribunals. This is probably the most techy bit among many technical announcements, but the signal that this sends is important. Currently, claimants can ask for a “mandatory reconsideration” of a decision not to award benefit. This involves the case being reviewed by an independent DWP decision-maker. For the WCA, fewer than one in seven decisions are revised by DWP at this stage. However, at the next stage (an appeal tribunal) more than three fifths of decisions are revised (rising to nearly three quarters for PIP). Until now the government has defended this discrepancy on the basis that very few claimants pursue an appeal. By announcing that she will look at this process again, Amber Rudd is acknowledging that the reconsideration stage is not working as it should, and is creating the space to reform or improve it.
Overall, these are potentially significant changes. At the same time though, both the WCA and PIP assessment processes will need more fundamental and radical reform – as Amber Rudd indirectly acknowledges – to deliver a system that really does deliver the right support in the right place at the right time. And ultimately this will require time, trust, some consensus and a government that has the capacity and the parliamentary support to legislate.
Beyond the announcements on the assessment process, this week's speech also tells us more on the direction that Amber Rudd wants to take on increasing employment for disabled people and those with health conditions. There is less detail here, but three things stand out.
First, there’s a refreshing emphasis on employment support rather than (just) conditionality. The Secretary of State confirms that the government will now pilot changes that will ease the conditionality regime for those awaiting their Work Capability Assessment. Currently, under UC the default position is that those awaiting a WCA should be subject to the same (full) conditionality as unemployed claimants without health conditions. These pilots (first floated in a government response to the Work and Pensions Committee last month) will set the default to ‘no conditionality’, with discretion for work coaches to vary this. This is a small but important change, and should create the space to then deliver more supportive, and more personalised, employment assistance at the start of a claim.
Linked to this, Amber Rudd focuses in particular on the scope to do more to reduce absences from work and to intervene earlier. So far, the government’s efforts here have focused on making changes to Statutory Sick Pay and promoting Access to Work and its Disability Confident campaign (with nearly 11,000 employers having signed up). Not much more detail is given in this speech, but there is clear scope to go much further in this area. Much of our own work is focused on these earlier stages of absence – whether through our evaluation of the Fit for Work Service, our work on employee assistance programmes, or our evaluation (for the Work and Health Unit) of the large-scale trialling of Individual Placement and Support. Many of the lessons from these and other initiatives have been summarised here (for the Welsh Government) and point to the need for strong referral pathways; close working with GPs and health professionals; evidence-based employment and health support; and more active employer engagement.
Finally, Amber Rudd gives a clear indication that she wants the government to be more ambitious in its goals on disability employment. For those with longer memories, the Conservatives’ 2015 Manifesto set a target to halve the ‘gap’ between the employment rate of disabled people (around 50%) and non-disabled people (around 80%). By the 2017 election, this had been replaced with a far less stretching aim to increase the level of employment of disabled people by one million – defined in the 2017 white paper as getting from 3.5 million to 4.5 million by 2027. Fast forward to the latest figures, and there are now 3.9 million disabled people in work – so the government is nearly half way to its revised target with more than eight years still to go. However over this time the employment gap has barely budged – standing at a huge 30.2 percentage points. So while more disabled people are in work, the inequalities that they face in accessing work are virtually unchanged. A better and more ambitious measure is needed.
What was not mentioned in this week's speech, however, was employment support for those who have been out of work for some time. And here, the signs are less promising. The government’s main programme for those out of work is now firmly up and running (the Work and Health Programme) but reaching far fewer people than the programmes that it replaced – with the latest figures suggesting that around 45,000 disabled people a year (or around 1% of all disabled people out of work) are likely to benefit. And there was no mention this week of the two million people in the ‘Support Group’ for ESA, who continue to receive virtually no employment support at all. If the government wants to make inroads on employment for disabled people, then we need also to trial better ways to deliver voluntary, engaging and personalised support to these groups – including through wider health and local partners.
So there is much to welcome in Amber Rudd’s speech. While this has been a priority for successive Secretaries of State, this week's speech suggests that we can look forward to a renewed focus on addressing the problems in the benefits system, improving employment support for disabled people and in working more closely and inclusively with disabled people. In all of these areas, there is room to do more – and we will be keen to share our insights on how to do this, and what works, in the year ahead.
Any views expressed are those of the author and not necessarily those of the Institute as a whole.