Disability and Inequality in the UK

‘Ensuring fairness’ has been the slogan for the moral crusade which the UK Coalition government has been embarking on in its policy of welfare reform since its ascent to office in 2010. So far, draconian measures have been implemented with relatively little resistance. Undoubtedly this is because – as its leaders know, see here  – the British public is largely on its side. They are sceptical about the benefits system, all too eager to differentiate between ‘deserving’ and ‘undeserving’ claimants.

A frequent group labelled ‘undeserving’ are the 2.5 million claimants of sickness benefits. These are perhaps the most diverse body of welfare recipients, comprised of a wide spectrum of people with a plethora of health problems of varying severity. Below I present some facts on disability and social security in the UK and suggest arguments which those on the Left may use to overcome the dilemma between public perceptions of the ‘deserving’ and ‘undeserving’ sick.

The ‘deserving’ sick

Many recipients of disability benefits are extremely sick, with fluctuating conditions which would not be tolerated by any employer. This makes it impossible for them to work, thus making them entirely dependent on state and/or family support. For these individuals, not only do they need income replaced that would otherwise be gained through work, they also require additional funds to meet the costs associated with being disabled.

An analysis by Zadia and Burchardt (2003) shows the significant financial penalty on those with disabilities, which increases dramatically with severity of impairment(s). This ranges from 11% of extra costs in cases of the lowest severity to 69% in the highest. The first argument that the Left must consistently make is that there is a moral obligation for a civilised society to genuinely ensure that people who are sick have an adequate income to live on.

The strength of this argument must not be underestimated. Van Oorschot’s (2006) ‘universal ordering’ of deservingness places disabled people as second only to the elderly in terms of perceptions of entitlement. Indeed, the Coalition is aware of public attitudes on this, repeatedly claiming to ‘protect the vulnerable’. However, while this rhetoric is often banded around, evidence is lacking about the extent to which those with disabilities, and particularly the most severe kinds, are being affected by austerity. The Left must produce and respond to cumulative evidence of the impact of the cuts on those where there can be little to no question about their ‘deservingness’.

‘Undeserving’ claimants

The other side that the Left must wrestle with is how to deal with those on disability benefits who the public consider less ‘deserving’. Undoubtedly this is the greater challenge, as it is currently being monopolised by the Coalition government as a way to drive forward its reforms. Those whom the public are likely to distrust might include people reporting mild/moderate depression, back problems or other less severe or constant conditions.

First, it is important to establish that public concerns are not unfounded. A 2002 survey of Incapacity Benefit claimants found that only one third of adult males felt they could do no work at all (Beatty and Fothergill). Other surveys and qualitative studies reveal similar results (e.g. Alcock et al., 2003, Beatty and Fothergill, 2005). It is therefore unhelpful and counter-productive for those seeking to defend social security to deny that there are people on sickness benefits that should be at work. This does not reflect reality and does nothing to counteract public perceptions.

Rather, a robust argument ought to be constructed about the role of labour market demand in fuelling high and rising sickness benefit costs. The evidence is compelling for a link between claims of sickness benefits and unemployment. For example, Beatty and Fothergill (1997 and 2004) demonstrate that regional variations in claims are concentrated in areas of low labour market demand such as former coalfields, seaside towns and disadvantaged rural areas. The authors describe this as a “diversion from unemployment to sickness”, a rational move as sickness benefits are generally more generous, less intrusive and less stigmatising than unemployment benefits. Similarly, as Baumberg (2011) illustrates, the evolution of a more competitive labour market over the past thirty years has pushed people with work-limiting disabilities - who may otherwise have worked – on to benefits.

In sum, the rub lies in how the problem of the ‘undeserving’ sick is presented and the way in which it is addressed. First, it must not be denied that there are people on sickness benefits that ought not to be there because: 1) the evidence is compelling and 2) wherever possible, we should promote a better life for people than living on benefits. Crucially, however, it must not be drawn from this that people need ‘sticking’ in to work. Rather, the Left ought to promote the right to work and highlight labour market reforms as the best and most humane way to cut the sickness benefits bill. Demand must be stimulated in economically depressed regions and employers must make greater adjustments so that real opportunities are created.