I’ve just read the Green Paper Pathways to Work: Reforming Benefit and Support to Get Britain Working. Over recent weeks there’s been much speculation about what would be in the paper. What’s equally important is what’s missing from it. Here’s what caught my attention…
The government wants to tackle the recent increase in benefit claims since 2019, using a two-pronged approach: reduce the cost of benefits, and move as many people as possible from benefits into work. Makes sense. Getting more people into work will reduce the benefits bill. But the government plans to do it the other way round.
Sounding the alarm
The government’s alarm over the cost of health-related and incapacity benefits for working-age adults has been triggered by the significant increase in benefit claims in the past five years, and by projections for costs in future. Total spending on incapacity and disability benefits for working-age adults is expected to reach £70bn by 2030 (p.2). I couldn’t find that figure in the table referenced. That’s not to say the projection is wrong, but it doesn’t appear to take into account the short-term nature of the impacts of the Covid-19 pandemic.
Pandemics usually take the form of successive waves of infection, the first wave causing the most deaths and debility, and later waves having less impact. The Spanish flu pandemic (H1N1 virus) that began in 1918, was considered endemic by 1922, and occurred seasonally for decades afterwards. The number of people with long-term health conditions following each outbreak is cumulative, so with regard to benefit payments what you’d expect to see is an initial sudden increase in sickness and disability claims that tails off over time. The increase in sickness and disability claims following the outbreak of SARS-CoV-2 in 2020 isn’t surprising, but is unlikely to remain at that level for the next five years, as the Institute for Fiscal Studies (IFS) report Recent trends in and the outlook for health-related benefits recognises (Ray-Chaudhuri & Waters, 2024).
The Green Paper claims that post-pandemic spending on disability and incapacity benefits has increased significantly more in the UK than in other comparable countries (§17). However, another IFS report Health related benefit claims post-pandemic: UK trends and global context citing those data notes that if in 2019 the UK had been spending the 2028 projected percentage of GDP on working-age sickness and disability benefits, it would have ranked only 16th in spending amongst the 38 OECD countries and would have been only marginally above the OECD average (Latimer, Pflanz & Waters, 2024, p.25).
The pandemic didn’t only increase the number of people in poor health. It also drove up inflation, which together with the impact of the war in Ukraine on energy prices, triggered a cost-of-living crisis. Ray-Chaudhuri and Waters (2024) point out that people with health issues who hadn’t previously applied for benefits because the process is so onerous, might have been prompted to do so due to pressure on their finances. In short, there is cause for concern about the rise in benefit claims, but it probably doesn’t warrant the level of alarm the government has signalled.
Changes to benefits
The government recognises the structure of the benefits system itself might be a disincentive to people being in work, so changes are proposed for Universal Credit (UC) which is means-tested, and Personal Independence Payment (PIP) which isn’t. Currently, PIP has two components; daily living comprising ten different activities, and mobility comprising two. Points are awarded depending on how much support people need to carry out the activities. Anyone with 8 points gets PIP at the standard rate; they’ll need 12 points to qualify for the higher rate. The assessment isn’t based on whether or not someone can complete a particular activity. The activities have to be carried out reliably; safely, repeatedly, and within a reasonable time period.
UC claimants are currently subject to a Work Capability Assessment (WCA). Recipients are allocated to four different conditionality groups depending on what work-related activity they’re expected to undertake. If it’s the limited capacity for work and work-related activity group (LCWRA), they don’t have to look for work at all, and receive an additional payment referred to as the health element.
The new proposals include scrapping the WCA. That means the PIP assessment will be the only assessment of capacity to work, and there will no longer be a UC LCWRA group – although people who won’t ever be able to work will be recognised. This will decouple the health element of UC from work status, to ensure that seeking work doesn’t jeopardise benefit entitlement. But this proposal isn’t being consulted on; details will be available in the forthcoming White Paper (§37).
The higher rate of PIP is to be frozen for existing recipients – and the rate almost halved for new ones. Probably the most controversial proposal is that PIP will be paid only to those who score at least 4 points on a single daily living component. One of the main purposes of PIP is to enable people to pay for the support they need, which might be aids like a wheelchair or walking frame, or support from a carer. Currently, a claimant who has low level support needs in multiple areas of daily living can score as many points as one who needs substantial support in only one. The problem with the government’s proposal is that several support needs that score fewer than 4 points involve assistance from another person; so if someone needs help with every daily living activity, but still doesn’t qualify for PIP, who will provide it?
Many disabled people rely on family or friends for daily living support. If you provide assistance for a PIP recipient for at least 35 hours a week, and you’re earning no more than £151 a week, you can claim Carer’s Allowance. It’s not much (current rates work out at most at £2.32 an hour) but it can help if you’ve had to give up work or reduce your working hours to provide care for a loved one. The government proposes increasing the amount unpaid carers are allowed to earn, but that will be no help if the people they care for don’t qualify for PIP.
The assumption that people with low-level support needs probably have the capacity to earn a living is not unreasonable. What is unreasonable is the assumption that denying them the support they need for daily living will help them find suitable work. The government has its strategy back-to-front. If people who need assistance with daily living can’t get it, and are unable to find a suitable job, the government’s proposals will in many cases result in people’s health deteriorating.
Young people
The government is especially alarmed at the rise in young people not in education, employment or training (NEET). A Youth Guarantee is proposed to ensure every young person aged 18-22 is in education, employment or training. There’s more detail in the Get Britain Working White Paper published in November 2024, but not much more. Pathways to Work suggests GDP could increase by 1.8% if the UK could reduce the number of young people who are NEET by a third, to match Germany’s rate (§251). It doesn’t mention that the German education system is structured differently, and has a long-standing focus on apprenticeships.
The government is also considering raising the age at which PIP replaces Disability Living Allowance for children (DLAc) from 16 to 18. That makes sense because young people are currently required to be in education or training until they’re 18. Another proposal is to delay access to the health element of UC until the age of 22 – it’s currently accessible to those over 18 and in exceptional cases to 16 and 17 year-olds. But the plan doesn’t appear to have been thought through from the perspective of disabled young people and their families.
The benefits situation for young people with disabilities is not straightforward, but the Green Paper doesn’t clarify how Child Tax Credit (that can be claimed until 20 if a young person is still in full-time education), or how Education Health and Care Plans (EHCPs) that can be in place up to age 25 fit into the proposals. Currently, a young person in full-time education can’t claim UC, and under the new proposals they’re less likely to qualify for PIP, so their unpaid carer wouldn’t qualify for Carers Allowance either. Pathways to Work is dismissive about the impact; “there would be some who gain financially under this proposal and others who would lose out … overall, the proposal would reduce expenditure”(§264). Well, that’s alright then.
Mental health
The government is also concerned about the increase in benefit claims due to mental health problems. It wants to expand access to NHS Talking Therapies (§204). Talking therapies can be effective, but they’re not preventative. Someone on a zero hours contract, who’s built up significant debts, has to use a foodbank, and is caring for a relative who’s been waiting months for medical treatment, is likely to be anxious and depressed. Talking therapies won’t address the root causes of those problems.
Assessments
There have been many complaints about the quality of assessments for both UC and PIP, which the Green Paper understates as ‘some disabled people who claim health and disability benefits lack trust in the health assessment process’ (§165). It proposes to address the lack of trust by making audio recording of assessments standard practice. This is an improvement, but still means claimants will have to actively challenge an assessment they’re unhappy about. There’s no mention of preventing problems by not outsourcing them, or ensuring assessors have the appropriate expertise.
Medical evidence
Pathways to Work points out that people are currently asked to voluntarily provide evidence about how their health condition or disability affects their daily life. That would be because their medical records belong to them, so disclosure has to be voluntary. The Green Paper implies that the problem is with the quality of evidence, and proposes that digitised evidence could be transferred from the NHS to the DWP (§176). That would still require consent, but there’s obviously a risk that people will be required to give the DWP access to their medical records in order to be eligible for benefits.
The right level of support
The Green Paper makes frequent mention of getting the ‘right support’. But it doesn’t explore where that support is supposed to come from. Raising the eligibility threshold for PIP will mean many people won’t be able to pay for support, and many unpaid carers won’t be eligible for Carers Allowance. The NHS has long waiting lists, social care services are close to collapse, independent advice services are overstretched, and there’s little detail about what support people will be offered to help them move into employment.
What is being considered is ‘a new support conversation’ (§217ff) to identify the best next steps for people with a health condition or disability. The support conversation will be ‘delivered’ (I can’t believe I’m reading this) by an ‘appropriately skilled person’ and will result in ‘signposting’. Such conversations might help, but ‘signposting’ is notoriously challenging for anyone with a disability because it puts the onus of taking action on someone who’s already likely to be struggling with daily living. We already know that if people are vulnerable or the system they’re trying to access is difficult to navigate, it’s far more effective to have someone support them by ‘pulling in’ the services they need.
Job-seeking
The new proposals “should make it possible for more people with work limiting health conditions to remain job seeking or preparing for work” (§237) and “there will be the ultimate backstop of sanctions”(§247). Despite reassurances that people in receipt of the health element of UC will not be required to look for work or take jobs (§239) and that sanctions will be a last resort (§247), the proposed system sounds remarkably like the current one.
Employers
To get work, most people will need someone to employ them. The Green Paper wants to develop the ‘digital support offer’ to small to medium-sized employers (SMEs) to enable them to “feel more confident having conversations about health and disability, understand and fulfil their legal obligations and signposts to sources of expert knowledge” (§277). The majority of employers in the UK are SMEs. The challenge for them in employing someone with a disability isn’t primarily a lack of understanding or knowledge – it’s that employing someone with a disability will require the employer to make reasonable adjustments, and making reasonable adjustments requires spare capacity, which is in short supply in SMEs.
But there’s no indication of any practical support being provided, such as specialist work coaches who could be on site to help with the reasonable adjustments; much like the very successful Access to Work scheme that the government feels is unsustainable (§282).
The government is keen on ‘balance’. It wants to ‘balance’ the recruitment and retention of disabled people, and “to get the balance right between supporting employers to understand and provide reasonable adjustments as part of their legal duties and interventions that go beyond this to enable employment” (§282). It’s clear from the experience of Access to Work that the challenge isn’t one of ‘balance’. An effective policy will require recruitment and retention, and employers will have to understand their duties and be able to fulfil them. ‘Conversations’ aren’t going to be enough.
Conclusion
The government’s concern about the benefits and work situation is understandable – although in the context of other OECD countries, the level of alarm seems disproportionate.
The Green Paper is short on joined-up thinking. The UK’s public services and welfare system are in desperate need of reform. It’s a massive challenge which would be impossible to tackle all at once. But to tackle it effectively requires a coherent plan, and there’s no evidence of one in Pathways to Work. Much of the work involving local bodies doesn’t appear to have started yet. Plans for safeguarding and working with employers won’t be revealed until Autumn 2025, and the report on social care won’t be completed until 2028.
The process of getting disabled people off benefits and into work is an equation with a supply side and a demand side. Pathways to Work has a lot of detail about the demand side – the cost of benefits. There’s precious little about the supply side – the practical support required to get people into work.
The Green Paper has the Treasury’s fingerprints all over it; it’s based on the assumption that you have to save money before you can invest it. Rachel Reeves’ self-imposed ‘fiscal rules’ mean the Treasury can’t borrow money to fund government day-to-day expenditure. But restructuring the benefits system and providing support to help people get into work isn’t day-to-day expenditure, it’s an investment likely to reduce costs over time. The government doesn’t need to cut benefits before making that investment.
There are doubtless some people who’ve been awarded PIP who don’t have additional expenses as a result of their disability. And some who could earn enough to cover any additional expenses if they found suitable work. But for most, not being eligible for PIP means they won’t be able to look after themselves properly, so will be in no fit state to look for work, let alone hold down a job. In my view this is a truly poor piece of policy-making. It’s about cutting costs not adding value, doesn’t recognise the wide variation in people’s circumstances, and is incoherent and unworkable. Hopefully, the consultation on the Green Paper will make that plain.
References
Department for Work and Pensions (2025). Pathways to Work: Reforming Benefits and Support to Get Britain Working. HMSO.
HM Government (2024). Get Britain Working. HMSO.
Latimer E, Pflanz, F & Waters, T (2024). Health-related benefit claims post-pandemic: UK trends and global context. Institute for Fiscal Studies.
Ray-Chaudhuri, S & Waters, T (2024). Recent trends in and the outlook for health-related benefits. Institute for Fiscal Studies.
