A response to Stephen Timms

I recently had the opportunity to meet with Stephen Timms, the Labour MP who is Minister for Social Security and Disability. This was as part of a small group of people in receipt of social security, supported by Church Action on Poverty to speak to the minister about the importance of including people with lived experience in the design of policy. You can also read about our experience at the CAoP blog here.

The meeting centred on Labour’s planned cuts and changes to social security for sick and disabled people. Due to technology problems, we asked Syd wasn’t able to join initially, so couldn’t open for us as planned. Niall (CEO of CAoP) opened instead. He had suggested I open, but I felt too overwhelmed at that point, and too unsure of Stephen Timms’ position to really know where to start. Timms then responded to us with three points:

• Employment support will successfully see sick and disabled people, who have been or would be assessed as unfit for work by the Work Capabiity Assessment, enter paid work. This will mitigate the impact of cuts to social security;

• The value of the Limited Capability for Work-Related Activity element of Universal Credit is too high relative to the base rate and creates perverse incentives. Therefore, this element needs to be reduced;

• PIP awards are unsustainable and need to be cut.

Once Timms had given his response to Niall, and in doing so had come across as genuinely believing in and supporting Labour’s rhetoric, I had something on which to frame my own response. However, I couldn’t in the space of that meeting and whilst dealing with my own stress and exhaustion respond as thoroughly and concisely as I would have liked. There were key responses which I only thought of later.

My initial response was:

• Employment support is not going to get substantial numbers of unfit-for-work people into work. For example,

  • In the Employment Support in IAPT trials, people who were in work whilst accessing the service were less likely to be in work after twelve months if they saw an employment support worker than if they didn’t see an ESW.

  • In the Health Led Employment Trials, one site saw a 3% point positive impact, but the second site made no difference.

  • In Work-Related Activity Group pilots for people expected to be able to work within 18-24 months, the Work Programme Pilot and Healthcare Pilot not only made no difference but only say 2-4% enter work at all in two years.

• It is not a bad thing to support sick and disabled people to have a life.

• In saying that PIP is unsustainable, Timms is saying that sick and disabled people are unsustainable. It is not acceptable to say this. 

Timms came back in response:

• Conservative employment support programmes are not comparable to the New Deal for Disabled People which Labour provided when last in government. A disabled constituent of his had been substantially helped by getting employment support through the New Deal for Disabled People. The NDDP saw the disability employment gap fall from 50% to 30%. It was highly successful, and therefore Labour’s employment support will be highly successful now.

This was a very short meeting and already we were running behind in terms of the points that we wished to raise. I think I responded, and I think that what I said was:

• A person with a static disability is not comparable to a person with chronic illness. Conflating the two leads to bad policy.

• People with chronic illness like mine are at risk under the government’s proposals. I don’t get Daily Living PIP, and so if I lose LCWRA status at my next WCA, I will never regain the Health Element of Universal Credit with my current health levels despite having no realistic prospect of ever being able to sustain myself through paid work.

Timms seemed keen to reassure me that I would not lose LCWRA status; he seemed to be very clear that people like me should be treated as unfit for work and unfit for work-related activity.

The points that I did not have time to think of or raise were:

In relation to the constituent given by Timms as an example of the virtues of employment support for sick and disabled people:

• The constituent described by Timms would never have been assessed as unfit for work under the WCA, although they would under the previous Personal Capability Assessment for Incapacity Benefit. Instead of showing that disabled people assessed as unfit for work can in fact work if given support, Timms’ constituent shows that disabled people assessed as fit for work nevertheless need employment support in order to obtain work. Instead of showing that the WCA is too generous and that cuts to sickness benefit will not be a problem, Timms’ constituent shows that the current system does not adequately support sick and disabled people who have enough capacity for work as to be treated as fit for work by the WCA.

• The constituent described by Timms is very unlikely to receive PIP for the Daily Living component.

• The constituent described by Timms is not relevant as an example of someone for whom Labour’s cuts are a good thing. This is because the constituent does not receive sickness benefit and almost certainly doesn’t receive PIP. They are therefore not relevant to discussions of the impact of cuts on people who are too sick or disabled to work, and/or receive PIP Daily Living.

• If Timms thinks that the example he gave is representative of people in receipt of sickness benefit and/or PIP Daily Living, it explains why he is so relaxed about the cuts. He underestimates the level of illness or disability experienced by people on sickness benefit and /or PIP DL, and therefore underestimates the harm caused by cutting our finances and overestimates the potential impact of employment support.

• It is important that Labour MPs understands that people like Timm’s constituent are already not helped by the current social security system. The system is already so harsh as to exclude such people. It is unlikely that making the system even harsher, when Timms clearly thinks that this person is sufficiently disabled to be inadequately supported by standard unemployment benefits, is going to be a positive thing for sick and disabled people.

In relation to my LCWRA status:

• It is not possible for Timms to say that I will retain my LCWRA status at my next reassessment. Whilst I think it unlikely that I lose my Limited Capability for Work status, I do think it is plausible that an assessor would decide – based possibly on government pressure since I was last assessed – that I should not be treated as being at substantial risk if I have to do work-related activity. An assessor might decide that I should be treated as unable to walk, but this isn’t guaranteed either, given that they didn’t use that criterion last time despite my receiving PIP mobility.

• If Timms thinks that people like me should be treated as having limited capability for work-related activity, then his support for Labour’s cuts makes no sense. Under the new system, people who have my type and level of illness but don’t become ill until after 2028 will be treated as fit for work. This is because I don’t get the Daily Living component of PIP. I only score 2 points on washing and bathing (assistance with washing hair and washing below the waist) and 2 points on cooking (can cook a simple meal using a microwave). Yet I am so disabled by fatigue, pain, and post-exertional malaise that I pay for five hours of help in the home each week, including doing my cooking for me, and only wash/bathe once a week. I also have to use mobility scooters to get around outside, and struggle to use buses because of the time they take up and the constant jolting and changes of speed and direction.

  It is not enough for Timms to say that I personally will be okay. Either he thinks that people like me should be treated as unfit for work – in which case he needs to oppose the plans to scrap the WCA and rely on PIP DL – or he thinks that people like me should be treated as fit for work, in which case his support for me is emotive rather than rational.

• Mary was very ill by the end of the meeting, and collapsed onto the floor. She was passing in and out of semi-consciousness. Mary has been assessed as fit for work. Hopefully Timms, having met Mary, would understand that she is not well enough to sustain work. Yet this level of illness is already rejected by our current social security system. If Timms thinks that a person like Mary should be treated as unfit for work, then he needs to work for an assessment system that is more generous than the current process, not substantially less generous.

In relation to the New Deal for Disabled People (NDDP):

• The NDDP was in place when the sickness benefit was Incapacity Benefit, and the test for this was the Personal Capability Assessment. This was a less harsh test than the current Work Capability Assessment. IB therefore included people who were healthier or less disabled than today’s sickness benefit recipients. Furthermore, participants in the NDDP were healthier on average than the typical Incapacity Benefit recipient. The NDDP therefore supported a healthier group of people than those who are on sickness benefit today. The NDDP is therefore not of direct relevance to today’s sickness benefit recipients, and certainly not more relevant than recent employment support programmes.

• In contrast to Timms’ implication that the NDDP had substantial success, participants said merely that it had made ‘some’ positive difference. Only a small number thought the impact was ‘considerable’. Of these, progress was typically slow and variable. Initial courses of action could prove unsuitable, health could deteriorate, and paid work prove unsustainable. Despite volunteering for the programme, over half of participants did not engage in any work-related activities, which report authors said “might reflect their distance from paid work”; and over 80% who applied for work or prepared for self-employment said that they would have done so anyway;

• 25% of participants obtained and maintained work. This meant that the majority of participants, despite being healthier than current sickness benefit recipients and despite receiving employment support, did not obtain and sustain work.

• It is estimated that NDDP made a 10-11% point difference in employment. However, this is looking at point-in-time employment rates, and not at sustained employment. Sustained employment is lower.

• Staff in the NDDP could work with sick and disabled people prior to registering them for the NDDP. This meant that staff would work for an indefinite period with a person, and then only register those people who were close to finding work. The NDDP therefore does not fully capture those people who are unable to find work despite employment support, because many of these people were simply never registered for the NDDP. Despite this, only 25% of NDDP participants got and sustained work.

• It is plausible that the initial fall in the disability employment gap relates more to economic circumstances than to the NDDP. This may also relate to increases in computer-based work, which may have expanded job opportunities for disabled people, but which is not replicable now.

• It is plausible that, as with the recent fall in the disability employment gap, the change relates more to employers recognising existing employees who are disabled (but previously were not recorded as disabled by the employer) rather than because disabled people moved into work.

In conclusion, the example that Timms gave of his disabled constituent, and his conviction that I (and presumably all people like me) should be treated as unfit for work and for work-related activity, shows that the social security system for sick and disabled people should be more generous than it currently is. But Timms is supporting proposals that will make the system substantially less generous. People like Timms’ constituent already can’t get sickness benefit or PIP. People like me already don’t get the Daily Living component of PIP, and therefore won’t get sickness benefit if they only become ill after 2028.

Employment support largely does not work for people treated as unfit for work by the WCA, for the simple reason that we are genuinely unfit for work (see my previous blog posts for more on this). The system already lets down many people who are assessed as fit for work and therefore don’t get a level of benefits adequate to their circumstances. The NDDP had very little impact and is extremely unlikely to have made any measurable difference to the disability employment gap. There is no reason to believe that employment support programmes under the current Labour government will have any better impact than those under the Conservatives or previous Labour governments.

The cuts proposed to the social security system for sick and disabled people have no justification. They are deeply immoral and should be opposed by all those who know anything about disability, chronic illness, social security, and work. The fact that Timms appears to genuinely support these cuts, given his long experience in this arena, is genuinely baffling.