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The government doesn’t understand disability

On Monday the government started the roll-out of its new disability benefit, Personal Independence Payments. According to the government, PIP “better reflects today’s understanding of disability.”

As a disabled person and researcher, my first response was to think that ‘DWP’ would have been a better fit than the word ‘today’ in that sentence. PIP is widely viewed as based heavily on the ‘medical’ model of disability, whilst people with understanding of disability today would use the social model.

The distinction is important. The medical model blames the individual for the disability: it is the loss of legs or the pain or the weakness that is the problem. The social model blames society: it is the lack of provision of ramps and automatically opening doors, or inflexible working practices, or the high cost of public transport, that is the problem. If society were built for disabled people, rather than only for able-bodied people, then disability wouldn’t exist.

This isn’t the only reason PIP is controversial. As Bristol and South Gloucestershire Link said, “We are heartily sick of repeated consultations being used against us instead of being positively used.” The Responsible Reform report, also known as the Spartacus Report, was written specifically to point out the numerous instances in which the government ignored disabled people and organisations.

Then there is the issue of cost and need. The government is assuming that the cost of something is correlated to the level of disability an individual experiences. But what does it matter to you if you need supervision, assistance, prompting or another person to convey the food and drink in order for you to be able to eat and drink?  In all four cases (scoring 2, 2, 4 and 10 points respectively) you need someone with you.  That is the same time cost to that person and monetary cost to you, even though the need has increased.

You could assign people into groups based on whether they can walk 1m, 20m, 50m or 100m.  And you could assign people into groups based on whether they can walk 1km, 2km, 5km or 10km.  Both of these would create a gradient of need.  But it isn’t necessarily the case that either is a reliable indicator of cost.

100m isn’t very far; people who can manage that distance may face similar mobility costs as people who can walk only 20m. 10km is relatively far, but a person who can walk only 2km may not have much more if any additional mobility cost. The key issue is at what distance mobility costs increase rapidly. The government appears to think it is at 20m, as this is the cut-off they are using, but if the real threshold is 100m or 200m then many people with the same costs are not getting the support they need.

The government appears to have consistently graded people by ‘need’ without any consideration of at what point costs start to accrue.

The government is also assuming that by measuring a few proxies, a sub-section of abilities, they can assess someone’s overall level of disability and thereby gain an accurate assessment of the extra costs that person experiences. But they haven’t shown that the proxies they use capture enough of a person’s disability to provide a valid scoring system, even if that disability score correlated with cost.

Disability Living Allowance may be out-dated, but then so is PIP is modern given that it seems to be based on the out-dated medical model. DLA didn’t always involve a face-to-face assessment because it was recognised from the precursor, Attendance Allowance, that the face-to-face assessment often brings in a lot of error. Recipients of DLA were subject to review, although understandably those with permanent conditions experienced fewer reviews as there was unlikely to be any change. The DLA budget increased because there are more people now living in the UK, because there are more pensioners claiming DLA, because more people with disabilities are surviving and because there is increased recognition and/or prevalence of mental health issues and learning difficulties.

The DLA budget is being cut. Whilst the forecast expenditure for 2015-16 is higher than expenditure in 2009-10, it is smaller than the expenditure would have been had DLA continued. Expenditure ought to be higher in 2015-16 than 2009-10 simply because there will be more disabled people living then who qualify. 450,000 disabled people will have no disability benefit entitlement at all and 510,000 disabled people will have a reduced award. Yet not only is DLA – like all benefits – under-claimed, but the Joseph Rowntree Foundation concluded that recipients of DLA still face material deprivation because it doesn’t meet all the extra costs that come with disability.

I’m out of space. There’s so much more to say. There is one positive note: claimants who are blind without also being deaf will now qualify for the higher rate mobility component. But all the old flaws of DLA remain: the benefit is out-dated, unlinked to cost, and won’t help get disabled people out of material deprivation.

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