{"id":10410,"date":"2025-03-26T16:26:10","date_gmt":"2025-03-26T16:26:10","guid":{"rendered":"https:\/\/www.dannydorling.org\/?p=10410"},"modified":"2025-03-26T16:26:10","modified_gmt":"2025-03-26T16:26:10","slug":"uk-welfare-reforms-threaten-health-of-the-most-vulnerable","status":"publish","type":"post","link":"https:\/\/www.dannydorling.org\/?p=10410","title":{"rendered":"UK welfare reforms threaten health of the most vulnerable"},"content":{"rendered":"

Cuts to disability benefits will worsen health and the economy<\/strong><\/p>\n

The chancellor of the exchequer, Rachel Reeves, will set out the UK government\u2019s spending plans in her spring statement on 26 March.1<\/strong> The consultative green paper, Pathways to Work,2<\/strong> has already outlined plans to cut several billion from the welfare budget, with the aim of saving \u00a35bn by 2029-30.3 The plans include stricter criteria for personal independence payments (PIP) for people with disabilities; halving incapacity benefit payments under Universal Credit for new claimants; and restriction of incapacity benefit top-ups to those aged 23 years and older.<\/p>\n

Ministers have argued there is a \u201cmoral case\u201d for these cuts, and that \u201cpeople that can work [should be] able to work.\u201d3<\/strong> However, the chancellor\u2019s approach is unlikely to achieve this goal for two key reasons. First, high rates of economic inactivity in the UK reflect its almost unique failure among industrialised countries to recover population health after the pandemic,4,5,6<\/strong> which came on top of over a decade of declining health linked to austerity,7<\/strong> as well as long term structural weaknesses of precarious employment in a low pay economy.8<\/strong> Second, health outcomes and economic policy are inseparably intertwined\u2014even if the government chooses to focus solely on the economy, it cannot expect growth without a healthy population.5,6<\/strong><\/p>\n

Evidence from austerity<\/strong>
\nThe experience of the past 14 years of austerity is a warning. From 1945 to 2012, life expectancy in the UK rose steadily. But after 2012 it flatlined, and for those in the most disadvantaged areas, it declined,9<\/strong> caused by deep cuts to social security and local government spending.7,10,11<\/strong> The list of consequences is shameful, including increased infant mortality, deterioration of mental health, particularly in young adults,12<\/strong> and record numbers of children being taken into care in England.13,14<\/strong><\/p>\n

Policies justified on the grounds of austerity\u2014including real term reductions in the value of benefits, stricter eligibility requirements, and harsher sanctions\u2014have harmed health and pushed millions of people, especially children, further into poverty.15,16,17<\/strong> The cost of living has risen sharply in recent years,18,19<\/strong> leaving prices far higher than they were just five years ago. The combined result is that, since 2010, more people in Britain are experiencing destitution and many more people in full-time work live in poverty.20<\/strong><\/p>\n

Since 2012 the UK has seen the largest rise in child poverty among countries in the Organisation for Economic Cooperation and Development, according to Unicef.21<\/strong> Child poverty adversely affects child mental health, creating a cascade of mental health challenges into young adulthood,22<\/strong> which in turn creates difficulties transitioning into the labour market, and higher social security spending in the long term.23<\/strong><\/p>\n

A key proposal in the green paper is to tighten access to PIP\u2014a benefit covering the extra costs of disability or long term health conditions\u2014by raising the eligibility threshold. The Fraser of Allander Institute, an independent economic research centre, estimates that saving \u00a31bn a year could mean about 250 000 fewer people receiving PIP.24<\/strong> Existing evidence suggests this is unlikely to increase employment rates.25,26<\/strong> Previous governments have sought to restrict eligibility to, and levels of, these benefits. Most notably, just over one million existing recipients had their eligibility re-assessed between 2010 and 2013, with benefits removed if the assessor thought they were fit for work. This led to an increase in 290 000 people with mental health problems, increased antidepressant prescribing, and an estimated 600 suicides.27,28<\/strong> It did not increase employment, but rather shifted people, particularly those with mental health problems, onto unemployment benefits, many of whom later moved back onto disability benefits.29<\/strong><\/p>\n

The idea that introducing sanctions or restricting the value of, or eligibility for, social security is an effective, harm reducing or \u201cmoral\u201d means of increasing \u201ceconomic activity\u201d is not borne out by evidence.17,26<\/strong> When people become too sick to work, or when people with disabilities lose the support they need to enable them to live and work independently, there are costs to the state as well as to society, notably in terms of health and social care. Instead, enhancing social security and public services to improve population health, and creating high quality, better paid, and accessible jobs, is better evidenced as the key means to support people into work, and to reduce the costs of social security for those who are experiencing in-work poverty.6<\/strong> Policies and interventions to improve health are more likely to achieve the economic gains the government is pursuing, and further cuts are unlikely to achieve either the \u201cmoral case,\u201d or the reductions in public spending, that the chancellor is seeking.<\/p>\n

Solving this austerity fuelled health crisis will take political will and commitment to recreate a society with high quality public services (to provide both the services the population needs and fulfilling work) and rebuild a social security system that lifts people securely out of poverty. If the government is serious about supporting people with disabilities and long term health conditions to work, it needs to collaborate with people with relevant lived experience (for example, disabled people\u2019s user led organisations), employers, and researchers to develop and implement effective, evidence based policies and interventions.25<\/strong><\/p>\n

Acknowledgments<\/strong>
\nDavid Taylor-Robinson, Clare Bambra, Danny Dorling, Benjamin Barr, and Martin McKee also contributed to this editorial.<\/p>\n

 <\/p>\n

For where this post was originally published and a PDF of it click here<\/a>.<\/strong><\/p>\n

 <\/p>\n

\n
 <\/div>\n<\/div>\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\"\"

The Chancellor delivers the spring statement, 26 March 2025<\/p><\/div>\n

 <\/p>\n<\/div>\n

 <\/div>\n
\n
\n
\n
\n
\n
\n
\n
\n
 <\/div>\n<\/div>\n<\/div>\n
 <\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n

References<\/h2>\n
\n
\n

 <\/p>\n

References<\/p>\n

\u21b51 HM Treasury. Reeves R. Chancellor commissions Spring Forecast on 26 March 2025. 2024. https:\/\/www.gov.uk\/government\/news\/chancellor-commissions-spring-forecast-on-26-march-2025.<\/p>\n

\u21b52 Department for Work and Pensions. Pathways to Work: reforming benefits and support to Get Britain Working green paper. 2025. https:\/\/www.gov.uk\/government\/consultations\/pathways-to-work-reforming-benefits-and-support-to-get-britain-working-green-paper\/pathways-to-work-reforming-benefits-and-support-to-get-britain-working-green-paper.<\/p>\n

\u21b53 Islam F. Chancellor set to cut welfare spending by billions. BBC News. 5 Mar 2025. https:\/\/www.bbc.co.uk\/news\/articles\/c1lpjqg2mp5o.<\/p>\n

\u21b54 McKee M, Hiam L. Britain\u2019s not working. BMJ2022;378:o1883. doi:10.1136\/bmj.o1883 pmid:35905984FREE Full TextGoogle Scholar<\/p>\n

\u21b55 Bambra C, Munford L, Brown H, et al. Health for wealth: building a healthier northern powerhouse for UK productivity.Norther Health Science Alliance, 2018. https:\/\/www.thenhsa.co.uk\/app\/uploads\/2018\/11\/NHSA-REPORT-FINAL.pdf.Google Scholar<\/p>\n

\u21b56 Bambra C, McNamara C, Munford L, Wickham S. To get Britain working we need to get Britain healthy. BMJ2025;388:r76. doi:10.1136\/bmj.r76 pmid:39824618FREE Full TextGoogle Scholar<\/p>\n

\u21b57 Walsh D, McCartney G. Social murder? Austerity and life expectancy in the UK.Policy Press, 2025.Google Scholar<\/p>\n

\u21b58 Hiam L, Marmot M. Is Britain sicker than a decade ago? The number of people being signed off sick from work has tripled in the past decade. But will the government do anything about it? Prospect 17 Jan 2024. https:\/\/www.prospectmagazine.co.uk\/politics\/policy\/health\/64510\/is-britain-sicker-than-a-decade-ago.<\/p>\n

\u21b59 de Haro Moro MT, Schofield L, Munoz-Arroyo R, McCartney G, Walsh D. A new era of inequality: profound changes to mortality in England, Scotland, and 10 major British cities. Eur J Public Health2025:ckaf008. doi:10.1093\/eurpub\/ckaf008 pmid:39965773CrossRefPubMedGoogle Scholar<\/p>\n

\u21b510 Alexiou A, Fahy K, Mason K, et al. Local government funding and life expectancy in England: a longitudinal ecological study. Lancet Public Health2021;6:e641-7. doi:10.1016\/S2468-2667(21)00110-9 pmid:34265265CrossRefPubMedGoogle Scholar<\/p>\n

\u21b511 McCartney G, McMaster R, Popham F, Dundas R, Walsh D. Is austerity a cause of slower improvements in mortality in high-income countries? A panel analysis. Soc Sci Med2022;313:115397. doi:10.1016\/j.socscimed.2022.115397 pmid:36194952CrossRefPubMedGoogle Scholar<\/p>\n

\u21b512 Vriend M, Rocks C, Finch D. Mental health trends among working-age people.Health Foundation, 2025, https:\/\/www.health.org.uk\/reports-and-analysis\/analysis\/mental-health-trends-among-working-age-people.Google Scholar<\/p>\n

\u21b513 Pickett K, Taylor-Robinson D, Bennett D, Davies H, Mason K, Parkinson S. Child of the North. Building a fairer future after COVID-19.Norther Health Science Alliance, 2021, https:\/\/www.thenhsa.co.uk\/app\/uploads\/2022\/01\/Child-of-the-North-Report-FINAL-1.pdf.Google Scholar<\/p>\n

\u21b514 Bennett DL, Schl\u00fcter DK, Melis G, et al. Child poverty and children entering care in England, 2015-20: a longitudinal ecological study at the local area level. Lancet Public Health2022;7:e496-503. doi:10.1016\/S2468-2667(22)00065-2 pmid:35660211CrossRefPubMedGoogle Scholar<\/p>\n

\u21b515 Katikireddi SV, Molaodi OR, Gibson M, Dundas R, Craig P. Effects of restrictions to Income Support on health of lone mothers in the UK: a natural experiment study. Lancet Public Health2018;3:e333-40. doi:10.1016\/S2468-2667(18)30109-9 pmid:29976327CrossRefPubMedGoogle Scholar<\/p>\n

\u21b516 Cheetham M, Moffatt S, Addison M, Wiseman A. Impact of universal credit in North East England: a qualitative study of claimants and support staff. BMJ Open2019;9:e029611. doi:10.1136\/bmjopen-2019-029611 pmid:31272984Abstract\/FREE Full TextGoogle Scholar<\/p>\n

\u21b517 Taulbut M. Improving lives? Monitoring the impacts on health and health inequalities of post-2010 Welfare Reform and economic change in Scotland. 2024. https:\/\/publichealthscotland.scot\/publications\/improving-lives-monitoring-the-impacts-on-health-and-health-inequalities-of-post-2010-welfare-reform-and-economic-change-in-scotland\/improving-lives-monitoring-the-impacts-on-health-and-health-inequalities-of-post-2010-welfare-reform-and-economic-change-in-scotland<\/p>\n

\u21b518 Broadbent P, Thomson R, Kopasker D, et al. The public health implications of the cost-of-living crisis: outlining mechanisms and modelling consequences. Lancet Reg Health Eur2023;27:100585. doi:10.1016\/j.lanepe.2023.100585. pmid:37035237CrossRefPubMedGoogle Scholar<\/p>\n

\u21b519 Richardson E, McCartney G, Taulbut M, Douglas M, Craig N. Population mortality impacts of the rising cost of living in Scotland: scenario modelling study. BMJ Public Health2023;1:e000097. doi:10.1136\/bmjph-2023-000097 pmid:40017862Abstract\/FREE Full TextGoogle Scholar<\/p>\n

\u21b520 Edmiston D. Plumbing the depths: the changing (socio-demographic) profile of UK poverty. J Soc Policy2022;51:385-411. doi:10.1017\/S0047279421000180CrossRefGoogle Scholar<\/p>\n

\u21b521 Unicef. Child poverty in the midst of wealth. Innocenti Report Card 18. 2023 https:\/\/www.unicef.org\/innocenti\/media\/3296\/file\/UNICEF-Innocenti-Report-Card-18-Child-Poverty-Amidst-Wealth-2023.pdf.<\/p>\n

\u21b522 Latimer E, Ray-Chaudhuri S, Waters T. The role of changing health in rising health-related benefit claims.Institute of Fiscal Studies, 2025. doi:10.1920\/re.ifs.2025.0012.CrossRefGoogle Scholar<\/p>\n

\u21b523 Kreshpaj B, Elsenburg LK, Andersen SH, De Vries TR, Thielen K, Rod NH. Association between childhood adversity and use of the health, social, and justice systems in Denmark (DANLIFE): a nationwide cohort study. Lancet Public Health2025;10:e29-35. doi:10.1016\/S2468-2667(24)00242-1 pmid:39681123CrossRefPubMedGoogle Scholar<\/p>\n

\u21b524 Sousa J, McFadyen C, Congreve E. Welfare Green Paper: what we know and what we don\u2019t know. Fraser of Allander Institute. 2025. https:\/\/fraserofallander.org\/welfare-green-paper-what-we-know-and-what-we-dont-know\/.<\/p>\n

\u21b525 Mehta J, Taggart D, Clifford E, Speed E. \u201cThey say jump, we say how high?\u201d conditionality, sanctioning and incentivising disabled people into the UK labour market. Disabil Soc2021;36:681-701. doi:10.1080\/09687599.2020.1766422CrossRefGoogle Scholar<\/p>\n

\u21b526 McHale P, Pennington A, Mustard C, et al. What is the effect of changing eligibility criteria for disability benefits on employment? A systematic review and meta-analysis of evidence from OECD countries. PLoS One2020;15:e0242976. doi:10.1371\/journal.pone.0242976 pmid:33259544CrossRefPubMedGoogle Scholar<\/p>\n

\u21b527 Barr B, Taylor-Robinson D, Stuckler D, Loopstra R, Reeves A, Whitehead M. \u2018First, do no harm\u2019: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study. J Epidemiol Community Health2016;70:339-45. doi:10.1136\/jech-2015-206209 pmid:26573235Abstract\/FREE Full TextGoogle Scholar<\/p>\n

\u21b528 Barr B, Taylor-Robinson D, Stuckler D, et al. Fit-for-work or fit-for-unemployment? Does the reassessment of disability benefit claimants using a tougher work capability assessment help people into work?J Epidemiol Community Health2016;70:452-8. doi:10.1136\/jech-2015-206333 pmid:26646692Abstract\/FREE Full TextGoogle Scholar<\/p>\n

\u21b529 Judge L, Murphy L. Under strain: Investigating trends in working-age disability and incapacity benefits.Resolution Foundation, 2024, https:\/\/www.resolutionfoundation.org\/app\/uploads\/2024\/06\/20-Under-strain.pdfGoogle Scholar<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Cuts to disability benefits will worsen health and the economy<\/p>\n","protected":false},"author":1,"featured_media":10406,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[19],"tags":[],"class_list":["post-10410","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts\/10410","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=10410"}],"version-history":[{"count":1,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts\/10410\/revisions"}],"predecessor-version":[{"id":10411,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/posts\/10410\/revisions\/10411"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=\/wp\/v2\/media\/10406"}],"wp:attachment":[{"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=10410"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=10410"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.dannydorling.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=10410"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}