The coalition government have continued slowly turning the screws on disabled people, a task started by the previous government. Harsh cuts to existing benefits and services announced through an eager media have created a climate of fear for Britain’s disabled people. Despite that, when finally announced, the changes to Disability Living Allowance were sweeping in a way some had feared but not expected. D L A will cease to exist in 2013-14, replaced by the Personal Independence Payment (PIP). PIP is supposed to be simpler than DLA, although much of the perceived complexity is due to a wider lack of understanding of the nature of disability. In this context, what simpler really means is cheaper – especially as the plans are to cut 20% of the DLA caseload. This cut will be needed to pay for incredibly costly reassessments to people with conditions with no hope of recovery such as quadriplegia or degenerative genetic diseases. There is a clear indicator of intent to limit entitlement in the words ‘focusing on those with greatest support needs’
Some people may lose money as the aids and adaptations they use enabling them to live with their disability will be considered to negate the need for that financial support. The new system will lead to situations where wheelchair-users who can get around themselves may be denied support, even though the intention of the present DLA system is to help towards extra costs of mobility and care. This approach ignores the fact that benefits may be the only thing enabling the purchase of adaptations such as wheelchairs or use of taxis for those unable to use public transport. In any case, aids and adaptations depend on availability with long waiting lists for appropriate wheelchairs. Many disabled people, including this author, fall through the gaps of the provision in the current system and thus are much more significantly disabled by their environment than impairment.
This change will be an unnecessary and expensive rebranding exercise. Although the caseload will be reduced PIP will still look very much like DLA albeit with a 21st century name at a time when government spending, is supposedly, being squeezed. The current system also allows for automatic entitlement to DLA for certain conditions. The new system will not; all claimants will be required to be reassessed every few years. This is not only foolish, but also costly as automatically entitled conditions are by nature the most severe and incurable. The only thing that will be achieved is extra cost of unnecessary assessment, additional complication instead of simplification and inconvenience for severely ill people. Additional waste comes from ignoring the reality that people will remain disabled and have needs even if they are no longer able to qualify for benefits. They will be ignored up to the point they become seriously ill and end up costing the NHS and local authorities more in terms of hospitals and residential care. Furthermore, the proposed reforms ignore the fact that some conditions are severe but acute. Not supporting short-term illness and disability makes it more likely this will become a costly long-term problem therefore increasing dependency.
The PIP proposals will see some current recipients of social care losing financial benefits now paid over at least in part to the local authorities for receipt of that care. This will force local authorities to make up the shortfall in funding likely achievable through cutting care packages. Another hole in the recommendations made is the impact of these plans on independent living, making that harder to achieve. Removing DLA from those who receive care packages, and especially recipients in residential care, will not promote independence.
This system will use independent assessment to form an objective assessment although it is not known why the DLA assessment is understood to not be objective. Current practice is to be assessed by a variety of resources; information from family or a carer, the persons GP, specialist consultant or physiotherapist are standard with face- to-face medical assessments if these and more do not provide enough evidence. What independent means is that a private company such as Atos will be contracted to run assessments and offered incentives to remove people from the system, as they already do with work related benefits. This process will include meeting with an independent healthcare professional not necessarily qualified as a doctor-working for the assessors similarly to the already problematic Employment Support Allowance (ESA) system. The objections to a private company (foreign-owned) using unqualified staff who know their jobs depend on keeping to strict targets with the sole goal being to reduce benefits are too many to count.
More important is the question of whether it is ever possible to make a truly objective assessment of disability. Disability is, by its very nature, as complex and variable as human beings and influenced by many different factors. What severely disables one person may not be such a significant barrier to another, yet both will require tailored support to enable them.
The focus on DLA as a disincentive to work is false and disingenuous. People who receive DLA do often have lower work expectations as the reform consultation paper suggests, and rightly so. Regardless of desire, many disabilities and conditions make work impossible. Disabled people are often unable to compete equally in the labour market, even if there is work for them, which too often there is not. People with high rate awards have highest level of disabilities and are least likely to be able to work regardless of benefits. Those who do work and with lower awards are often only able to work because of the aids, support and adaptations DLA allows them to purchase. The focus on move to work has no place in a discussion about DLA other than to make the important clarification that DLA is not work related and exists to assist life with a disability.